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End of life care Exam/157 Questions with Answers 2024
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End of life care Exam/157 Questions withAnswers 2024
1. The client tells the nurse, "Every time I come in the hospital you hand me
one of these advance directives (AD). Why should I fill one of these out?"
Which statement by the nurse is most appropriate? 1. "You must fill out this
form because Medicare laws require it." 2. "An AD lets you participate in
decisions about your health care." 3. "This paper will ensure no one can
override your decisions." 4. "It is part of the hospital admission packet and I
have to give it to you."
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 668). F.A. Davis
Company. Kindle Edition. - - 1. 1. Advance directives (AD) are not legally
required. It is a standard of the Joint Commission, and any facility which
accepts federal funds must ask and offer the AD. 2. ADs allow the client to
make personal health-care decisions about end-of-life issues, including
cardiopulmonary resuscitation (CPR), ventilators, feeding tubes, and other
issues concerning the client's death. 3. This is not a legal document
guaranteed to stand up in a court of law; therefore, the client should make
sure all family members know the client's wishes. 4. It is part of the hospital
admission requirements, but it is not the reason why the client should
complete an AD. TEST-TAKING HINT: The test taker could eliminate option
"1" because the nurse cannot make the client do anything. The client has a
right to say no. Option "3" is an absolute, and unless the test taker knows for
sure this is correct information, the test taker should not select this option.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 676). F.A. Davis
Company. Kindle Edition.
2
- 2. The nurse is presenting an in-service discussing do not resuscitate
(DNR) orders and advance directives. Which statement should the nurse
discuss with the class? 1. Advance directives must be notarized by a notary
public. 2. The client must use an attorney to complete the advanced
directive. 3. Once the DNR is written, it can be used for every hospital
admission. 4. The health-care provider must write the DNR order in the
client's chart.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 668). F.A. Davis
Company. Kindle Edition. - - 2. 1. This is not true; someone who is not family
or directly involved in the client's care must witness the AD, but the
,document does not have to be notarized. 2. This form can be filled out
without the use of an attorney; copies of an AD can be obtained at hospitals
or online from various sources. 3. The DNR order must be written on each
admission. 4. The HCP writes the DNR order in the client's chart, and the
client completes the AD. TEST-TAKING HINT: Options "1" and "2" involve
other legal entities outside the healthcare arena, which would make the test
taker eliminate them.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 676). F.A. Davis
Company. Kindle Edition.
4
- 3. In which client situation would the AD be consulted and used in decision
making? 1. The client diagnosed with Guillain-Barré who is on a ventilator. 2.
The client with a C6 spinal cord injury in the rehabilitation unit. 3. The client
in end-stage renal disease who is in a comatose state. 4. The client
diagnosed with cancer who has Down syndrome.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 668). F.A. Davis
Company. Kindle Edition. - - 3. 1. A client diagnosed with Guillain-Barré
syndrome is mentally competent, and being on a ventilator does not indicate
the client has lost his or her decision-making capacity. 2. A client in the
rehabilitation unit would be alert, and spinal cord injuries do not cause the
client to lose decision-making capacity. 3. The client must have lost decision-
making capacity as a result of a condition which is not reversible or must be
in a condition specified under state law, such as a terminal, persistent
vegetative state; an irreversible coma; or as specified in the AD. 4. A client
with Down syndrome may have some mental challenges, but unless the
client has been declared legally incompetent in a court of law, the client can
complete an AD and participate in his/her own case. TEST-TAKING HINT: If
the test taker knows what an AD is, then the words "end-stage" and
"comatose" would lead the test taker to select option "3" as a correct
answer. Remember, clients with congenital or genetic disorders are not
incompetent, even if they are mentally challenged.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 676). F.A. Davis
Company. Kindle Edition.
3
- 4. The nurse is moving to another state which is part of the multistate
licensure compact. Which information regarding ADs should the nurse be
aware of when practicing nursing in other states? 1. The laws regarding ADs
are the same in all the states. 2. Advance directives can be transferred from
,state to state. 3. A significant other can sign a loved one's advance directive.
