Author Question: A health care provider asks the nurse about an older man's durable power of attorney (DPA) because ... (Read 149 times)

captainjonesify · **on:** Jul 11, 2018

A health care provider asks the nurse about an older man's durable power of attorney (DPA) because consent is needed for a medically necessary invasive procedure. The patient has end-stage disease, is intubated, and is on mechanical ventilation.

Which steps should the nurse implement? a. Refer to the patient's advance directive for a name.
b. Assist with obtaining informed consent from the patient.
c. Use the oral trail-making test to measure cognitive function.
d. Apply the Confusion Assessment Method for critical care.

Question 2

The older adult residents of an assisted-living facility are preparing for a 14-day trip to Europe. Which is the most important exercise for the nurse to recommend for the group?

a. Practice standing on one foot for 30 seconds.
b. Move light weights in a rowing motion 8 times.
c. Stretch the hips by pulling the knee to the chest.
d. Swim laps in the pool for 10 minutes continuously.

Cheesycrackers · **Reply #1 on:** Jul 11, 2018

Answer to Question 1

D
The health care provider assumes the intubated older adult lacks the cognitive skill to give con-sent for treatment. Before the search begins for the DPA and to help determine the patient's cog-nitive status, the nurse assesses the patient for delirium using the Confusion Assessment Method for the intensive care unit. As the patient's advocate, the nurse implements this valid and reliable tool because the nurse wants to give the patient every opportunity to participate in the plan of care and make his own determinations.
If the patient has an advance directive, then the attorney-in-fact named in the power of attorney should be on that document. However, because the patient has the right to make his own decisions about care, his cognitive status should be established first. Before informed consent can be given, the patient's cognitive status must be determined. The patient is unable to perform an oral test while he is intubated.

Answer to Question 2

D

Feedback
A Incorrect. This is a reasonable exercise to recommend because balance tends to decrease with age; however, the cornerstone of the group's exercise must be endurance.
B Incorrect. This is a reasonable exercise to recommend because muscle bulk tends to decrease with age; however, the cornerstone of the group's exercise must be endurance.
C Incorrect. This is a reasonable exercise to recommend because joint flexibility tends to decrease with age; however, the cornerstone of the group's exercise must be endurance.
D Correct. The nurse should recommend endurance exercises for the group to im-prove cardiovascular and respiratory conditioning. Endurance training is suitable to prepare the residents to withstand the rigors of travel.