HURST REVIEW MANAGEMENT OF
CARE Exam
A competent elderly client is admitted with a diagnosis of malnutrition following a 30-
pound (13.6 kg) weight loss in a month. The family requests insertion of Peg tube for
enteral feedings, despite the client's advanced directives indicating "no life-prolonging
measures". What is the most appropriate comment by the nurse to the family?
1. "Perhaps you could convince your parent to allow a Peg tube insertion."
2. "Maybe the client just needs family to prepare meals and help feed the client."
3. "The client completed an advanced directive form specifying what we may do."
4. "It is the client's right to refuse procedures not wanted." - correct answer-3.
CORRECT. This statement by the nurse provides an explanation of advanced directives
as well as the fact the client has completed such a form. The focus is placed on the
purpose of advanced directives and how medical personal must abide by the client's
wishes. The nurse has given the family a response which includes accurate knowledge
as well as advocating for the client.
1. INCORRECT. Such a statement does not focus on the client's right to refuse life-
extending procedures as noted in the advanced directives. The family is given false
hope rather than a correct explanation regarding advanced directives and client rights.
2. INCORRECT. The nurse is attempting to refocus the family on the client's weight loss
rather than the client's choices. The issue at this time is not the cause of the weight
loss, but rather the client's right to refuse life-extending procedures as detailed in the
advanced directives.
4. INCORRECT. Though this statement is accurate, it is abrupt and closed-ended.
When addressing family, the nurse needs to remember that stress, fear and frustration
can overwhelm judgment. The family may fear losing the client and the nurse's
statement would not address those fears or the advanced directives.
Review page 272 of your student book if you missed this question.
A competent elderly client is admitted with a diagnosis of malnutrition following a 30-
pound (13.6 kg) weight loss in a month. The family requests insertion of Peg tube for
enteral feedings, despite the client's advanced directives indicating "no life-prolonging
measures". What is the most appropriate comment by the nurse to the family?
Choose One
1. "Perhaps you could convince your parent to allow a Peg tube insertion."
2. "Maybe the client just needs family to prepare meals and help feed the client."
3. "The client completed an advanced directive form specifying what we may do."
4. "It is the client's right to refuse procedures not wanted."
Submit - correct answer-3. CORRECT. This statement by the nurse provides an
explanation of advanced directives as well as the fact the client has completed such a
form. The focus is placed on the purpose of advanced directives and how medical
, personal must abide by the client's wishes. The nurse has given the family a response
which includes accurate knowledge as well as advocating for the client.
1. INCORRECT. Such a statement does not focus on the client's right to refuse life-
extending procedures as noted in the advanced directives. The family is given false
hope rather than a correct explanation regarding advanced directives and client rights.
2. INCORRECT. The nurse is attempting to refocus the family on the client's weight loss
rather than the client's choices. The issue at this time is not the cause of the weight
loss, but rather the client's right to refuse life-extending procedures as detailed in the
advanced directives.
4. INCORRECT. Though this statement is accurate, it is abrupt and closed-ended.
When addressing family, the nurse needs to remember that stress, fear and frustration
can overwhelm judgment. The family may fear losing the client and the nurse's
statement would not address those fears or the advanced directives.
Review page 272 of your student book if you missed this question.
A facility housekeeper approaches the nurse, reporting their sibling with no advanced
directive has been admitted in a coma following a massive stroke. As the client's only
family member, the housekeeper requests information on the client's condition and
prognosis. What actions by the nurse are most appropriate?
Select All That Apply
1. Offer to contact a spiritual leader to provide comfort.
2. Inform housekeeper that you are not the client's nurse.
3. Check the chart data and provide brief update on client.
4. Ask Social Services to help housekeeper with legal issues.
5. Offer to call primary healthcare provider for housekeeper. - correct answer-1.,4., and
5. CORRECT. There are obvious legal issues which complicate this situation. Though
the housekeeper claims to be the only living relative, unless this claim can be legally
proven, the nurse cannot verify this information. However, the nurse can still assist the
housekeeper or any family member with other needs. Contacting a spiritual leader of
choice can be easily accomplished. Even more important is involving Social Services as
part of an interdisciplinary team which can assist the housekeeper with multiple needs,
including legal requirements to obtain guardianship or power of attorney. It would also
be helpful to advise the primary healthcare provider that the housekeeper is the sole
relative, and allow that physician to make a determination what to reveal under such
dire circumstances.
2. INCORRECT. The nurse's statement may be correct but does not provide the
housekeeper with usable information or alternatives to achieve the goal regarding
sibling's condition.
3. INCORRECT. HIPAA prohibits accessing charts of client's unless directly involved
with the care for that individual. Even if the nurse was assigned to the sibling, it is a
violation to share information, even under the unique circumstances described in the
scenario.
Review pages 269-272 of your student book if you missed this question.
A new nurse is assigned to address quality improvement on a medical-surgical unit. The
nurse is aware what tasks could not be safely completed by a UAP?
