An 87-year-old woman has a history of depression and ...

[ETearle]

An 87-year-old woman has a history of depression and hypothyroidism. She was recently diagnosed as having breast cancer.
 
  Her daughter tells her health care provider that her mother cannot participate in decision making about her care because she is too old. Which of the following statements is true about decision-making capacity?
 
  A) Determination of decision-making capacity is based on the older adult's diagnosis and chronologic age.
  B) The older adult has decision-making capacity if she understands most of the risks and benefits of medical treatment.
  C) The older adult needs to understand the issues involved in decision making and communicate about them.
  D) Decision-making capacity of older adults is always determined by a mental health judge.

Question 2

A 76-year-old Hispanic woman has been admitted to the hospital. There are no advance directives in the chart. Which of the following questions will best prepare the nurse to begin a dialogue with this client about advance directives?
 
  A) With whom do you talk to about your health care decisions?
  B) I see that you have no advanced directives on your chart, could you tell me about that?
  C) Is there someone we should call to join us while we discuss your care?
  D) Tell me about your living arrangements; do you live alone or with others?

[mrphibs]

Answer to Question 1

Ans: C
Decision making should not be determined by the diagnosis or the age of the older adult. The older adult needs to understand all of the risks and benefits of medical treatment. Decision-making capacity is determined by the health care practitioner or by the interdisciplinary team assigned to the client.

Answer to Question 2

Ans: A
Nurses need to identify patterns of culturally influenced decision making in order to ask questions and obtain relevant information from clients of different cultures. Why there are no advance directives on the chart is not the place to start to open the conversation. Whether or not she lives with someone, inviting family to join reflects an emphasis on family caregiving consistent with the Hispanic culture.

[ETearle]

Correct answers!

[mrphibs]

Great! Please up vote