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 Choices 1 and 2 are incorrect because the 1998 version is now outdated.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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When working with multicultural populations, the nurse should consider all of the following when planning care for a client with an altered sexuality pattern except:
- A. some members of the Hispanic and Native-American cultures are very open when discussing sexuality
- B. some cultures view the postpartum period as a state of impurity
- C. some women in the African-American culture view childbearing as a validation of their femaleness
- D. some Native-American women believe monthly menstruation maintains physical well-being and harmony
Correct Answer: A
Rationale: Hispanic and Native-American cultures are often reserved about discussing sexuality, unlike the other culturally accurate statements, which inform care planning.
In conducting a health screening for 12-month-old children, the nurse expects them to have been immunized against which of the following diseases?
- A. measles, polio, pertussis, hepatitis B
- B. diptheria, pertussis, polio, tetanus
- C. rubella, polio, pertussis, hepatitis A
- D. measles, mumps, rubella, polio
Correct Answer: B
Rationale: By 12 months, children should have received DTaP (diphtheria, tetanus, pertussis) and polio vaccines. MMR (measles, mumps, rubella) is given after 12 months, and hepatitis A is not routine at this age.
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.
An assessment of the skull of a normal 10-month-old baby should identify which of the following?
- A. closure of the posterior fontanel.
- B. closure of the anterior fontanel.
- C. overlap of cranial bones.
- D. ossification of the sutures.
Correct Answer: A
Rationale: The posterior fontanel should close by the age of 2 months.
The acts enacted by states to provide immunity from liability to persons who provide emergency care at an accident scene are called:
- A. Good Samaritan laws.
- B. HIPAA.
- C. Patient Self-Determination Act (PSDA).
- D. OBRA.
Correct Answer: A
Rationale: The Good Samaritan laws protect providers of care in an emergency situation. HIPAA's focus is confidentiality of information and right to privacy. The PSDA concerns a client's autonomous decision-making. OBRA was passed in the late 1980s to promote nursing home reform due to quality issues.