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. Serum osmolarity B. Urinary output C. Insensible fluid loss D. Blood pressure

Correct Answer is B

Explanation

When a client experiences increased production of antidiuretic hormone (ADH) and aldosterone due to extreme stress, the body's response is aimed at retaining fluid to maintain blood pressure and hydration. As a result, urinary output decreases because the kidneys retain more water, leading to concentrated urine production. This decrease in urinary output helps conserve fluids and contributes to maintaining blood pressure and hydration levels in response to stress.

A. Serum osmolarity: With increased ADH production, serum osmolarity tends to remain stable or may even increase slightly due to the retention of water. ADH acts on the kidneys to increase water reabsorption, which can concentrate the blood and elevate serum osmolarity.

B. Urinary output: Increased production of ADH and aldosterone leads to decreased urinary output as the kidneys retain more water. This response helps conserve fluid volume and maintain hydration during times of stress.

C. Insensible fluid loss: Insensible fluid loss, which includes water lost through respiration and skin evaporation, is not directly affected by ADH and aldosterone. These hormones primarily influence renal water retention rather than insensible fluid loss.

D. Blood pressure: Although aldosterone can indirectly affect blood pressure by increasing sodium retention and therefore influencing fluid balance, its primary role is to regulate sodium and potassium levels. Blood pressure may be influenced by various factors, including stress, hydration status, and cardiovascular health, but it is not directly decreased as a result of increased ADH and aldosterone production.

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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

A client who is under extreme stress will have an increased production of antidiuretic hormone (ADH) and aldosterone. The nurse should expect a decrease in which clinical finding?

Correct Answer is B

Explanation

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