A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (Select all that apply.)

A. An advance directive is a legal document that outlines a person's preferences for medical treatment, including end-of-life care. Asking the client if they have a copy of their advance directive is appropriate because it can provide valuable information about their wishes regarding medical interventions. It allows the nurse to review the document to ensure that the client's current wishes align with what is documented in their advance directive.
B. In most cases, a competent adult's healthcare decisions, including decisions to refuse treatment, are legally binding and cannot be overridden by family members. It is important for the nurse to educate the client about their rights and ensure that their wishes are respected. Family members may be involved in discussions and support the client's decisions, but they cannot override a competent adult's wishes regarding their medical care.
C. While it's important to involve family members in discussions about the client's wishes, especially if they are the client's designated healthcare proxy or legally authorized decision-maker, family agreement is not required for the client's decision to refuse life-saving measures. The nurse should primarily focus on the client's expressed wishes and ensure that these wishes are understood and respected.
D. The provider's agreement with the client's decision may be necessary to document and implement the plan of care accordingly, but ultimately, the decision to refuse treatment rests with the competent client. The nurse should facilitate communication between the client and the provider to ensure that the client's wishes are understood and documented appropriately.

A. Episodes of confusion could indicate various issues, such as metabolic disturbances, disease progression affecting the central nervous system, or medication side effects. However, confusion alone would not typically lead to an increase in morphine dosage. Therefore, this is not a likely explanation for why the client needed more morphine for pain relief.
B. Tolerance occurs when the body adapts to the effects of a medication over time, requiring higher doses to achieve the same therapeutic effect. This is a common phenomenon with opioids like morphine when used long-term for pain management. If the client's pain relief diminished despite increasing the dose, tolerance to morphine could indeed be the reason why higher doses were needed.
C. Addiction is a psychological and physiological dependence on a substance characterized by compulsive drug-seeking behavior and use despite harmful consequences. Addiction is not typically the reason why a client with terminal cancer would require an increased dose of morphine for pain relief. In this context, the focus is on managing pain rather than addiction.
D. If the client has not been adhering to the prescribed dosing schedule or has missed doses, it could result in inadequate pain control. This might necessitate an increase in morphine dosage to achieve adequate pain relief. However, this scenario would require further assessment to confirm.