An RN’s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN’s teaching to the client?

Correct Answer: C

Rationale: Let’s analyze each choice in detail to understand why **C** is correct and the others are not. **Choice C: A DNR order can be written after the health-care provider has discussed it with the client and family.** This is the correct answer because it accurately reflects the ethical and legal process of establishing a DNR order. A DNR (Do Not Resuscitate) order is a medical directive that prevents healthcare providers from performing CPR or other life-sustaining measures if the patient's heart stops or they stop breathing. The decision must involve **informed consent**, meaning the healthcare provider (physician, nurse practitioner, or other authorized professionals depending on jurisdiction) must discuss the implications, benefits, and risks with the patient (if competent) and/or their legal surrogate or family. This ensures the patient's autonomy and aligns with medical ethics, including respect for patient wishes and shared decision-making. **Why other choices are incorrect:** **Choice A: When a heart ceases to beat, the client is pronounced clinically dead.** This is incorrect because it misrepresents the definition of clinical death. Clinical death is determined by **irreversible cessation of circulatory and respiratory functions** *or* irreversible cessation of all brain activity (brain death). A stopped heartbeat alone does not always mean clinical death—CPR or defibrillation can sometimes restore circulation. Additionally, the question focuses on DNR discussions, not the criteria for declaring death. This choice is irrelevant to the client’s question about DNR orders. **Choice B: Physicians must write do not resuscitate (DNR) orders.** This is incorrect because it overgeneralizes who can write a DNR order. While physicians often write DNR orders, **other authorized healthcare providers** (such as nurse practitioners or physician assistants, depending on state or institutional policies) may also be legally permitted to do so. The key requirement is that the decision follows informed discussions with the patient/family, not strictly that a physician must be the one to document it. **Choice D: A DNR requires a court decision.** This is incorrect because DNR orders do not typically involve courts unless there is a **legal dispute** (e.g., family members disagreeing with the decision). Normally, DNR decisions are made by the healthcare team in collaboration with the patient or their legally designated decision-maker (e.g., healthcare proxy, next of kin). Courts only intervene in exceptional cases where conflicts arise or if the patient lacks decision-making capacity without a clear surrogate. Implying that a court must always be involved is misleading and could unnecessarily complicate the process for patients and families. **Summary:** The correct answer (**C**) emphasizes **patient-centered communication** and the legal-ethical process of DNR orders, while the incorrect choices either misrepresent medical definitions (A), oversimplify roles (B), or introduce unnecessary legal hurdles (D). Understanding these distinctions ensures accurate patient education and upholds ethical standards in end-of-life care.

Correct Answer: C

Rationale: A caring leader embodies traits such as respecting coworkers as unique individuals and showing empathy towards their needs and concerns. These qualities are essential for fostering a supportive and compassionate work environment, where team members feel valued and understood. Choice A is incorrect because a caring leader balances serving others with effective leadership, not prioritizing one over the other. Choice B, though important, focuses solely on recognizing emotions and does not encompass the broader traits of caring leadership. Choice D is also important but does not capture the essence of respecting individuals and empathizing with their needs, which are core aspects of caring leadership.

Correct Answer: D

Rationale: In today's healthcare environment, professionals require a diverse skill set to effectively navigate the complexities of patient care. Communication is fundamental for effective patient interactions, teamwork, and collaboration. Supervision and management skills are crucial for overseeing patient care and ensuring operational efficiency. Delegation is important for distributing tasks appropriately among team members. Therefore, all the skills mentioned (communication, supervision, management, and delegation) are essential for healthcare professionals in today's healthcare environment. The correct answer is 'All of the above' because all the skills listed are crucial and interlinked in providing high-quality patient care in the current healthcare setting. Choices A, B, and C are incorrect because each skill plays a vital role in the multifaceted responsibilities of healthcare professionals, and focusing on only one aspect would be limiting in today's dynamic healthcare landscape.

Correct Answer: B

Rationale: The correct answer is 'Functional.' In a functional structure, organizations group employees into departments based on specialty, where similar tasks are performed by the same group. In this scenario, the hospital organizing its departments by specialty such as nursing, dietary, and pharmacy aligns with the characteristics of a functional structure. Choice A, 'Parallel,' does not fit the scenario described; parallel structures involve separate, independent units operating in parallel with little interaction. Choice C, 'Service-integrated,' does not align with the scenario either as it involves integrating services across departments. Choice D, 'Matrix,' is not the correct answer as it involves a complex organizational structure where employees report to multiple managers simultaneously, which is not the case in the scenario provided.

Correct Answer: B

Rationale: A critical pathway should be revised when variances in the patient's progress indicate a new trend or deviation from the expected course of treatment. This allows healthcare providers to adjust the pathway to ensure optimal patient care and outcomes. Changes in the critical pathway are not typically driven by its length or external factors like team member retirements or client discharges. Therefore, the correct answer is B. Choice A is incorrect because the length of the critical pathway alone does not determine the need for revision. Choices C and D are irrelevant to the patient's progress and treatment plan, making them incorrect.