A client, whose cancer is very advanced, has decided not to have surgery or chemotherapy. The nurse believes that, as a rule, everything possible should be done to preserve life. However, once the client has decided, the nurse supports the decision. Which ethical principle provides the best basis for the nurse's actions?

Justice

Nonmaleficence

Beneficence

Respect for autonomy

Answer and Explanation

The Correct Answer is D

A. Justice: Justice refers to fairness and equitable distribution of resources and treatment. While it is important in healthcare decision-making, it is not directly applicable in this scenario, where the focus is on respecting the client's autonomy in decision-making.

B. Nonmaleficence: Nonmaleficence is the principle of doing no harm. While it is essential for healthcare professionals to avoid causing harm to clients, it does not directly address the client's right to make autonomous decisions about their care.

C. Beneficence: Beneficence refers to the duty to do good and act in the best interest of the client. While it is important for nurses to promote the well-being of their clients, in this scenario, the client's autonomous decision not to undergo surgery or chemotherapy takes precedence over the nurse's desire to promote beneficence.

D. Respect for autonomy: This is the correct answer. Respect for autonomy is the ethical principle that recognizes individuals' right to make their own decisions and choices regarding their healthcare, based on their values, beliefs, and preferences. In this scenario, the nurse respects the client's autonomous decision not to pursue surgery or chemotherapy, even though it may conflict with the nurse's personal beliefs about preserving life.

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Correct Answer is B

Explanation

A. Use open-ended questions to find out about the sensation: While open-ended questions can help the nurse gather information about the nature and quality of the pain, they may not provide a precise measure of pain intensity. Open-ended questions are valuable for understanding the client's subjective experience of pain, but they may not be as effective as using a pain scale for quantifying pain intensity.

B. Offer the client a pain scale to quantify the current level of pain: This is the most appropriate action for assessing pain intensity. Pain scales, such as the Numeric Rating Scale (NRS) or Visual Analog Scale (VAS), allow clients to indicate their pain intensity on a scale from 0 to 10 or by marking a point along a continuum. Pain scales provide a standardized method for quantifying pain intensity, which helps healthcare providers monitor changes in pain over time and assess the effectiveness of pain management interventions.

C. Question the client about the location of the pain: While identifying the location of pain is important for understanding its source and potential underlying causes, it does not directly assess pain intensity. Location is one aspect of pain assessment but does not provide a complete picture of pain intensity on its own.

D. Ask about what precipitates the pain: Understanding what precipitates or exacerbates pain is important for comprehensive pain assessment, but it focuses more on pain triggers rather than pain intensity. While this information can be valuable for developing a holistic pain management plan, it does not directly assess the current level of pain intensity.

A. "How often do you punish him by giving him a time-out or by using physical discipline?" B. "Physical punishment is not the best way to modify a child's behavior." C. "It isn't unusual for him to fondle his genitals, as this is part of his exploration of his body." D. "Constantly touching the genitals indicates a urinary tract infection in a toddler." E. "Give him a little time, and he'll grow out of it. He's just too young to understand right now."

Correct Answer is ["B","C","E"]

Explanation

A. "How often do you punish him by giving him a time-out or by using physical discipline?": This response focuses on the mother's disciplinary methods rather than addressing the child's behavior directly. It may come across as judgmental or critical of the mother's parenting approach and does not provide helpful guidance or support.

B. "Physical punishment is not the best way to modify a child's behavior.": This response is appropriate because it addresses the mother's concern about punishment for the child's behavior. It educates the mother about the ineffectiveness and potential harm of physical punishment in modifying behavior. Instead, positive reinforcement, redirection, and open communication are recommended strategies for guiding children's behavior.

C. "It isn't unusual for him to fondle his genitals, as this is part of his exploration of his body.": This response normalizes the child's behavior of touching and playing with his genitals as part of natural childhood development. It reassures the mother that such behavior is common and not necessarily indicative of abnormality or misconduct. Education about normal childhood sexual development can alleviate parental concerns and promote understanding and acceptance.

D. "Constantly touching the genitals indicates a urinary tract infection in a toddler.": This response is incorrect and may unnecessarily alarm the mother. While frequent touching of the genitals could indicate discomfort or irritation associated with a urinary tract infection in a toddler, it is not the case for a 7-year-old child. Additionally, it is essential to avoid making medical diagnoses without proper assessment by a healthcare professional.

E. "Give him a little time, and he'll grow out of it. He's just too young to understand right now." This response acknowledges the child's developmental stage and suggests that the behavior is likely temporary and will naturally resolve as the child matures. It reassures the mother that the behavior is typical for a child of this age and may not require immediate intervention.

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Naxlex Comprehensive Predictor Exams

Which of the following is most appropriate when the nurse assesses the intensity of the client's pain?

Correct Answer is B

Explanation

The mother of a 7-year-old child is concerned that the child "touches and plays" with the genitals despite being punished for doing so. Which response should the nurse make to the mother? (SELECT ALL THAT APPLY)

Correct Answer is ["B","C","E"]

Explanation

When caring for a patient in pain, the most important principle that the nurse must recognize is that:

The nurse assesses a client admitted with a history of vomiting and diarrhea for 5 days. Which laboratory value validates the symptoms of the client?

The nurse must administer an enema to an adult patient with constipation. Which is a safe and effective distance for the nurse to insert the tubing into the patient's rectum? (SELECT ALL THAT APPLY)

The nurse is assessing a 66-year-old client who reports having a fever and feeling weak and dizzy with nausea and vomiting for three days. The nurse observes a dry tongue and oral mucosa, and concentrated urine. To best assess the client's fluid status, which parameter(s) should the nurse check?

The nurse receives an order for a medication that will assist the client at bedtime. The abbreviation for the best time to administer this medication is:

The client tells the nurse. "The need to urinate comes on me all of a sudden, and it feels as though I have to go immediately-that I can't wait." The nurse charts that the client is experiencing:

When assessing a client's sexuality, the nurse is aware that one's own personal values and attitudes:

The nurse understands that examples of sensible fluid loss in a client are: (SELECT ALL THAT APPLY)