Examkin

Soru

Zorluk: Çok zorAdvance Directives and Informed Consent

An adult client with end-stage renal failure is admitted to a medical unit requiring emergent hemodialysis. The client's adult child, who is the designated durable power of attorney for healthcare (DPOAHC), is at the bedside. The healthcare provider explains the risks, benefits, and alternatives of central venous catheter placement to both individuals. The client, who is alert, oriented, and communicating clearly, explicitly refuses the procedure. The child insists the procedure is necessary, signs the informed consent document, and hands it to the practical nurse (PN). The provider asks the PN to sign the form as a witness.

Which action should the PN take?

  1. A
    Sign the document as requested to verify that the designated proxy voluntarily signed after receiving the provider's explanation.
  2. B
    Accept the provider's delegation to independently assess the client's cognitive capacity to refuse the emergent treatment.
  3. Decline to sign the document as a witness and notify the provider that the competent client's refusal supersedes the proxy's decision.Cevap
  4. D
    Re-explain the medical consequences of refusing the central venous catheter to the client before taking further action.

Cevap

Decline to sign the document as a witness and notify the provider that the competent client's refusal supersedes the proxy's decision.
The correct answer acknowledges that a Durable Power of Attorney for Healthcare is only invoked when a client is unable to make their own decisions. Because the client is alert and oriented, their refusal is legally binding. The practical nurse cannot witness a consent form signed by someone without active legal authority.

Adım Adım Çözüm

1
Evaluate the client's current cognitive status and legal capacity.
The client is alert, oriented, and clearly communicating their wishes.
A healthcare proxy (DPOAHC) only gains legal decision-making authority when the primary client is deemed incapacitated.
2
Determine the validity of the informed consent document.
The document signed by the child is legally invalid.
Because the client retains capacity, their explicit refusal of the procedure overrides any consent provided by family members or designated proxies.
3
Identify the appropriate scope of practice for the practical nurse (PN).
The PN must refuse to witness an invalid consent and must escalate the issue to the provider.
The PN's role is to ensure that the voluntary signature belongs to the legally authorized decision-maker without independently assessing capacity or explaining medical risks.

Anahtar Kavram

Advance Directives and Informed Consent
Bu soruyu puanla

Konular

Advance Directives and Informed Consent

Bu konudan daha fazla soru