A charge nurse provides an annual in-service for the nursing staff regarding ethical practice. Which of the following actions should the nurse include as an example of ethical practice?
A nurse raises all four side rails on the bed of a client who is confused.
A nurse elects not to care for a client who had an abortion.
A nurse withholds nutrition from a client who has a do-not-resuscitate (DNR) order.
A nurse administers prescribed opioids to a client who has a terminal illness and respiratory rate of 8/min.
The Correct Answer is D
Choice A Reason:
Raising all four side rails on the bed of a confused client can be considered a form of restraint, which should be avoided unless necessary for the safety of the patient. It may infringe on the client's autonomy and dignity.
Choice B Reason:
Electing not to care for a client who had an abortion is discriminatory and violates the principle of nonmaleficence (doing no harm). Nurses have a professional obligation to provide care to all patients regardless of their personal beliefs or circumstances.
Choice C Reason:
Withholding nutrition from a client with a do-not-resuscitate (DNR) order without clear medical indications goes against the principle of beneficence and could be considered unethical. Nutritional support is a basic aspect of care that should not be withheld unless it is medically indicated or aligns with the patient's wishes.
Choice D Reason:
A nurse administers prescribed opioids to a client who has a terminal illness and respiratory rate of 8/min represents ethical practice because administering prescribed opioids to a client with a terminal illness and a respiratory rate of 8/min is appropriate and aligns with the principle of beneficence. The nurse's action aims to alleviate the client's pain and suffering, which is essential in end-of-life care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
White blood cell count (WBC) is incorrect. Melena, which is the passage of black, tarry stools, is typically associated with upper gastrointestinal bleeding rather than an infection. While changes in WBC count might occur in response to infection or inflammation, it is not the primary laboratory test to monitor in response to melena.
Choice B Reason:
Glucose is incorrect.
Glucose monitoring is important for assessing blood sugar levels, particularly in diabetic patients or those at risk of hypoglycemia or hyperglycemia. However, it is not directly related to the presence of melena, which indicates gastrointestinal bleeding.
Choice C Reason:
Blood urea nitrogen (BUN) is incorrect. Blood urea nitrogen (BUN) levels can indicate renal function and hydration status, but they are not specifically related to the presence of melena. Monitoring BUN may be relevant in other clinical contexts, such as assessing kidney function or dehydration, but it's not the primary laboratory test to monitor in response to melena.
Choice D Reason:
Hematocrit is correct. Melena indicates upper gastrointestinal bleeding, which can lead to a significant loss of blood. Monitoring the hematocrit level is crucial in this context because it helps assess the severity of bleeding and guide appropriate interventions such as blood transfusions if necessary. A decrease in hematocrit indicates a decrease in the volume of red blood cells, which reflects blood loss and the need for further evaluation and management.
Correct Answer is D
Explanation
Choice A Reason:
Having the client sign a consent for treatment is not appropriate. In emergency situations where a patient's life or health is in immediate danger, obtaining written consent may not be feasible or appropriate. The priority is to provide necessary medical treatment and stabilize the patient's condition. Consent may be obtained verbally if possible, but it should not delay urgent interventions.
Choice B Reason:
Contacting the client's next of kin to obtain consent for treatment is not appropriate. While it's important to involve the patient's family or next of kin in decision-making when possible, obtaining consent from them in an emergency may not be practical or timely. The focus should be on providing immediate medical care to stabilize the patient.
Choice C Reason:
Notifying risk management before initiating treatment is not appropriate. Risk management concerns are important in healthcare settings, but in emergency situations where a patient's life is at risk, the priority is to provide urgent medical care. Risk management can be addressed after the patient has been stabilized.
Choice D Reason:
Proceeding with treatment without obtaining written consent is appropriate. In emergency situations, healthcare providers have a duty to provide care without delay to stabilize the patient's condition. Written consent may be obtained later if the patient becomes stable or when circumstances allow. The primary focus is on providing necessary medical interventions to address the disorientation and cardiac arrhythmia.
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