CARE Exam
A competent elderly client is admitted with a diagnosis of malnutrition following a 30-
pound (13.6 kg) weight loss in a month. The family requests insertion of Peg tube for
enteral feedings, despite the client's advanced directives indicating "no life-prolonging
measures". What is the most appropriate comment by the nurse to the family?
1. "Perhaps you could convince your parent to allow a Peg tube insertion."
2. "Maybe the client just needs family to prepare meals and help feed the client."
3. "The client completed an advanced directive form specifying what we may do."
4. "It is the client's right to refuse procedures not wanted." - correct answer-3.
CORRECT. This statement by the nurse provides an explanation of advanced directives
as well as the fact the client has completed such a form. The focus is placed on the
purpose of advanced directives and how medical personal must abide by the client's
wishes. The nurse has given the family a response which includes accurate knowledge
as well as advocating for the client.
1. INCORRECT. Such a statement does not focus on the client's right to refuse life-
extending procedures as noted in the advanced directives. The family is given false
hope rather than a correct explanation regarding advanced directives and client rights.
2. INCORRECT. The nurse is attempting to refocus the family on the client's weight loss
rather than the client's choices. The issue at this time is not the cause of the weight
loss, but rather the client's right to refuse life-extending procedures as detailed in the
advanced directives.
4. INCORRECT. Though this statement is accurate, it is abrupt and closed-ended.
When addressing family, the nurse needs to remember that stress, fear and frustration
can overwhelm judgment. The family may fear losing the client and the nurse's
statement would not address those fears or the advanced directives.
Review page 272 of your student book if you missed this question.
A competent elderly client is admitted with a diagnosis of malnutrition following a 30-
pound (13.6 kg) weight loss in a month. The family requests insertion of Peg tube for
enteral feedings, despite the client's advanced directives indicating "no life-prolonging
measures". What is the most appropriate comment by the nurse to the family?
Choose One
1. "Perhaps you could convince your parent to allow a Peg tube insertion."
2. "Maybe the client just needs family to prepare meals and help feed the client."
3. "The client completed an advanced directive form specifying what we may do."
4. "It is the client's right to refuse procedures not wanted."
Submit - correct answer-3. CORRECT. This statement by the nurse provides an
explanation of advanced directives as well as the fact the client has completed such a
form. The focus is placed on the purpose of advanced directives and how medical
, personal must abide by the client's wishes. The nurse has given the family a response
which includes accurate knowledge as well as advocating for the client.
1. INCORRECT. Such a statement does not focus on the client's right to refuse life-
extending procedures as noted in the advanced directives. The family is given false
hope rather than a correct explanation regarding advanced directives and client rights.
2. INCORRECT. The nurse is attempting to refocus the family on the client's weight loss
rather than the client's choices. The issue at this time is not the cause of the weight
loss, but rather the client's right to refuse life-extending procedures as detailed in the
advanced directives.
4. INCORRECT. Though this statement is accurate, it is abrupt and closed-ended.
When addressing family, the nurse needs to remember that stress, fear and frustration
can overwhelm judgment. The family may fear losing the client and the nurse's
statement would not address those fears or the advanced directives.
Review page 272 of your student book if you missed this question.
A facility housekeeper approaches the nurse, reporting their sibling with no advanced
directive has been admitted in a coma following a massive stroke. As the client's only
family member, the housekeeper requests information on the client's condition and
prognosis. What actions by the nurse are most appropriate?
Select All That Apply
1. Offer to contact a spiritual leader to provide comfort.
2. Inform housekeeper that you are not the client's nurse.
3. Check the chart data and provide brief update on client.
4. Ask Social Services to help housekeeper with legal issues.
5. Offer to call primary healthcare provider for housekeeper. - correct answer-1.,4., and
5. CORRECT. There are obvious legal issues which complicate this situation. Though
the housekeeper claims to be the only living relative, unless this claim can be legally
proven, the nurse cannot verify this information. However, the nurse can still assist the
housekeeper or any family member with other needs. Contacting a spiritual leader of
choice can be easily accomplished. Even more important is involving Social Services as
part of an interdisciplinary team which can assist the housekeeper with multiple needs,
including legal requirements to obtain guardianship or power of attorney. It would also
be helpful to advise the primary healthcare provider that the housekeeper is the sole
relative, and allow that physician to make a determination what to reveal under such
dire circumstances.
2. INCORRECT. The nurse's statement may be correct but does not provide the
housekeeper with usable information or alternatives to achieve the goal regarding
sibling's condition.
3. INCORRECT. HIPAA prohibits accessing charts of client's unless directly involved
with the care for that individual. Even if the nurse was assigned to the sibling, it is a
violation to share information, even under the unique circumstances described in the
scenario.
Review pages 269-272 of your student book if you missed this question.
A new nurse is assigned to address quality improvement on a medical-surgical unit. The
nurse is aware what tasks could not be safely completed by a UAP?
