A nurse is providing information to a client about durable power of attorney. The nurse should include that durable power of attorney is enforceable under which of the following conditions?
The client is incapable of providing self-care.
The client is terminally ill.
The client is unable to express their wishes.
The client has refused treatment.
The Correct Answer is C
Choice A Reason:
The condition that the client is incapable of providing self-care does not necessarily make a durable power of attorney enforceable. While incapacity can be a factor, the key aspect is the client’s ability to make decisions. A durable power of attorney becomes effective when the client is unable to make their own decisions, not merely when they are unable to provide self-care.
Choice B Reason:
Being terminally ill does not automatically make a durable power of attorney enforceable. The enforceability of a durable power of attorney is based on the client’s decision-making capacity. While terminal illness might lead to incapacity, it is the inability to make decisions that triggers the use of the durable power of attorney.
Choice C Reason:
A durable power of attorney is specifically designed to be enforceable when the client is unable to express their wishes. This legal document allows the designated agent to make decisions on behalf of the client when they are incapacitated and unable to communicate their preferences. This ensures that the client’s affairs are managed according to their wishes, even when they cannot express them.
Choice D Reason:
The refusal of treatment by the client does not make a durable power of attorney enforceable. The enforceability is related to the client’s capacity to make decisions. If a client is still capable of making informed decisions, even if they refuse treatment, the durable power of attorney does not come into effect.
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Correct Answer is B
Explanation
Choice A: Seat the client in a chair for 30 minutes prior to applying the stockings.
Seating the client in a chair for 30 minutes before applying the stockings is not necessary. In fact, it is recommended to apply antiembolic stockings while the client is in a supine position to prevent blood from pooling in the legs. This ensures that the stockings fit properly and provide the intended compression to promote venous return.
Choice B: Measure the length of the client’s leg from the heel to the gluteal fold.
Measuring the length of the client’s leg from the heel to the gluteal fold is essential for ensuring the correct fit of knee-length antiembolic stockings. Proper measurement helps in selecting the right size, which is crucial for the stockings to be effective in preventing deep vein thrombosis (DVT) by promoting blood circulation. Incorrectly sized stockings may either be too tight, causing discomfort and impaired circulation, or too loose, failing to provide adequate compression.
Choice C: Instruct the client to point their toes while applying the stockings.
Instructing the client to point their toes while applying the stockings is not a standard practice. Instead, the nurse should gather the stocking material and gently roll it over the foot and up the leg, ensuring it is evenly distributed and free of wrinkles. This method helps in applying the stockings smoothly and effectively without causing discomfort or improper fit.
Choice D: Roll the top of the client’s stockings down to just below the knee.
Rolling the top of the stockings down to just below the knee is incorrect and can lead to a tourniquet effect, which can impede blood flow and increase the risk of DVT. The stockings should be applied smoothly and should extend to their full length without being rolled down to ensure proper compression and effectiveness.
Correct Answer is C
Explanation
Choice A: Have a padded tongue blade available at the client’s bedside.
Having a padded tongue blade available is not recommended for seizure management. Inserting any object into a patient’s mouth during a seizure can cause injury to the teeth, gums, or jaw1. Current guidelines advise against placing anything in the mouth of a person having a seizure. Instead, focus on ensuring the patient’s safety by turning them on their side to maintain an open airway and prevent aspiration.
Choice B: Keep the four side rails down when the client is in bed.
Keeping the side rails down is not advisable for a client with a seizure disorder. To prevent injury during a seizure, it is important to keep the side rails up and padded. This helps prevent the client from falling out of bed and sustaining injuries. Additionally, the bed should be kept in its lowest position to minimize the risk of injury from falls.
Choice C: Keep suction equipment available in the client’s room.
Keeping suction equipment available is crucial for managing a client with a seizure disorder. During a seizure, there is a risk of aspiration due to excessive salivation or vomiting. Having suction equipment readily available allows the nurse to quickly clear the client’s airway, reducing the risk of aspiration and ensuring the client can breathe properly.
Choice D: Have wire cutters available at the client’s bedside.
Wire cutters are not typically necessary for managing a seizure disorder. They are sometimes mentioned in the context of clients with Vagus Nerve Stimulators (VNS), where the wire cutters might be used in an emergency to cut the VNS wire. However, this is a rare situation and not a standard precaution for all clients with seizure disorders4.