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NurseDive Free Nursing Practice Question
A nurse is caring for a client who is unconscious and has a living will. The client's family asks if they can make changes to lifesaving measures now that the client is unconscious. Which of the following statements should the nurse make?
A. "The Patient Self-Determination Act (PSDA) will explain your rights to change lifesaving measures."
B. "The durable power of attorney for health care can cancel the client's living will."
C. "The living will states the client's wishes regarding lifesaving measures."
A living will is a legal document that outlines an individual's wishes regarding medical treatment in the event that they become incapacitated or unable to communicate their preferences. It typically includes instructions about lifesaving measures such as resuscitation, mechanical ventilation, and other interventions. In this case, since the client is unconscious and has a living will, the family should refer to the living will to understand the client's wishes regarding lifesaving measures. The living will serves as a guide for healthcare providers and family members in making decisions about the client's care. The other statements are not accurate in this context: The Patient Self-Determination Act (PSDA) requires healthcare facilities to inform patients about their rights regarding advance directives, including living wills. However, it does not address the family's ability to change the client's wishes or modify the living will. The durable power of attorney for health care, also known as a healthcare proxy or healthcare agent, is a separate legal document that designates a person to make medical decisions on behalf of an individual who is unable to do so. However, the durable power of attorney does not cancel the client's living will but rather allows the designated person to make decisions based on the client's expressed wishes. The case manager typically facilitates communication and coordination of care but does not have the authority to make changes to a client's living will. Any changes to the living will would need to follow the legal process specified in the applicable jurisdiction, such as revoking or updating the document through legal means.
D. "The case manager can make changes to the client's living will."
This question is an excerpt from Nurse Dive's nursing test bank - ATI Med surg exam 1A Proctored Exam. Take the full exam now
Similar Questions
A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGS?
pH 7.22
PaCO2 68 mm Hg Base excess-2 PaO2 78 mm Hg Saturation 80%
Bicarbonate 26 mEq/L
A. Respiratory acidosis
Respiratory acidosis occurs when there is an excess of carbon dioxide (PaCO2) in the blood, leading to a decrease in pH. The ABG values that support this analysis are as follows: pH 7.22: A pH below the normal range of 7.35-7.45 indicates acidosis. PaCO2 68 mm Hg: An elevated PaCO2 level is consistent with respiratory acidosis. The normal range for PaCO2 is typically 35-45 mm Hg, so a value of 68 mm Hg indicates an excess of carbon dioxide. Base excess -2: Base excess measures the amount of excess or deficit of base (bicarbonate) in the blood. A negative base excess suggests an acidosis state. PaO2 78 mm Hg: The PaO2 value of 78 mm Hg is within the normal range, indicating adequate oxygenation. Saturation 80%: The saturation value of 80% indicates poor oxygen saturation and is lower than the normal range. However, in this case, it is more indicative of the respiratory issue causing acidosis rather than reflecting a primary oxygenation problem. Bicarbonate 26 mEq/L: The bicarbonate level is within the normal range, suggesting the compensatory response of the body to maintain pH balance in response to respiratory acidosis.
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
A nurse is caring for a client who has metabolic alkalosis. For which of the following clinical manifestations should the nurse monitor? (Select all that apply.)
A. Lethargy
When caring for a client with metabolic alkalosis, the nurse should monitor for the following clinical manifestations: Lethargy: Metabolic alkalosis can cause central nervous system (CNS) depression, leading to lethargy, confusion, and even coma in severe cases. Monitoring the client's level of consciousness is important to assess for any changes in mental status. Circumoral paresthesia: Metabolic alkalosis can cause a sensation of tingling or numbness around the mouth, known as circumoral paresthesia. This is often associated with hypocalcemia, which can occur as a compensatory mechanism in metabolic alkalosis. Bicarbonate excess: Metabolic alkalosis is characterized by an excess of bicarbonate (HCO3-) in the blood. Monitoring the bicarbonate levels is important to assess the severity of the alkalosis and guide treatment. Flushing: Flushing, or a reddening of the skin, can occur in metabolic alkalosis. It is thought to be due to the dilation of blood vessels caused by the alkalotic state. The following clinical manifestation, Kussmaul's respirations, is not typically associated with metabolic alkalosis. Kussmaul's respirations are deep, rapid, and labored breathing patterns that are more commonly seen in metabolic acidosis, where the body compensates by increasing the respiratory rate to eliminate excess CO2 and reduce acidity.
