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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.
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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.
How does a durable power of attorney differ from a power of attorney?
- A. It is granted by the court on behalf of an incompetent individual.
- B. It stays in effect if the individual granting it becomes incompetent.
- C. It goes into effect only after an individual becomes incompetent.
- D. It includes responsibility for managing an individual's financial assets.
Correct Answer: B
Rationale: A durable power of attorney allows competent individuals to appoint someone else to make decisions on their behalf in the event they become incompetent. Choice A is incorrect because a durable power of attorney is typically granted by the individual themselves, not the court. Choice C is incorrect as a durable power of attorney can be effective both before and after incompetency. Choice D is incorrect because managing financial assets is just one aspect of the authority granted by a power of attorney, not specifically for a durable power of attorney.
A local community has a small budget for community health programs aimed specifically toward its black population. Which type of community health program will the nurse recommend as the best use of the budget?
- A. depression screening
- B. meal planning
- C. blood pressure screening
- D. sleep disorder information
Correct Answer: C
Rationale: The best use of the budget for the black population in the local community would be blood pressure screening. Hypertension is a prevalent health issue among black Americans, occurring at a higher rate than in the white population. Therefore, focusing on blood pressure screening would help in early detection and management of hypertension within this community. Depression screening and sleep disorder information are not the priority as there is not a higher incidence of these conditions in older black clients. Meal planning could be beneficial for clients with diabetes, but it may not be the most critical focus considering the higher prevalence of hypertension among the black population.
A nurse has been providing care for a 69-year-old female client who has recently had her right foot amputated as a result of a chronic diabetic foot ulcer. The nurse undertook to perform debridement of the wound despite her lack of relevant education and experience. The client experienced permanent nerve damage as a result of the nurse's misguided efforts. Which category of legal liability is most likely relevant in this case?
- A. Larceny
- B. Assault
- C. Invasion of privacy
- D. Negligence
Correct Answer: D
Rationale: In this case, the most likely relevant category of legal liability is negligence. Negligence involves the commission of an improper act, as exemplified by the nurse's actions of performing a procedure without the necessary education and experience, leading to permanent nerve damage for the client. Larceny refers to theft, assault involves a deliberate threat to harm, and invasion of privacy pertains to the violation of a person's right to privacy. Therefore, in this scenario, the nurse's actions align more closely with negligence.
A gerontological nurse is providing care at a local community health center that serves large black American and white American older adult populations. The nurse is working to develop culturally appropriate programs to meet each group's health needs and notes differences in health status between the groups. Which reason would the nurse most likely identify as accounting for the differences between the populations?
- A. High incidence of violent crime and sexually transmitted diseases in the black population
- B. Reliance on family for health care advice and rejection of formal service agencies in the white population
- C. Cultural preference for unconventional medical treatments like herbal remedies in the white population
- D. Lower standard of living and less access to health care services in the black population
Correct Answer: D
Rationale: The correct answer is D. Black older adults historically possess many health problems that have accumulated over a lifetime due to a poor standard of living and limited access to health care services. Option A is incorrect because it presents stereotypes about the black population that are not supported by evidence. Option B is incorrect because it generalizes the behavior of the white population without a strong basis. Option C is incorrect as it also generalizes the white population and does not address the disparities in health status between the two groups.