A facility provides annual staff education regarding ethical practice. A charge nurse recognizes a need for further education when which of the following behaviors is observed?
A nurse refuses to actively participate during an elective abortion procedure scheduled for their client
A nurse explains to a client's family that a DNR order includes withholding comfort measures
A nurse informs a confused client who wants to go home that they are going to stay at the facility until they are better
A nurse gives prescribed opioids to a client who has a terminal illness and respirations of 8/min
The Correct Answer is B
Choice A reason: A nurse refusing to actively participate during an elective abortion procedure scheduled for their client is not a behavior that indicates a need for further education. The nurse has the right to conscientious objection, which means they can decline to perform or assist in a procedure that violates their moral or religious beliefs. The nurse should inform the charge nurse of their objection and request to be reassigned to another client.
Choice B reason: A nurse explaining to a client's family that a DNR order includes withholding comfort measures is a behavior that indicates a need for further education. The nurse is providing false and misleading information that can cause harm and distress to the client and the family. A DNR order only means that no cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS) will be initiated in the event of a cardiac or respiratory arrest. A DNR order does not affect the provision of other treatments, such as pain management, hydration, nutrition, oxygen, or emotional support.
Choice C reason: A nurse informing a confused client who wants to go home that they are going to stay at the facility until they are better is not a behavior that indicates a need for further education. The nurse is using therapeutic communication and providing reassurance to the client. The nurse is also respecting the client's autonomy and right to refuse treatment, as long as the client is competent and informed. The nurse should assess the client's mental status and decision-making capacity, and involve the client's family or surrogate decision-maker if needed.
Choice D reason: A nurse giving prescribed opioids to a client who has a terminal illness and respirations of 8/min is not a behavior that indicates a need for further education. The nurse is following the principle of beneficence, which means doing good and preventing harm to the client. The nurse is also following the principle of double effect, which means that an action that has both a good and a bad effect is morally permissible if the good effect outweighs the bad effect. The nurse is providing adequate pain relief to the client, even if it may hasten their death. The nurse should monitor the client's vital signs and level of consciousness, and adjust the opioid dose as prescribed.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Purchasing primary tubing for IV therapy is not a cost-effective client care task, as it involves spending money on supplies that may not be necessary or appropriate for every client. The nurse should recommend using secondary tubing or changing the primary tubing according to the facility's policy and the client's condition.
Choice B reason: Implementing a fall prevention program is a cost-effective client care task, as it can prevent injuries, complications, and lawsuits that can result from client falls. The nurse should recommend using evidence-based strategies, such as assessing the client's fall risk, providing appropriate supervision and assistance, and using safety devices and alarms.
Choice C reason: Providing staff education on infection control is not a cost-effective client care task, as it involves investing time and resources on training that may not have a direct impact on the client's outcomes. The nurse should recommend following the standard precautions and the facility's protocol for infection prevention and control.
Choice D reason: Hiring a wound care specialist is not a cost-effective client care task, as it involves paying for an additional staff member who may not be needed or utilized for every client. The nurse should recommend providing wound care according to the provider's orders and the facility's guidelines, and consulting a wound care specialist only when necessary.
Correct Answer is C
Explanation
Choice A reason: The partner does not have the legal authority to make the care decision for the client, unless they are designated as the health care proxy or surrogate. The partner may have a personal or emotional interest in the client's well-being, but they cannot override the client's wishes or rights.
Choice B reason: The oldest adult child does not have the legal authority to make the care decision for the client, even though they have durable power of attorney. The durable power of attorney only becomes effective when the client is incapacitated or unable to make their own decisions. Since the client is oriented to person, place, and time, they are presumed to have the mental capacity to consent or refuse treatment.
Choice C reason: The client has the legal authority to make the care decision for themselves, as long as they are competent and informed. The client has the right to self-determination and autonomy, which means they can choose what is best for their own health and well-being. The client's decision should be respected and honored by the provider and the family members.
Choice D reason: The provider does not have the legal authority to make the care decision for the client, unless there is an emergency or a court order. The provider has the duty to inform the client of the benefits and risks of the surgery, and to obtain the client's consent before proceeding. The provider cannot coerce or force the client to undergo the surgery against their will.
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