B. Circumoral paresthesia
C. Bicarbonate excess
D. Flushing
E. Kussmaul's respirations
A nurse is caring for a client who is postoperative and whose respirations are shallow and 9/min. Which of the following acid-base imbalances should the nurse identify the client as being at risk for developing initially?
A. Metabolic acidosis
Metabolic acidosis occurs due to either increased production of metabolic acids, such as lactic acid in anaerobic metabolism, or decreased excretion of acids, such as in renal failure.Shallow respirations would not directly cause metabolic acidosis. While they may decrease the elimination of CO2, resulting in respiratory acidosis, they do not directly affect metabolic acid-base balance.
B. Respiratory alkalosis
Respiratory alkalosis occurs when there is excessive elimination of CO2 from the body, leading to decreased levels of carbonic acid (H2CO3) in the blood. Shallow respirations would not typically lead to excessive elimination of CO2; instead, they would likely result in CO2 retention, leading to respiratory acidosis rather than respiratory alkalosis.
C. Metabolic alkalosis
Metabolic alkalosis occurs due to excessive loss of acids or increased levels of bicarbonate (HCO3-) in the blood, often caused by conditions such as vomiting, excessive diuretic use, or excessive bicarbonate intake.Shallow respirations would not directly cause metabolic alkalosis. Again, while they may decrease CO2 elimination and lead to respiratory acidosis, they do not directly affect metabolic acid-base balance.
D. Respiratory acidosis
Respiratory acidosis is a condition that occurs when there is an excess of carbon dioxide (CO2) in the body due to inadequate ventilation. Shallow respirations can lead to inadequate elimination of CO2, resulting in its accumulation in the bloodstream. This can lead to an increase in carbonic acid (H2CO3) levels and a decrease in blood pH, causing respiratory acidosis.
Full Explanation
Correct answer: D
A. Metabolic acidosis occurs due to either increased production of metabolic acids, such as lactic acid in anaerobic metabolism, or decreased excretion of acids, such as in renal failure.Shallow respirations would not directly cause metabolic acidosis. While they may decrease the elimination of CO2, resulting in respiratory acidosis, they do not directly affect metabolic acid-base balance.
B. Respiratory alkalosis occurs when there is excessive elimination of CO2 from the body, leading to decreased levels of carbonic acid (H2CO3) in the blood. Shallow respirations would not typically lead to excessive elimination of CO2; instead, they would likely result in CO2 retention, leading to respiratory acidosis rather than respiratory alkalosis.
C. Metabolic alkalosis occurs due to excessive loss of acids or increased levels of bicarbonate (HCO3-) in the blood, often caused by conditions such as vomiting, excessive diuretic use, or excessive bicarbonate intake.Shallow respirations would not directly cause metabolic alkalosis. Again, while they may decrease CO2 elimination and lead to respiratory acidosis, they do not directly affect metabolic acid-base balance.
D.Respiratory acidosis occurs when the lungs cannot remove enough of the carbon dioxide (CO2) produced by the body. Shallow respirations lead to inadequate elimination of CO2, causing it to accumulate in the bloodstream. This accumulation of CO2 results in an increase in carbonic acid (H2CO3) in the blood, leading to a decrease in blood pH and resulting in respiratory acidosis.
Therefore, the nurse should identify the client as being at risk for developing respiratory acidosis initially due to the shallow respirations of 9/min.