Nokea
How can the nurse best respond to this situation?
- A. The nurse should accept that the relationship plays a positive role for the man.
- B. The nurse should organize a family meeting that includes both the children and the man's partner in an effort to facilitate reconciliation.
- C. The nurse should document the children's concerns and investigate the truth of their claims.
- D. The nurse should ask the partner to demonstrate that she is not a negative influence on the resident.
Correct Answer: A
Rationale: In this scenario, the nurse should respect the father's perspective and accept that the relationship with his common-law partner may indeed be positive and beneficial for him. The nurse's role is to support the patient's autonomy and decisions, especially when there are no legal concerns or signs of abuse. Organizing a family meeting (Choice B) might be premature without first acknowledging the father's viewpoint. Documenting concerns and investigating (Choice C) may create unnecessary conflict and breach the father's trust. Asking the partner to prove herself (Choice D) could strain the relationship further and is not within the nurse's role unless there are clear signs of harm or abuse.
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During a family meeting that the nurse organized during an older adult's discharge planning from the hospital, there is visible animosity between the son and daughter of the patient. What should the nurse's initial response be to the apparent family dysfunction?
- A. Teach the patient's children alternative methods of interaction.
- B. Encourage the family to choose one spokesperson to represent all the children.
- C. Organize separate meetings with the son and with the daughter.
- D. Assess the family history and the nature of the son and daughter's relationship.
Correct Answer: D
Rationale: The correct initial response for the nurse in this situation is to assess the family history and the nature of the son and daughter's relationship. By gathering data and identifying factors contributing to the dysfunction, the nurse can better understand the underlying issues and dynamics at play. Teaching alternative methods of interaction (Choice A) may not address the root cause of the animosity. Encouraging one spokesperson for the family (Choice B) may overlook individual concerns. Organizing separate meetings (Choice C) may not provide a holistic view of the family dynamics and may not address the issues affecting the family unit as a whole. Therefore, assessing the family history and relationship dynamics is essential for effective intervention and resolution of the family dysfunction.
To receive government funding, a county hospital must provide demographic statistics on its client population. When selecting the box labeled Hispanic on the forms, what characteristic of the client population would a worker consider?
- A. immigrant workers who entered the United States and their descendants
- B. immigrants who have a Spanish accent
- C. native Spanish-speaking people living in the United States
- D. persons with brown skin and dark hair
Correct Answer: C
Rationale: The correct answer is C because the term 'Hispanic' includes Spanish-speaking individuals from various countries like Spain, Cuba, Mexico, and Puerto Rico. It is essential to understand that Hispanic does not solely refer to individuals with brown skin, dark hair, or those with a Spanish accent. Therefore, choices A, B, and D do not accurately represent the characteristic of the client population that would be classified as Hispanic.
An 81-year-old female client was diagnosed one year ago with Alzheimer's disease following a noticeable increase in confusion. She now possesses a durable power of attorney. Which of the following statements most accurately conveys an aspect of this legal arrangement?
- A. The parameters of the arrangement must be revisited if the client's condition declines.
- B. The arrangement was most likely initiated by court order.
- C. The client appointed someone to take care of her affairs in the event that she becomes incompetent.
- D. The family has control of logistical arrangements for the client but must gain court permission around financial affairs.
Correct Answer: C
Rationale: The correct answer is C. Usually, a power of attorney becomes invalid if the individual granting it becomes incompetent, except in the case of a durable power of attorney. A durable power of attorney allows competent individuals to appoint someone to make decisions on their behalf in the event that they become incompetent. This legal arrangement is recommended for individuals with conditions like Alzheimer's disease where competency decline can be anticipated. It is not initiated by the court, unlike guardianship. A durable power of attorney encompasses both logistical and financial affairs, providing authority to the appointed person to act on behalf of the individual should they become incapacitated. Choices A, B, and D are incorrect because they do not accurately describe the purpose and nature of a durable power of attorney in the context of planning for incompetency due to conditions like Alzheimer's disease.
Mrs. W, aged 82, resides with her son and daughter-in-law who are finding it challenging to provide adequate care while maintaining their careers and home life. During a homecare visit, Mrs. W tells the nurse that, 'My children's generation doesn't know how good they've got it; when I was younger we all had to take care of our parents, and for a lot longer than most people do now.' Which of the following statements most accurately underlies the response that the nurse will provide to Mrs. W?
- A. The increasing prevalence of chronic illnesses means that there are indeed fewer old-old adults than there were in earlier generations.
- B. The increasing acceptance of long-term care means that the caregiving burden of the son and daughter-in-law's generation is lighter than that of Mrs. W's generation.
- C. More older people are living longer and receiving care in the community than when Mrs. W was in her middle-adult years.
- D. The caregiving needs of the old-old are increasing but these needs are more commonly met in institutional settings rather than in the community.
Correct Answer: C
Rationale: The correct answer is C because people are living longer and receiving more of their care in the community than in years past. This reflects the current trend where older individuals tend to receive care in community settings rather than institutional ones. Choices A, B, and D are incorrect because they do not align with the reality that more older people today are living longer and being cared for in the community.
Nurse R works on the geriatric medicine unit of the university hospital and provides care for numerous older adult clients nearing the end of life, many of whom have no-code orders. Which of the following situations is incompatible with the legal requirements for a no-code order?
- A. A client who is mentally competent has declared his wish to have a no-code order despite the availability of treatment options for his condition.
- B. A client has expressed her desire to have a no-code order but her daughter is adamantly opposed to it.
- C. A client clearly tells the nurse her desire to have a no-code order, which the nurse documents at the bedside.
- D. A client has been in a coma and the family has decided to put in place a no-code order.
Correct Answer: C
Rationale: The correct answer is C. No-code orders require a written and signed order by a physician. Therefore, a client expressing the desire for a no-code order to a nurse, without a documented physician's order, is incompatible with legal requirements. Choices A and B are not incompatible as competent clients can make their own decisions, regardless of treatment options or family opposition. Choice D is also not incompatible as family decisions can be made on behalf of incompetent clients.