A nurse is teaching a client about the purpose of advance directives. When assessing the client's understanding of the teaching, which of the following client statements should the nurse expect?

"They cannot be changed once I have signed it."

"They will need to be reviewed by my attorney."

"They will require me to appoint a durable power of attorney."

"They will include my preferences for end-of-life treatment."

Answer and Explanation

The Correct Answer is D

Rationale:

A. This option is incorrect because advance directives are not permanent and can be changed or revoked at any time, as long as the client is competent to make healthcare decisions. Clients may revise their directives to reflect changes in their health status, personal values, or preferences for medical care. Telling clients they cannot be changed could lead to misunderstandings about their rights and autonomy.

B. This option is incorrect because while consulting an attorney may provide legal guidance, it is not a required step for creating an advance directive. Many advance directives are valid when completed using standardized forms provided by healthcare facilities or state resources without legal review.

C. This option is incorrect because appointing a durable power of attorney (also called a healthcare proxy) is optional. While designating someone to make healthcare decisions on the client’s behalf can be helpful, especially if the client becomes incapacitated, it is not mandatory for an advance directive to be valid.

D. This option is correct because advance directives are intended to document a client’s preferences for end-of-life care. This includes decisions about life-sustaining treatments, resuscitation (CPR), mechanical ventilation, feeding tubes, and other medical interventions. By having an advance directive, clients ensure that their wishes are respected if they become unable to communicate or make healthcare decisions in the future. This empowers clients, guides healthcare providers, and helps prevent unwanted or unnecessary interventions.

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Correct Answer is A

Explanation

Rationale:

A. This option is correct because measuring and recording a client’s urinary output is within the scope of practice for an assistive personnel (AP). This task is noninvasive, routine, and does not require nursing judgment, making it appropriate for delegation.

B. This option is incorrect because performing a sterile dressing change is a nursing intervention that requires knowledge of aseptic technique, assessment skills, and clinical judgment. It cannot be delegated to an AP.

C. This option is incorrect because instructing a client on the use of crutches involves teaching, assessment of the client’s abilities, and evaluation of safety, all of which are nursing responsibilities and cannot be delegated to an AP.

D. This option is incorrect because interpreting an ECG strip requires specialized nursing knowledge and clinical judgment to identify dysrhythmias and respond appropriately. This is outside the AP’s scope of practice.

A. Discuss the situation with the facility administrator. B. Document thoroughly any unusual behavior by the nurse. C. Impose a 2-week suspension with a strong recommendation for rehabilitation, D. Counsel the nurse before referring the nurse for help.

Correct Answer is B

Explanation

Rationale:

A. This option is incorrect as the first step because discussing the situation with the facility administrator may be necessary eventually, but initial action should involve objective documentation of observed behaviors rather than immediate reporting or action.

B. This option is correct because the nurse manager should first document thoroughly any unusual or concerning behaviors, incidents, or patterns. Objective documentation provides a factual basis for addressing the suspected substance use disorder and ensures the nurse manager can follow facility policies and legal requirements accurately.

C. This option is incorrect because imposing a suspension without investigation or objective evidence is premature, may violate facility policy, and could have legal consequences. Correct procedure requires documentation and adherence to established protocols for suspected impairment.

D. This option is incorrect because counseling the nurse before gathering documented evidence may not be appropriate. The nurse manager must follow facility policy, which typically starts with documentation and reporting to ensure safety and legal compliance, rather than immediately providing informal counseling.

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Ethical principle	Findings
Autonomy	Informed consent obtained by provider and verified by nurse. Provider prescriptions for a mammogram and ultrasound of the breasts. Client reassured that medical records remain confidential.
Fidelity	Client reassured that staff will treat all clients equally. Client provided with additional information about recovery as promised at last visit. Client states, "I have a bad feeling about this, tell me the truth even if it's bad news."
Nonmaleficence	Documentation of living will and durable power of attorney on client's chart. Evidence-based standards of postoperative care reviewed with nursing staff prior to procedure. Client provided resources for support groups for clients who have diagnosis of cancer.

A nurse is teaching a client about the purpose of advance directives. When assessing the client's understanding of the teaching, which of the following client statements should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing assignments for the upcoming shift. Which of the following tasks should the nurse delegate to an assistive personnel (AP)?

Correct Answer is A

Explanation

A nurse manager suspects that a staff nurse on the night shift has a substance use disorder. Which of the following actions should the nurse manager take?

Correct Answer is B

Explanation

A charge nurse in an acute care facility is teaching a newly licensed nurse about caring for a client who has a cognitive impairment. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

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A nurse is teaching a client about the purpose of advance directives. When assessing the client's understanding of the teaching, which of the following client statements should the nurse expect?

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