4. Advance directives are state regulated, not federally regulated.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 668). F.A. Davis
Company. Kindle Edition. - - 4. 1. Individual states are responsible for
specific legal requirements for ADs. 2. Moving from one state to another
does not nullify or honor the AD; the nurse must be aware of the individual
state's requirements. 3. Only the individual can complete and sign an AD.
The significant other may be asked to implement the AD. 4. The state
determines the definition of terms and requirements for an AD; individual
states are responsible for specific legal requirements for ADs. TEST-TAKING
HINT: The test taker should know the registered nurse must obtain a copy of
the Nurse Practice Act of the state he or she is practicing in. The test taker
should realize every state has different regulations regarding ADs and other
health-care issues. Option "4" is the only option which reflects this thought.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 676). F.A. Davis
Company. Kindle Edition.
4
- 5. Which client would be most likely to complete an advance directive? 1. A
55-year-old Caucasian person who is a bank president. 2. A 34-year-old Asian
licensed practical nurse. 3. A 22-year-old Hispanic lawn care worker. 4. A 65-
year-old African American retired cook.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 668). F.A. Davis
Company. Kindle Edition. - - 5. 1. ADs are more frequently completed by
white, middle- to upper-class individuals. 2. Many nurses do not have ADs,
although they discuss them with clients daily. 3. Culturally, Hispanics allow
their family members to make decisions for them. 4. Many cultures, including
the African American culture, often distrust the health-care system and
believe necessary care will be withheld if an AD is completed. TEST-TAKING
HINT: If the test taker were not aware of the research, the test taker could
examine the occupations and ask themselves, "Which client would want to
direct his or her own care and make his or her own decisions?" Nurses may
want this but many do not have ADs.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 677). F.A. Davis
Company. Kindle Edition.
1
, - 6. The client with an AD tells the nurse, "I have changed my mind about
my AD. I really want everything possible done if I am near death since I have
a grandchild." Which action should the nurse implement? 1. Notify the health
information systems department to talk to the client. 2. Remove the AD from
the client's chart and shred the document. 3. Inform the client he or she has
the right to revoke the AD at any time. 4. Explain this document cannot be
changed once it is signed.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 668). F.A. Davis
Company. Kindle Edition. - - 6. 1. This department has nothing to do with the
AD. 2. The most appropriate action would be for the nurse to have the client
write on the AD he or she is revoking the document; the nurse cannot shred
legal documents from the client's chart. 3. The client must be informed the
AD can be rescinded or revoked at any time for any reason verbally, in
writing, or by destroying his or her own AD. The nurse cannot destroy the
client's AD, but the client can destroy his or her own. 4. This is an incorrect
answer because the client always has the right to change his or her mind.
TEST-TAKING HINT: Option "4" can be eliminated by remembering
statements with absolutes should not be selected as correct answers unless
the test taker knows for sure the answer is correct. The client's chart is a
legal document, and these papers cannot be shredded or altered by using
anything that obscures the writing or by erasing information.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 677). F.A. Davis
Company. Kindle Edition.
3
- 7. The client has just signed an AD at the bedside. Which intervention
should the nurse implement first? 1. Notify the client's health-care provider
about the AD. 2. Instruct the client to discuss the AD with significant others.
3. Place a copy of the advance directive in the client's chart. 4. Give the
original advance directive to the client.
Colgrove, Kathryn Cadenhead. Med-Surg Success A Q&A Review Applying
Critical Thinking to Test Taking (Davis's Q&A Success) (Page 668). F.A. Davis
Company. Kindle Edition. - - 7. 1. The HCP should be made aware of the AD,
but this is not the first intervention. 2. This is the most important
intervention because the legality of the document is sometimes not honored
if the family members disagree and demand other action. If the client's
family is aware of the client's wishes, then the health-care team can support
and honor the client's final wishes. 3. Copies of the AD should be placed in
the chart and given to significant others, the client's attorney, and all health-
care providers. 4. The original should be given to the client and a copy
should be placed in the chart, but this is not the first intervention. TEST-
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