A nurse is caring for a client who is seeking information about end-of-life decisions. According to the Patient Self-Determination Act, which of the following applies to medical decisions that can be made within organizations that receive Medicare and Medicaid reimbursements?

Rationale: A. The person holding financial power of attorney will make health care decisions based on the client's advance directives: A financial power of attorney manages financial matters, not health care decisions. A separate designation such as a health care proxy or medical power of attorney is needed for making medical decisions. B. The client has the right to refuse medical treatment, even if health care providers recommend it: Under the Patient Self-Determination Act (PSDA), clients have the legal right to make autonomous decisions about their care, including the right to refuse or discontinue treatment, regardless of medical advice. C. The client's eldest adult child has the right to change advance directives in an end-of-life situation: Advance directives reflect the client’s own decisions. No family member, regardless of birth order, has the legal authority to change them unless specifically authorized as a health care proxy and even then, only if the client is incapacitated. D. If the client's advance directives are in writing and notarized, the client cannot change it in the future: Clients can revise or revoke advance directives at any time, as long as they remain mentally competent. Notarization does not make the document legally fixed or unchangeable.