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 reason:
Lowering the head of the client’s bed to 15 degrees can help facilitate the drainage of the NG tube. This position uses gravity to assist in the movement of gastric contents through the tube. However, it is not the most effective method to address the issue of the NG tube not draining. This action might be more appropriate for other clinical scenarios, such as preventing aspiration, but it is not the primary intervention for a non-draining NG tube.
Choice B reason:
Injecting 10 mL of air into the vent lumen is a common technique used to clear an obstruction in the NG tube. This action can help dislodge any blockages that may be preventing the tube from draining properly. By injecting air, the nurse can ensure that the tube is patent and functioning correctly. This method is often recommended in clinical guidelines for managing NG tube blockages.
Choice C reason:
Placing the NG tube to high suction is not recommended as it can cause damage to the gastric mucosa and lead to complications such as bleeding or ulceration. High suction can create excessive negative pressure, which can harm the delicate tissues of the stomach lining. Therefore, this action is not appropriate for managing a non-draining NG tube and should be avoided.
Choice D reason:
Connecting the air vent to the suction is incorrect and can lead to malfunction of the NG tube. The air vent, also known as the pigtail, is designed to allow air to enter the stomach and prevent the tube from adhering to the gastric mucosa. Connecting it to suction would negate its purpose and could cause the tube to become blocked or damaged. This action is not recommended in any clinical guidelines for NG tube management.
Correct Answer is D
Explanation
Choice A Reason:
Telling the client to ask their provider if they recommend traditional Chinese medicine (TCM) is a cautious approach, but it may not fully address the client’s interest in exploring alternative treatments. While it is important for the client to discuss their treatment options with their provider, the nurse can take a more proactive role by facilitating access to TCM practitioners.
Choice B Reason:
Suggesting that the client try the prescribed medication before choosing an alternative may come across as dismissive of the client’s preferences. It is important to respect the client’s autonomy and support their informed decision-making. Encouraging the client to explore TCM while also considering the prescribed medication can be a more balanced approach.
Choice C Reason:
Stating that the FDA regulates traditional Chinese medicine is inaccurate. The FDA does not regulate TCM in the same way it regulates conventional pharmaceuticals. TCM practices and products are subject to different regulatory standards, and it is important for the nurse to provide accurate information about the regulatory status of TCM.
Choice D Reason:
Offering to arrange a referral to a practitioner of traditional Chinese medicine is an appropriate and supportive response. This approach respects the client’s interest in TCM and facilitates access to qualified practitioners who can provide safe and effective care. It also ensures that the client receives comprehensive information about their treatment options.
