In most states, directives to physicians, durable power of attorney for health care, and medical power of attorney are included in which legal documents?

Correct Answer: C

Rationale: In this case, the correct answer is C) Advance care planning. Advance care planning is a process that involves making decisions about the medical care a person would want to receive if they become unable to make their own decisions. Directives to physicians, durable power of attorney for health care, and medical power of attorney are legal documents that are typically included in advance care planning. Option A) Natural death acts and B) Allow natural death are related to end-of-life care but do not specifically include directives to physicians or powers of attorney. Option D) Do Not Resuscitate order is a specific medical order related to resuscitation preferences but does not encompass the broader scope of medical decision-making covered by advance care planning. Understanding legal documents related to healthcare decision-making is crucial for healthcare professionals to ensure they respect patients' autonomy and provide care that aligns with their wishes. By knowing the components of advance care planning, healthcare providers can better support patients in making informed decisions about their treatment preferences and end-of-life care.

Correct Answer: B

Rationale: In this scenario, Mary is displaying symptoms of mania, which can be induced by antidepressants like fluoxetine in individuals with bipolar disorder. The correct answer is to start a mood stabilizer because Mary's symptoms suggest a switch from depression to a manic state. Mood stabilizers are essential in managing manic episodes to prevent potential harm and stabilize mood fluctuations. Option A is incorrect because continuing the selective serotonin reuptake inhibitor can exacerbate Mary's manic symptoms. Switching to a tricyclic antidepressant (Option C) is not recommended as they can also induce manic episodes. Adding a monoamine oxidase inhibitor (Option D) is not the best choice as it can worsen mania. Educationally, this question highlights the importance of recognizing and managing manic symptoms induced by antidepressants, especially in individuals with bipolar disorder. Understanding the need for mood stabilizers in such cases is crucial for safe and effective patient care.

Correct Answer: A

Rationale: The correct answer is option A) Develop a method of communication. The priority intervention for a patient diagnosed with advanced ALS is to ensure effective communication. ALS is a progressive neurodegenerative disease that affects motor neurons, eventually leading to muscle weakness and paralysis. As the disease progresses, the patient may lose the ability to speak, swallow, and move. Therefore, developing a communication method is crucial to understanding the patient's needs, preferences, and concerns. Option B) Provide six small meals high in protein and assist with feeding is incorrect because although nutrition is important in ALS, communication takes precedence as the priority intervention. Option C) Do not involve the patient in decisions about his healthcare because he is not in the mental state to respond is incorrect and goes against patient-centered care principles. Patients with ALS maintain their mental capacities even as their physical abilities decline, and it is important to involve them in decisions about their care whenever possible. Option D) Provide six normal meals high in protein and assist with feeding is incorrect as it does not address the immediate priority of communication to understand the patient's needs and preferences. In an educational context, this question highlights the importance of prioritizing interventions based on the patient's immediate needs and the progressive nature of ALS. Effective communication is essential in providing holistic care to patients with ALS, ensuring their dignity, autonomy, and quality of life are maintained.

Correct Answer: C

Rationale: The correct answer is C) Ulcerative colitis. Ulcerative colitis is an inflammatory bowel disease that primarily affects the colon and rectum. It presents with symptoms such as abdominal pain, bloody diarrhea, tenesmus, and weight loss. This is because the inflammation in ulcerative colitis is continuous and affects the innermost lining of the colon. Option A) Crohn's disease is incorrect because while it is also an inflammatory bowel disease, it can affect any part of the digestive tract from mouth to anus, not just the colon and rectum. Option B) Diverticulitis is characterized by inflammation or infection of small pouches that can develop in the walls of the colon, leading to symptoms like abdominal pain and fever, but not typically bloody diarrhea. Option D) Appendicitis is the inflammation of the appendix and presents with symptoms such as right lower quadrant abdominal pain, nausea, and fever, but not typically bloody diarrhea or weight loss. Understanding the key differences between these conditions is crucial for healthcare professionals to make accurate diagnoses and provide appropriate treatments. This knowledge helps in delivering quality patient care and improving patient outcomes in medical-surgical settings.

Correct Answer: C

Rationale: In the case of idiopathic thrombocytopenic purpura (ITP), the correct answer is C) Platelet count and RBC. This is because ITP is characterized by a low platelet count, which significantly increases the risk of bleeding in affected individuals. Monitoring platelet count is crucial in assessing the severity of thrombocytopenia and guiding treatment decisions to prevent bleeding complications. Monitoring red blood cells (RBC) is also important as chronic bleeding can lead to anemia in patients with ITP. Option A) WBC and bleeding time is incorrect because ITP primarily affects platelets, not white blood cells. Bleeding time may be prolonged in ITP due to low platelet count, but monitoring platelet count directly is more specific. Option B) Prothrombin time (PT) and partial thromboplastin time (PTT) are coagulation tests that assess the clotting function of plasma factors, which are not directly affected in ITP. Monitoring these parameters would not provide information specific to platelet function. Option D) Iron and ferritin levels are indicators of iron stores in the body and are not directly related to the risk of bleeding in ITP. While chronic bleeding can lead to iron deficiency anemia, monitoring platelet count and RBC are more directly relevant in managing ITP. In an educational context, understanding the rationale behind monitoring specific parameters in different medical conditions is crucial for providing effective patient care. By emphasizing the importance of monitoring platelet count and RBC in ITP, healthcare providers can make informed decisions to optimize patient outcomes and prevent complications related to thrombocytopenia.