Nokea
The advanced directive in a client's chart is dated August 12, 1998. The client's daughter produces a Power of Attorney for Health Care, dated 2003, which contains different care direction(s). The nurse is supposed to:
- A. follow the 1998 version because it's part of the legal chart.
- B. follow the 1998 version because the physician's code order is based on it.
- C. follow the 2003 version, place it in the chart, and communicate the update appropriately.
- D. follow neither until clarified by the unit manager.
Correct Answer: C
Rationale: The document dated 2003 supersedes the previous version and should be used as a basis for care direction. Choices 1 and 2 are incorrect because the 1998 version is now outdated. Choice 4 is incorrect because the nurse can be held negligent for not responding to the 2003 document as directed.
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A gastroenterologist should be consulted for clients suffering from:
- A. digestive system diseases.
- B. urinary system diseases.
- C. female reproductive system diseases.
- D. nervous system diseases.
Correct Answer: A
Rationale: A gastroenterologist cares for clients with digestive system diseases. A urologist cares for clients with urinary system diseases. A gynecologist cares for clients with female reproductive system diseases. A neurologist cares for clients with nervous system diseases.
A client, age 28, is 8-12 months pregnant. She is most likely to display which normal skin-color variation?
- A. Vitiligo
- B. Erythema
- C. Cyanosis
- D. Chloasma
Correct Answer: D
Rationale: Chloasma, also known as the mask of pregnancy, is described as tan-to-brown patches on the face due to hormonal changes during pregnancy.
An LPN is having conflict with another nurse during her shift. She has tried to discuss the issues with the nurse with no resolution. What is the most appropriate way for the nurse to proceed?
- A. Report the conflict to the director of nursing over the unit.
- B. Report the conflict to the assigned charge nurse of the unit.
- C. Report the conflict to the nurse manager of the unit.
- D. Discuss the conflict with the other nurse to attempt resolution of issue.
Correct Answer: B
Rationale: It is important to follow the appropriate chain of command in a professional setting and to not overstep any levels when moving the issue up the ladder. It would not be appropriate to discuss the conflict with a nurse on your own level of authority.
Which of the following is not an advanced directive?
- A. informed consent
- B. living will
- C. durable power of attorney for health care
- D. health care proxy
Correct Answer: A
Rationale: Informed consent is not a type of advanced directive but is a process for obtaining consent to care or treatment.
The nurse is caring for a client who has just tested positive for HIV. The client asks the nurse not to tell anyone outside of the care team about his diagnosis. What response is most appropriate?
- A. I have to inform all clients on the unit of your diagnosis as it is transmissible.'
- B. I will not communicate your diagnosis to anyone without your permission.'
- C. Because this is a communicable disease, it may need to be reported to the CDC.'
- D. You should not be concerned with who I share your diagnosis with.'
Correct Answer: C
Rationale: Many communicable diseases, such as HIV, have surveillance programs that require mandatory reporting.