The client is a male who states his wife complains that his snoring awakens her at night.
The spouse is present.
To obtain further data, the nurse asks the spouse:

Choice A rationale

An older adult client without family support who is uncertain about a significant life change like moving to assisted living is particularly vulnerable. The nurse advocate can help this client understand their options, express their concerns, and ensure their wishes are considered, as they may lack the resources or confidence to navigate this process independently, making advocacy crucial for their well-being and autonomy.

Choice B rationale

A client who makes an informed decision to refuse chemotherapy is exercising their autonomy. While the nurse supports this decision, the client is already empowered and making their own choices based on understanding, thus requiring less direct advocacy in the sense of ensuring their voice is heard or their rights are upheld against potential opposition.

Choice C rationale

A client undergoing a repeat procedure is likely familiar with the process and has presumably consented previously. While the nurse ensures they are still informed and comfortable, the need for strong advocacy to ensure their wishes are respected against external pressures is less pronounced compared to a vulnerable client facing a new and uncertain situation.

Choice D rationale

A client who chooses alternative treatments after being educated on conventional options is also exercising their autonomy based on their values and understanding. The nurse's role is to ensure this decision is informed, but the client is already acting as their own advocate by making a conscious choice, reducing the immediate need for external advocacy.

Choice A rationale

While it might seem natural to inquire about prior discussions, this response could induce guilt or regret in the spouse and doesn't directly address the current emotional distress and uncertainty about the spouse's wishes as explicitly stated in the advance directive. It shifts the focus to the past rather than the present need for clarification regarding the existing directive.

Choice B rationale

Although the primary care provider may indeed have the client's best interests in mind, this statement dismisses the spouse's expressed uncertainty and relies on an assumption about the PCP's motivations. It doesn't help the spouse understand or feel confident about the content of the advance directive, which is the core of their concern.

Choice C rationale

This statement, while true, places the burden of decision-making solely on the spouse without acknowledging the existence of the advance directive, which is meant to guide such decisions. It overlooks the possibility that the directive already contains the spouse's wishes and could offer clarity, thereby increasing the spouse's anxiety.

Choice D rationale

This response directly addresses the spouse's statement by reminding them that their spouse's wishes are likely documented in the advance directive. It encourages the spouse to review the directive, which is the most direct way to understand what their spouse wanted regarding medical interventions like a PEG tube, thus providing immediate and relevant support.