Nokea
As a daughter and mother are extremely close emotionally, they made a pact years ago never to put the mother in a nursing home. Now, the physical demands of caregiving are becoming too great. What is the best way a nurse can help the daughter?
- A. Persuade her to admit her mother to a nursing home
- B. Aid her in finding help with in-home care
- C. Praise her success in being a good daughter and keeping her promise
- D. Point out her mistaken altruism
Correct Answer: B
Rationale: In this situation, the best course of action for the nurse is to aid the daughter in finding help with in-home care. Persuading her to admit her mother to a nursing home would likely cause guilt and emotional distress due to their pact. Praise alone may not address the current physical caregiving challenges. Pointing out her 'mistaken altruism' could be seen as insensitive and unhelpful. Providing practical assistance in finding in-home care can alleviate the physical demands on the daughter while still honoring the emotional commitment they made.
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Which of the following aspects of gerontological nursing would be most likely classified under private law?
- A. The regulation of who may call himself or herself a 'nurse'
- B. The contract between an older adult resident of a care facility and the owners of the facility
- C. The legal criteria for declaring an individual mentally incompetent
- D. The criminal consequences for instances of elder abuse
Correct Answer: B
Rationale: The correct answer is B because private law deals with relationships between individuals and organizations, such as the contract between an individual and the care facility. Choices A, C, and D are not classified under private law. Choice A pertains to professional regulation and is a matter of public law. Choice C involves legal criteria and decision-making related to mental competence, falling under public law. Choice D concerns criminal consequences, which are also part of public law.
An older adult client tells the nurse that blockage of qi in one of the body's meridians is causing severe headaches. The health care provider has diagnosed migraines and has prescribed a triptan drug. Which action would be most appropriate for the nurse to implement?
- A. Suggest that the prescribed medicine may stimulate the flow of qi
- B. Explain the vasoconstrictive and serotonin-moderating action of triptan
- C. Instruct the client to take as many doses as needed for relief
- D. Caution the client that the headaches will grow worse if the client fails to take the medication
Correct Answer: A
Rationale: Qi is the life force that circulates through the body in invisible pathways called meridians. In this scenario, the client believes that the blockage of qi is causing severe headaches. While explaining the scientific principles underlying the drug action could be valuable, it's crucial to consider the client's belief system. Therefore, the most appropriate response is to suggest that the prescribed medicine may stimulate the flow of qi, aligning with the client's perspective. Choice B, explaining the vasoconstrictive and serotonin-moderating action of triptan, does not address the client's concerns about qi blockage. Choice C, instructing the client to take as many doses as needed, can lead to potential medication misuse. Choice D, cautioning the client about worsening headaches without medication, may induce fear and hinder effective communication with the client.
A nurse is providing end-of-life care to an older female client who practices Judaism. Which intervention would the nurse identify as potentially problematic for this client and her family?
- A. The client requires transfusions of packed red blood cells during care.
- B. Assessment by a male health care provider was required.
- C. An autopsy was ordered due to the client's unique disease etiology.
- D. A do-not-resuscitate (DNR) order was recommended by the care team.
Correct Answer: C
Rationale: The correct answer is C. Autopsy is often opposed in the context of Jewish religious and cultural beliefs, as it is seen as desecration of the body. While a person who is a Jehovah's Witness would be opposed to blood transfusions (choice A), a Muslim client may prefer to be cared for by someone of the same gender (choice B). A DNR order (choice D) is not noted to be a particular issue in the context of Jewish culture.
What might a nurse suggest to help the grown children make the most of their limited incomes and time with their parents?
- A. Help them find nearby spots for picnics or other free outings
- B. Refer the family to a more appropriate practitioner
- C. Suggest they take out a second mortgage on the family house
- D. Encourage the entire family to participate in activities at Haven
Correct Answer: A
Rationale: A nurse, as a caring worker, may suggest helping the grown children find nearby spots for picnics or other free outings. This suggestion would allow the parents to get out of the facility and enjoy quality time with their children without any financial burden. While the family may also want to participate in activities at the facility, a picnic would provide a change of scenery. Referring the family to a more appropriate practitioner is not relevant to improving the limited incomes and time spent with the parents. Suggesting to take out a second mortgage on the family house could provide temporary financial relief but may not be the most suitable solution for maximizing time spent with the parents.
A nurse is providing care for an older adult client who has been admitted to the hospital with liver cirrhosis. The client has expressed to the nurse his concerns that the details of his condition and treatment remain confidential, and that written documentation not 'get out there.' How can the nurse best respond to the client's concerns?
- A. Anything that is discussed between us is confidential and will not be shared with anyone else.
- B. The Health Insurance Portability and Accountability Act ensures that your medical records will not leave this hospital.
- C. Provided you signed a directive on admission, your records will not be made public.
- D. The law protects your right to confidentiality and protects your health information from being released into unintended hands.
Correct Answer: D
Rationale: The correct answer is D. The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects individuals' right to confidentiality and safeguards health information from being accessed by unauthorized individuals. Assuring the client that the law protects their right to confidentiality and prevents their health information from being released into unintended hands is the best response. Choice A is too broad and may not cover all aspects of confidentiality. Choice B only mentions medical records staying within the hospital, which does not address the client's concern about written documentation. Choice C incorrectly implies that a signed directive is needed for confidentiality, which is not true under HIPAA regulations.