In which of the following situations would a living will provide clear direction to the care and treatment of the individual involved?
A) Mr. Penny, age 81, has been diagnosed with bone cancer, is experiencing severe pain, and has been presented with treatment options.
B) Ms. Jelic, age 78, has been brought to the emergency department after falling on an escalator.
C) Mrs. Kerr, age 77, has been admitted to hospital with an electrolyte imbalance secondary to an accidental overdose of diuretics.
D) Mr. Jimenez, age 84, has suffered a severe hemorrhagic stroke and is unconscious and unlikely to survive.
Question 2A series of transient ischemic attacks have caused an older adult to become dysphagic. Despite failing a swallowing assessment, the client is opposed to eating a minced and pureed diet and wishes to eat a regular diet.
How should the care team respond to this request?
A) Insert a feeding tube to provide nutrition while eliminating the risk of aspiration.
B) Continue providing a minced and pureed diet to the client in order to ensure safety.
C) Defer responsibility for feeding to the client's friends and family.
D) Provide the client's requested diet after ensuring the client understands the risks.
Question 3The children of a resident of a nursing home have approached the nurse because they believe their parent is being manipulated by a person who also lives in the facility.
Their parent has a diagnosis of early-stage Alzheimer disease and various comorbidities that affect mobility and function. How should the care team appraise the parent's decision-making capacity?
A) Her decision-making ability is nullified by the presence of a dementia.
B) Her decision-making capacity should be determined according to objective criteria.
C) She should be asked to demonstrate sound decision making in minor matter before being allowed to make more important decisions.
D) A surrogate should be appointed to make her decisions because she has been diagnosed with Alzheimer disease.
Question 4A 78-year-old was diagnosed with colorectal cancer 18 months ago and underwent a round of chemotherapy. The most recent computed tomographic scan, however, reveals that the cancer has metastasized to the lungs and liver.
The older adult states, I feel quite well and do not wish to undergo another round of chemotherapy. The client's children are adamantly opposed to their parent's decision to forgo treatment and have appealed to the nurse. Which factor is the priority consideration for the nurse to determine the best course of action?
A) The client's prognosis
B) The client's autonomy
C) The family's wishes
D) The client's treatment options
Question 5An older woman of Filipino heritage has been having rectal bleeding for several months. Her physician has told the woman and her daughters that she has advanced colon cancer.
Her daughters want to obtain hospice services but the client is reluctant and does not want to discuss what she feels is beyond her control. Which of the following concerns is this client most likely experiencing?
Question 6A nurse manager of a nursing care facility reviews potential health and safety interventions and outcomes with the nursing staff. Which of the following interventions places emphasis on quality of life with the best possible health and safety outcomes?
A) Telling the resident about his or her schedule for the day
B) Allowing the resident with a history of falls to walk with the help of an assistant
C) Discouraging the resident who states they are tired from participating in activities
D) Advising the resident not to attend church because the resident is not Catholic
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