Nursing Elites

1. How does guardianship differ from power of attorney?

• A. The court appoints a guardian; an individual grants a power of attorney to someone else to make decisions on his or her behalf.
• B. Guardianship is legally binding whether or not an individual is competent; power of attorney applies only to the incompetent.
• C. Courts monitor the actions of those executing a power of attorney, but guardians are free to act on behalf of another as long as standards of 'reasonable prudence' are met.
• D. Guardianship stays in effect for one calendar year and must be renewed annually; power of attorney stays in effect until one or both parties choose to revoke it.

Correct answer: A

Rationale: The correct answer is A. The key difference between guardianship and power of attorney is that the court appoints a guardian to make decisions on behalf of an individual who is deemed incompetent, while an individual grants a power of attorney to someone else to make decisions on their behalf when they are competent. Choice B is incorrect because both guardianship and power of attorney can apply to individuals who are competent or incompetent. Choice C is incorrect as guardians, like those with power of attorney, must act in the best interest of the individual they represent, and the level of oversight can vary. Choice D is incorrect as guardianship and power of attorney do not have fixed time limits; they remain in effect until revoked or ended by the appropriate legal process.

2. Mrs. W, aged 82, resides with her son and daughter-in-law who are finding it challenging to provide adequate care while maintaining their careers and home life. During a homecare visit, Mrs. W tells the nurse that, 'My children's generation doesn't know how good they've got it; when I was younger we all had to take care of our parents, and for a lot longer than most people do now.' Which of the following statements most accurately underlies the response that the nurse will provide to Mrs. W?

• A. The increasing prevalence of chronic illnesses means that there are indeed fewer old-old adults than there were in earlier generations.
• B. The increasing acceptance of long-term care means that the caregiving burden of the son and daughter-in-law's generation is lighter than that of Mrs. W's generation.
• C. More older people are living longer and receiving care in the community than when Mrs. W was in her middle-adult years.
• D. The caregiving needs of the old-old are increasing but these needs are more commonly met in institutional settings rather than in the community.

Correct answer: C

Rationale: The correct answer is C because people are living longer and receiving more of their care in the community than in years past. This reflects the current trend where older individuals tend to receive care in community settings rather than institutional ones. Choices A, B, and D are incorrect because they do not align with the reality that more older people today are living longer and being cared for in the community.

3. How does a durable power of attorney differ from a power of attorney?

• A. It is granted by the court on behalf of an incompetent individual.
• B. It stays in effect if the individual granting it becomes incompetent.
• C. It goes into effect only after an individual becomes incompetent.
• D. It includes responsibility for managing an individual's financial assets.

Correct answer: B

Rationale: A durable power of attorney allows competent individuals to appoint someone else to make decisions on their behalf in the event they become incompetent. Choice A is incorrect because a durable power of attorney is typically granted by the individual themselves, not the court. Choice C is incorrect as a durable power of attorney can be effective both before and after incompetency. Choice D is incorrect because managing financial assets is just one aspect of the authority granted by a power of attorney, not specifically for a durable power of attorney.

4. An older adult client tells the nurse that blockage of qi in one of the body's meridians is causing severe headaches. The health care provider has diagnosed migraines and has prescribed a triptan drug. Which action would be most appropriate for the nurse to implement?

• A. Suggest that the prescribed medicine may stimulate the flow of qi
• B. Explain the vasoconstrictive and serotonin-moderating action of triptan
• C. Instruct the client to take as many doses as needed for relief
• D. Caution the client that the headaches will grow worse if the client fails to take the medication

Correct answer: A

Rationale: Qi is the life force that circulates through the body in invisible pathways called meridians. In this scenario, the client believes that the blockage of qi is causing severe headaches. While explaining the scientific principles underlying the drug action could be valuable, it's crucial to consider the client's belief system. Therefore, the most appropriate response is to suggest that the prescribed medicine may stimulate the flow of qi, aligning with the client's perspective. Choice B, explaining the vasoconstrictive and serotonin-moderating action of triptan, does not address the client's concerns about qi blockage. Choice C, instructing the client to take as many doses as needed, can lead to potential medication misuse. Choice D, cautioning the client about worsening headaches without medication, may induce fear and hinder effective communication with the client.

5. A 52-year-old woman is preparing to have her father move into her home after his discharge from the hospital. Which of the following subjects should the discharge planning nurse prioritize when preparing the woman for her new caregiving role?

• A. The availability and scope of community resources
• B. The importance of her own self-care and techniques for maximizing it
• C. Assertiveness training to ensure she can set limits
• D. Management of finances

Correct answer: B

Rationale: The correct answer is B. It is crucial for the discharge planning nurse to prioritize the importance of the woman's self-care and provide techniques for maximizing it. When taking on a caregiving role, the caregiver's well-being is essential to ensure effective care for the patient. While community resources (choice A) are important, the immediate focus should be on self-care. Assertiveness training (choice C) and financial management (choice D) are also significant but not as critical as self-care for the caregiver in this scenario.

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