The nurse should encourage the spouse to communicate with the client about their preferences for end-of-life care, and express their love and support. This can help the client feel more comfortable and respected, and reduce the risk of conflicts or regrets later on.

Answer A is incorrect because it does not respect the client's autonomy or right to make informed decisions about their own care.

Answer C is incorrect because it may delay or prevent important conversations that need to happen before the client's condition worsens.

Answer D is incorrect because it violates the client's legal and ethical rights, and may cause resentment or anger from the client.

The nurse should document the client's decision in the medical record and notify the health care team, as this is part of their professional responsibility and legal obligation. The nurse should also respect and support the client's autonomy and right to self-determination, even if it differs from their own or their family's values or beliefs.

Answer A is incorrect because it may cause conflict or distress for both the client and their family, and it is not within the nurse's scope of practice to mediate such issues.

Answer C is incorrect because it may imply that the nurse does not respect or accept the client's decision, and it may interfere with their dignity or quality of life.

Answer D is incorrect because it may suggest that the nurse thinks that there is something wrong with the client's decision, or that they need to be convinced otherwise.

Advance care planning can be revised or updated at any time by the client or their designated surrogate, as long as they have decision-making capacity and communicate their wishes clearly. This allows for flexibility and adaptation to changing circumstances or preferences.

Answer A is incorrect because advance care planning is recommended for all adults, regardless of their health status or prognosis, as it can help them prepare for future situations and ensure that their values and goals are respected.

Answer B is incorrect because advance care planning involves more than just making decisions about life-sustaining treatments and organ donation; it also includes expressing one's values, beliefs, preferences, fears, hopes, and expectations for end-of-life care, as well as identifying a surrogate decision-maker and communicating with one's family and health care team.

Answer C is incorrect because advance care planning does not require a written document, although it is advisable to have one; it can also be done verbally or through other means, such as videos or audio recordings.

The nurse should acknowledge the client's decision and express empathy and understanding, without imposing their own values or judgments. The nurse should also explore the client's reasons, feelings, concerns, and expectations for having a PAD, and provide information, education, and support as needed.

Answer A is incorrect because it may make the client feel rejected, guilty, or ashamed, and it does not address the client's needs or concerns.

Answer C is incorrect because it may make the client feel invalidated, stigmatized, or patronized, and it does not respect the client's autonomy or dignity.

Answer D is incorrect because it may make the client feel abandoned, isolated, or betrayed, and it does not facilitate communication or continuity of care.

The nurse should inform the health care provider of the discrepancy between the client's advance directive and the spouse's consent, and request clarification on how to proceed. The health care provider should then discuss the situation with the spouse and explain their role and responsibilities as a surrogate decision-maker, as well as the benefits and burdens of dialysis for the client. The health care provider should also try to resolve any conflicts or misunderstandings that may exist between the client's wishes and the spouse's beliefs or values.

Answer A is incorrect because it does not respect the client's advance directive or their right to self-determination, and it may cause harm or suffering to the client.

Answer B is incorrect because it may delay or complicate the decision-making process, and it may not be necessary unless there is a serious ethical dilemma or legal dispute that cannot be resolved by other means.

Answer C is incorrect because it is not within the nurse's scope of practice to educate or persuade the spouse about the client's advance directive or its implications; this should be done by the health care provider or another qualified professional.

The nurse should explore the reasons for the family's reluctance and provide education and support, as this can help address their concerns and fears, and facilitate decision-making that respects the client's wishes and values. The nurse should also inform the family about the availability and benefits of home hospice care, which can provide medical, nursing, social, spiritual, and bereavement services for the client and the family at home.

Incorrect answers:

A) The nurse should not respect the client's wish and arrange for home hospice care without involving the family in the decision, as this may cause conflict and resentment among the family members, and compromise the quality of care and comfort for the client. The nurse should respect the client's autonomy, but also consider the family's perspectives and needs, and promote effective communication and collaboration among all parties.

C) The nurse should not suggest a compromise and recommend a palliative care unit in a hospital or facility without exploring the client's preferences and goals of care, as this may disregard

the client's autonomy and dignity. The nurse should respect the client's wish to die at home, unless there are compelling reasons to suggest otherwise, such as safety issues or lack of resources.

D) The nurse should not refer the client and the family to a social worker or a chaplain for counseling without first assessing their needs and preferences, as this may imply that the nurse is avoiding or delegating the issue, or imposing unwanted services on them. The nurse should provide emotional support and reassurance to the client and the family, and offer referrals to other professionals or resources as appropriate.

T

he nurse should initiate antibiotic therapy as prescribed for a client who has COPD and develops signs of a respiratory infection, such as fever, productive cough, and increased dyspnea. Antibiotics can help treat the infection and prevent complications such as sepsis or respiratory failure.

Incorrect answers:

A) The nurse should not obtain a sputum culture and sensitivity test for a client who has COPD and develops signs of a respiratory infection, as this is not necessary or appropriate in palliative care. The goal of palliative care is to relieve symptoms and improve quality of life, not to diagnose or cure diseases. A sputum culture and sensitivity test may cause discomfort or distress for

the client, and delay treatment.

B) The nurse should not administer acetaminophen as prescribed for a client who has COPD

and develops signs of a respiratory infection, as this is not sufficient or effective in managing

the condition. Acetaminophen may help reduce fever, but it does not address the underlying cause of infection or relieve other symptoms such as cough or dyspnea.

D) The nurse should not increase fluid intake as tolerated for a client who has COPD and develops signs of a respiratory infection, as this may worsen dyspnea or cause fluid overload. Fluid intake should be individualized