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The Patient Self Determination Act of the United States protects clients in terms of their rights to what? Select all that apply.
- A. Privacy and to have their medical information confidential unless the client formally approves the sharing of this information with others such as family members.
- B. Make healthcare decisions and to have these decisions protected and communicated to others when they are no longer competent to do so.
- C. Be fully informed about all treatments in term of their benefits, risks and alternatives to them so the client can make a knowledgeable and informed decision about whether or not to agree to having it
- D. Make decisions about who their health care provider is without any coercion or undue influence of others including healthcare providers.
Correct Answer: B,C
Rationale: The Patient Self Determination Act (PSDA) of 1990 ensures that patients are informed of their rights to make decisions about their healthcare, including the right to accept or refuse treatment and to formulate advance directives . It also requires that patients be informed about treatment options, risks, benefits, and alternatives to make informed decisions . Option A relates to HIPAA, not the PSDA, and option D is not a specific right protected under the PSDA.
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A client with rheumatoid arthritis tells the nurse that she feels 'quite alone' in adjusting to changes in her lifestyle. Which of the following nursing actions is most appropriate in response to this statement?
- A. Refer the client and her husband for counseling to decrease her sense of isolation.
- B. Suggest the client develop a hobby to occupy her time.
- C. Tell the client about her community's arthritis support group.
- D. Suggest that the client discuss her feelings with her minister.
Correct Answer: C
Rationale: A community arthritis support group provides peer support, reducing feelings of isolation and addressing specific needs.
Your pediatric client weighs 48 pounds. How many mg of a medication would you administer to this client with each dose when the doctor has ordered 5 mg/kg/day in two equally divided doses?
- A. 45 mg
- B. 60 mg
- C. 52 mg
- D. 55 mg
Correct Answer: C
Rationale: To calculate: 48 pounds ÷ 2.2 = 21.82 kg. Then, 5 mg/kg × 21.82 kg = 109.1 mg/day. Divided into two doses: 109.1 ÷ 2 = 54.55 mg, rounded to 52 mg per dose.
A client has been receiving radiation therapy for 3 weeks to treat his cancer. He is complaining of fatigue. Which of the following should be considered while the nurse plans interventions to help the client with the fatigue?
- A. Fatigue is a temporary problem that requires no active intervention
- B. The client should be closely examined to determine the cause of fatigue
- C. Fatigue indicates that the client's cancer is not under control
- D. The client should be encouraged to maintain activity to combat the fatigue
Correct Answer: B
Rationale: Fatigue during radiation therapy may have multiple causes (e.g., anemia, dehydration), requiring thorough assessment to guide interventions. It is not always temporary, not necessarily indicative of cancer progression, and activity should be balanced, not forced.
A client with a history of depression is prescribed escitalopram (Lexapro). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild headache.
- B. Suicidal thoughts.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: Suicidal thoughts are a serious side effect of escitalopram, requiring immediate reporting to ensure client safety.
A client with a history of epilepsy is prescribed carbamazepine (Tegretol). The nurse should monitor the client for which of the following adverse effects?
- A. Agranulocytosis.
- B. Hypernatremia.
- C. Hypotension.
- D. Weight gain.
Correct Answer: A
Rationale: Carbamazepine can cause agranulocytosis, requiring monitoring of white blood cell counts.