Nokea
During discussion with the patient and the patients husband, you discover that the patient has a living will. How does the presence of a living will influence the patients care?
- A. The patient is legally unable to refuse basic life support.
- B. The physician can override the patients desires for treatment if desires are not evidence-based.
- C. The patient may nullify the living will during her hospitalization if she chooses to do so.
- D. Power-of-attorney may change while the patient is hospitalized.
Correct Answer: C
Rationale: Because living wills are often written when the person is in good health, it is not unusual for the patient to nullify the living will during illness. A living will does not make a patient legally unable to refuse basic life support. The physician may disagree with the patients wishes, but he or she is ethically bound to carry out those wishes. A power-of-attorney is not synonymous with a living will.
You may also like to solve these questions
An adult patient has requested a do not resuscitate (DNR) order in light of his recent diagnosis with late stage pancreatic cancer. The patients son and daughter-in-law are strongly opposed to the patients request. What is the primary responsibility of the nurse in this situation?
- A. Perform a slow code until a decision is made.
- B. Honor the request of the patient.
- C. Contact a social worker or mediator to intervene.
- D. Temporarily withhold nursing care until the physician talks to the family.
Correct Answer: B
Rationale: The nurse must honor the patients wishes and continue to provide required nursing care. Discussing the matter with the physician may lead to further communication with the family, during which the family may reconsider their decision. It is not normally appropriate for the nurse to seek the assistance of a social worker or mediator. A slow code is considered unethical.
The care team has deemed the occasional use of restraints necessary in the care of a patient with Alzheimers disease. What ethical violation is most often posed when using restraints in a long-term care setting?
- A. It limits the patients personal safety.
- B. It exacerbates the patients disease process.
- C. It threatens the patients autonomy.
- D. It is not normally legal.
Correct Answer: C
Rationale: Because safety risks are involved when using restraints on elderly confused patients, this is a common ethical problem, especially in long-term care settings. By definition, restraints limit the individuals autonomy. Restraints are not without risks, but they should not normally limit a patients safety. Restraints will not affect the course of the patients underlying disease process, though they may exacerbate confusion. The use of restraints is closely legislated, but they are not illegal.
In response to a patients complaint of pain, the nurse administered a PRN dose of hydromorphone (Dilaudid). In what phase of the nursing process will the nurse determine whether this medication has had the desired effect?
- A. Analysis
- B. Evaluation
- C. Assessment
- D. Data collection
Correct Answer: B
Rationale: Evaluation, the final step of the nursing process, allows the nurse to determine the patients response to nursing interventions and the extent to which the objectives have been achieved.
A nurse is admitting a new patient to the medical unit. During the initial nursing assessment, the nurse has asked many supplementary open-ended questions while gathering information about the new patient. What is the nurse achieving through this approach?
- A. Interpreting what the patient has said
- B. Evaluating what the patient has said
- C. Assessing what the patient has said
- D. Validating what the patient has said
Correct Answer: D
Rationale: Critical thinkers validate the information presented to make sure that it is accurate (not just supposition or opinion), that it makes sense, and that it is based on fact and evidence. The nurse is not interpreting, evaluating, or assessing the information the patient has given.
An emergency department nurse is caring for a 7-year-old child suspected of having meningitis. The patient is to have a lumbar puncture performed, and the nurse is doing preprocedure teaching with the child and the mother. The nurses action is an example of which therapeutic communication technique?
- A. Informing
- B. Suggesting
- C. Expectation-setting
- D. Enlightening
Correct Answer: A
Rationale: Informing involves providing information to the patient regarding his or her care. Suggesting is the presentation of an alternative idea for the patients consideration relative to problem solving. This action is not characterized as expectation-setting or enlightening.