A nurse is putting together an educational seminar on advance directives. What information would
be included in the materials?
a. A patient may change a treatment decision in an advance directive if the patient's
health care agent approves the change.
b. When admitted to the hospital, a patient must appoint a Durable Power of
Attorney for health care decisions.
c. A health care facility must provide a patient informational material advising
them of their rights to declare their desires concerning treatment decisions.
d. A health care facility is required to provide a patient an attorney when the patient
is signing a living will.
Under Federal law, all healthcare facilities are required to provide patients with information on how
to make medical decisions under Federal and State law, including accepting or refusing treatments
and creation of an Advance Directive.
The patient has the right to change a treatment decision in an advance directive, regardless of
whether the patient’s healthcare agent approves or denies the change. It is the patient’s right to
appoint a Durable Power of Attorney at the time and place of his choosing. It is not required for
entry to a hospital. The healthcare facility is not required to provide an attorney to a patient to sign
a living will. The patient needs to determine which attorney they want to hire or if they want to hire
an attorney.
2. A nurse is advising a patient with Chronic Fatigue Syndrome on infection control procedures.
Which of the following statements by the patient indicates that the patient understands the advice?
a. I'm going to a basketball game tonight.
b. I should avoid anyone with cold symptoms.
c. I should have a blood test.
d. I'm not going to attend functions with large crowds.
A patient making this statement understands that one step in infection control is avoiding patients
who have cold symptoms. This is important as the person with Chronic Fatigue Syndrome may be
more susceptible to a virus or the virus may trigger more disease symptoms.
, The patient who verbalizes they are not going to the basketball game or are going to avoid functions
with large crowds may understand that Chronic Fatigue Syndrome can cause the patient to become
tired, but this does not indicate the patient understands infection control. Infection control
measures can be implemented at events by following standard precautions, such as handwashing. If
the patient stops going to social events, this can also cause the patient to become depressed and
isolated. Infection control statements would more accurately be made about prevention of
infection. A blood test would only indicate if the patient already has an infection.
3. Which of the following would be an expected finding in an age assessment of a 2 year old?
a. Has a 300 word vocabulary
b. Uses one hand to turn the pages of a book
c. Runs with a wide stance
d. All of the above
At 2 years old child, a patient should have reached certain developmental milestones. The child will
be developing their vocabulary and in addition to knowing almost 300 words, will be developing 2-4
sentences. The child may start using one hand to complete tasks and favoring one hand over the
other. The child may start running, as well as walking and standing on tiptoes. A child who is lagging
in performing these milestones may be at risk for developmental delay and further assessment is
indicated.
4. A patient's spouse died three months ago. The patient says "I would like my friend Tom to
have my collection of artwork because I don't need to look at them anymore". Which of the
following responses by the nurse would be proper?
a. Did Tom ask for the artwork?
b. Are you planning to commit suicide?
c. Does Tom know you want to give him the artwork?
d. Why do you want to give the artwork away?
It is appropriate for the nurse to ask this question of the patient as a close-ended question with two
responses. The nurse can decide based on the patient’s response if further evaluation is needed.
As to the other answer options, the focus should remain on the patient as it will be easy for the
patient to sidetrack a conversation. In answer option d, it is an open-ended question and gives the
patient an opportunity to evade further questions about the patient’s plan to commit suicide.
5. A nurse is instructing a patient on the use of a walker. Which of the following would be
included in the instructions?
a. While putting your body weight on your hands, step into the walker.