the intent of the patient self determination act psda of 1990 is to

NCLEX-PN

NCLEX PN Practice Questions Quizlet

1. What is the intent of the Patient Self Determination Act (PSDA) of 1990?

A. Enhance personal control over healthcare decisions.
B. Encourage medical treatment decision making prior to need.
C. Establish a federal standard for living wills and durable powers of attorney.
D. Emphasize client education.

Correct answer: B

Rationale: The correct answer is B: The purpose of the PSDA is to encourage medical treatment decision-making before it becomes necessary. This legislation aims to empower individuals to make their own healthcare choices in advance. Choice A is incorrect because while enhancing personal control over healthcare decisions is important, the primary goal of the PSDA is to facilitate medical decision-making before the need arises. Choice C is incorrect as the PSDA does not establish a federal standard for living wills and durable powers of attorney; instead, it encourages individuals to create their own advance directives according to state-specific regulations. Choice D is incorrect because while client education is valuable, the main focus of the PSDA is on empowering individuals to plan for their future healthcare needs.

2. The physician orders the antibiotics ampicillin (Omnipen) and gentamicin (Garamycin) for a newly admitted client with an infection. The nurse should:

A. administer both medications simultaneously
B. give the medications sequentially, and flush well between them
C. ask the physician or pharmacy which medication to give first and how long to wait before giving the other drug
D. start one medication now and begin the other medication in 2-4 hours

Correct answer: B

Rationale: The correct answer is to give the medications sequentially and flush well between them. Ampicillin has a pH of 8-10, while gentamicin has a pH of 3-5.5, making them incompatible when given together. Flushing well between drugs is necessary to prevent any potential interactions. Option A is incorrect because administering both medications simultaneously can lead to incompatibility issues. Option C is incorrect because the nurse should already be aware of the correct administration sequence and not need to consult the physician or pharmacy each time. Option D is incorrect because delaying the second medication by several hours can slow down the treatment of the client's infection, which is not ideal in this scenario.

3. How should a nurse listen to the breath sounds of a client?

A. Ask the client to lie prone.
B. Ask the client to breathe in and out through the nose.
C. Hold the bell of the stethoscope lightly against the chest.
D. Listen for at least one full respiration in each location on the chest.

Correct answer: D

Rationale: To best listen to breath sounds, the nurse should have the client sit, leaning slightly forward, with arms resting comfortably across the lap. The client should be instructed to breathe through the mouth a little deeper than usual, but to stop if feeling dizzy. The nurse should hold the flat diaphragm end piece of the stethoscope firmly against the client's chest wall. It is crucial to listen for at least one full respiration in each location on the chest to assess breath sounds accurately. Side-to-side comparison is essential in breath sound assessment. Therefore, options A, B, and C are incorrect as they do not align with the correct procedure for listening to breath sounds.

4. A client with massive chest and head injuries is admitted to the ICU from the Emergency Department. All of the following are true except:

A. The physician in charge of the case is the sole person allowed to decide whether organ donation can occur.
B. The client's legally responsible party may make the decision for organ donation for the donor if the client is unable to do so.
C. The organ procurement organization makes the decision regarding which organs to harvest.
D. The donor (or legally responsible party for the donor), the physician, and the organ-procurement organization are all involved in the process.

Correct answer: A

Rationale: While the physician plays a crucial role in the process of organ donation, they are not the sole decision-maker. The client's legally responsible party may make the decision for organ donation if the client is unable to do so. Additionally, the organ procurement organization is responsible for determining which organs are suitable for donation. Therefore, the statement that the physician in charge is the sole person allowed to decide whether organ donation can occur is incorrect. The correct answer is A. Choices B, C, and D are true statements as they highlight the involvement of the legally responsible party, the organ procurement organization, and the donor/legally responsible party, physician, and organ-procurement organization in the organ donation process respectively.

5. A client who was given a diagnosis of hypertension 3 months ago is at the clinic for a checkup. Which type of database does the nurse use in performing an assessment?

A. Emergency
B. Follow-up
C. Complete (total)
D. Problem-centered

Correct answer: B

Rationale: The correct answer is 'Follow-up.' A follow-up database is used to assess the status of an identified problem at regular intervals. An emergency database is for urgent data collection during life-saving measures. A complete database involves a full health history and physical examination. A problem-centered (episodic) database focuses on a limited or short-term issue, typically centered around one problem or body system.