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. A 65-year-old female client is experiencing postmenopausal bleeding. Which type of physician should this client be encouraged to see?

A. a radiologist
B. a gynecologist
C. a physiatrist
D. an oncologist

Correct answer: B

Rationale: A gynecologist is the appropriate physician for this scenario as they specialize in treating and managing diseases of the female reproductive system, including postmenopausal bleeding. Postmenopausal bleeding can indicate serious conditions such as endometrial cancer, which a gynecologist can evaluate and manage. A radiologist primarily evaluates X-rays and imaging studies, not directly involved in managing gynecological issues. A physiatrist is a specialist in physical medicine and rehabilitation, not related to gynecological concerns. An oncologist specializes in diagnosing and treating cancer, which is not the primary concern in this case of postmenopausal bleeding.

3. What is the primary focus of a case manager?

A. Addressing nursing care needs at discharge.
B. Managing the comprehensive care needs of the client for continuity of care.
C. Providing client education needs upon discharge.
D. Securing financial resources for needed care.

Correct answer: B

Rationale: The correct answer is 'Managing the comprehensive care needs of the client for continuity of care.' Case managers oversee all aspects of a client's care to ensure continuity throughout their healthcare journey. Choice A is incorrect as it focuses only on nursing care needs at discharge, which is just a part of the overall care needed. Choice C narrows down the focus to client education needs, excluding other essential care components. Choice D solely considers financial resources, neglecting the broader scope of care needs that a case manager is accountable for.

4. A nurse is preparing to screen a client's vision with the use of a Snellen chart. The nurse uses which technique?

A. Tests the right eye, then tests the left eye, and finally tests both eyes together
B. Assesses both eyes together, then assesses the right and left eyes separately
C. Asks the client to stand 40 feet from the chart and read the largest line on the chart
D. Asks the client to stand 40 feet from the chart and read the line that can be read 200 feet away by someone with unimpaired vision

Correct answer: A

Rationale: To test visual acuity with the use of a Snellen chart, the nurse places the chart in a well-lit spot at the client's eye level, with the client positioned exactly 20 feet from the chart. The client shields one eye at a time with an opaque card during the test. After testing each eye separately, both eyes are assessed together. The client is asked to read the smallest line of letters visible and encouraged to read the next smallest line as well. Therefore, option A is correct as it describes the correct technique of testing one eye at a time before assessing both eyes together. Option B is incorrect as it assesses both eyes together first, which is not the standard procedure. Options C and D are incorrect as they suggest standing 40 feet from the chart, which contradicts the standard distance of 20 feet for a Snellen chart test.

5. A nurse is interviewing an older adult while assisting with data collection. Which client comment regarding vision requires immediate discussion with the health care provider?

A. "If I go from a very bright room to a very dark room, I have some trouble adjusting."
B. "I have to hold my newspaper farther and farther away from me when I read."
C. "I have a little trouble telling if my same-colored shirts and blouses actually match; the colors seem the same to me."
D. "It looks like I have a blank spot in the middle of what I'm trying to see."

Correct answer: D

Rationale: The correct answer is "It looks like I have a blank spot in the middle of what I'm trying to see." Seeing blank spots in the middle of an object is a sign of central vision loss, which is a symptom of macular degeneration. Macular degeneration is a serious condition that requires immediate discussion with a healthcare provider to prevent further vision loss. Choice A, mentioning difficulty adjusting between bright and dark rooms, is a common issue related to changes in lighting and not a cause for immediate concern. Choice B, having to hold objects farther away when reading, is indicative of presbyopia, a normal age-related change in vision. Choice C, experiencing slight changes in color perception, is also a common age-related change and not an urgent issue that necessitates immediate discussion with a healthcare provider.