Advance Healthcare Directives: Implementing -- an Overview Flashcards
Which of the following most accurately describes the purpose of a values history?
A values history is intended to present a patient’s views about quality of life (QOL), which can assist treating clinicians and family members in end-of-life planning
A values history is intended to provide detailed instructions about end-of-life care for a specific illness
A values history is intended to designate one individual for all end-of-life decision making
A values history is intended to present a patient’s point of view on organ donation
A values history is intended to present a patient’s views about quality of life (QOL), which can assist treating clinicians and family members in end-of-life planning
A form of written advance healthcare directive (AHD) that identifies one person (and an alternate, if desired) as a decision-making healthcare agent/proxy if the patient becomes incapacitated is called
a legal healthcare decision-making declaration
a durable power of attorney for health care
a treatment directive
a guardian of health care declaration
a durable power of attorney for health care
A Natural Death Act Declaration is a type of AHD which is typically limited to
designating an individual to make healthcare decisions in case of incapacitation
stating the patient’s desire to not receive comfort measures at the end of life
stating the patient’s wishes regarding organ donation
stating the patient’s desire to not receive life-sustaining treatment in the event of terminal illness or permanent unconsciousness
stating the patient’s desire to not receive life-sustaining treatment in the event of terminal illness or permanent unconsciousness
Before assisting with an AHD, the nurse should verify the availability of
the different types of AHDs available, per facility protocol
witnesses or a notary public to verify the patient’s execution of the document
a professional certified medical interpreter, if necessary
specially trained clinicians and other healthcare personnel (clergy, patient representative, mental health clinician) who have been designated to discuss AHDs with patients and/or provide comfort for mental distress related to the process
all of the above
all of the above
Which of the following is not a correct statement about AHDs?
An AHD is active immediately upon creation, and always overrides verbal or written wishes a patient expresses while mentally and physically competent
Some states in the U.S. have specific documents called AHDs
In general, an AHD is an umbrella term that encompasses all forms of written documents in which a person indicates his or her health care preferences while cognitively and physically able to make decisions
AHDs afford legal immunity for health care professionals and family members from civil and criminal liability when AHDs are followed in good faith
An AHD is active immediately upon creation, and always overrides verbal or written wishes a patient expresses while mentally and physically competent
It is inappropriate to ask which of the following patients/family members about the existence of an AHD?
The parents of a child who is being admitted to the hospital for treatment of pneumonia
An older adult patient who is being admitted to the hospital for treatment of an infected pressure ulcer
The parents of an infant who is being admitted to the hospital with possible sepsis
A middle-aged patient being admitted to the hospital for observation following a severe allergic reaction
b) and d)
c) and d)
None of the above
None of the above
A nurse in the intensive care unit (ICU) is caring for a patient with a Do-Not-Resuscitate (DNR) order. This nurse should be prepared in the case of cardiac or pulmonary arrest to
use cardiopulmonary resuscitation (CPR)
not use CPR
use CPR, but only under certain circumstances
use CPR, but not allow intubation
not use CPR
A nurse is providing care for a patient with terminal cancer who has just signed a durable power of attorney for healthcare. The nurse should be aware that this designated individual(s)
will make healthcare decisions if and when the patient becomes incapacitated
will begin making healthcare decisions today, regardless of the patient’s physical or cognitive state
decisions will override any decisions made by the patient while physically and mentally sound
will decide in the future if he or she wishes to take on the role of decision-maker
will make healthcare decisions if and when the patient becomes incapacitated
A patient with limited English proficiency is admitted to a hospital in the U.S. due to a life-threatening infection. The patient is alert, but due to a language barrier he is unable to answer personal questions and to state whether or not he has an AHD. What can the nurse do to assist this patient in receiving optimal care?
Assume that the patient does not have an AHD
Arrange for the presence of a trained medical translator
Have a staff member who speaks the patient’s language inform the patient that he is required to have an AHD in order to receive hospital-based care
Have a staff member who speaks the patient’s language inform the patient that the healthcare team will make all decisions regarding the patient’s care
Arrange for the presence of a trained medical translator
A nurse who is assisting with the creation of an AHD should
offer assistance in identifying the type of AHD document best suited to the patient’s preferences
decide which type of AHD document is most appropriate for the patient
encourage the patient to refrain from telling friends and family members about decisions concerning the AHD
encourage the patient to inform friends and family members of decisions concerning the AHD
a) and d)
b) and c)
b) and d)
a) and d)
Why is it necessary to practice culturally competent care in assisting with the creation of an AHD?
Patients of certain religious backgrounds should not be asked about the existence of an AHD
Race, culture, ethnicity, and religion can influence a patient’s and family’s healthcare decision-making process
Ethnic background is the primary determinant of the type of AHD patients choose
In most cultures, approaching the topic of death is considered highly offensive and should be avoided
Race, culture, ethnicity, and religion can influence a patient’s and family’s healthcare decision-making process
Nurses should encourage patients to seek information about AHDs from the treating clinician, hospital personnel, and/or legal counsel in order to prepare an AHD ideally
prior to becoming seriously ill
immediately after becoming seriously ill
after the age of 50 years
after at least one hospitalization for a serious illness
prior to becoming seriously ill
AHDs can be completed by
adults ≥18 years of age
any hospitalized child between the ages of 10 and 17
emancipated minors who are of sound mind and acting without undue influence
any child or adolescent under the age of 17 who appears mature
a) and c)
a), b), and d)
a) and c)
The nurse is caring for a patient who has an AHD and who is able to make decisions for herself. The patient wants to make a decision that overrides her wishes expressed in the AHD. The nurse should explain to the patient that
she will need to change her AHD in writing, not verbally
no treatment decisions can be made that conflict with the AHD unless a new one is written, signed, and notarized
she can always override the wishes expressed in the AHD
she will need to create a durable power of attorney for health care to override the AHD
none of the above
she can always override the wishes expressed in the AHD
A nurse is assisting a patient with creating an AHD and the patient states, “I’d like to die with dignity.” What is/are the appropriate nursing action(s)?
Specifically ask the patient to explain his statement and define his specific wishes
Do not address the patient’s statement because everyone has the same understanding of what that statement means
Encourage the patient to write his or her specific wishes on the AHD form in the free text section
Advise the patient that he will need to complete a combination AHD
a) and c)
a) and c)
