A 68-year-old client with newly diagnosed metastatic cancer is admitted to the medical-surgical unit. The client is alert, oriented, and fully decisional. During the admission process, the client asks the nurse to explain advance directive documents before signing them. Which explanations by the nurse are accurate? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
The nurse should explain that a health care proxy can use the client's known values when a living will does not anticipate a specific situation (Choice 1), that a living will records treatment preferences for periods of incapacity (Choice 2), and that a client with decisional capacity may revise or revoke the directive (Choice 5). A capable client does not need a proxy to co-sign treatment decisions (Choice 3). The only signed copy should not be confined to one hospital record (Choice 4), and financial power of attorney does not automatically include health care authority (Choice 6).
Clinical Reasoning The nurse should explain that a health care proxy can use the client's known values when a living will does not anticipate a specific situation (Choice 1), that a living will records treatment preferences for periods of incapacity (Choice 2), and that a client with decisional capacity may revise or revoke the directive (Choice 5). A capable client does not need a proxy to co-sign treatment decisions (Choice 3). The only signed copy should not be confined to one hospital record (Choice 4), and financial power of attorney does not automatically include health care authority (Choice 6).
Option Review
Correct — A designated health care proxy can apply the client's known goals and values when an unanticipated clinical decision is not specifically addressed in the living will.
Correct — A living will records treatment preferences for circumstances in which the client cannot communicate or make decisions.
Incorrect — A client who has decisional capacity makes and authorizes the client's own treatment decisions; proxy co-signature is not required to make them effective.
Incorrect — Copies should be available to the proxy, relevant clinicians, and others identified by the client so the directive can be accessed across care settings; one hospital copy is not sufficient.
Correct — A client with decisional capacity may revise or revoke an advance directive according to applicable law and facility procedure.
Incorrect — Financial and health care powers of attorney grant different authority. A financial appointment does not automatically authorize health care decisions.
Sources
12026 NCLEX-RN Test Plan
2NIA: Advance care planning and advance directives
A 68-year-old client with newly diagnosed metastatic cancer is admitted to the medical-surgical unit and asks the nurse to explain advance directive documents before signing them.