A nurse is assisting in the care of a client who has terminal cancer. Which of the following actions should the nurse take to promote the client's autonomy?
Be honest with the client about their prognosis.
Include the client's input when setting treatment goals.
Keep an agreement made with the client to administer an antiemetic medication
Administer pain medication to the client on a routine schedule.
The Correct Answer is B
A. Be honest with the client about their prognosis: Honesty is essential for building trust but does not alone promote autonomy. Autonomy specifically involves allowing the client to make informed decisions about their own care based on truthful information.
B. Include the client's input when setting treatment goals: Including the client’s input directly supports their autonomy by allowing them to actively participate in decisions about their care, treatments, and end-of-life goals, ensuring their personal values and wishes are respected.
C. Keep an agreement made with the client to administer an antiemetic medication: Honoring agreements builds trust and supports ethical practice but focuses more on fidelity than directly on promoting autonomy, which centers on the client’s decision-making role.
D. Administer pain medication to the client on a routine schedule: Providing pain management is important for comfort but does not by itself promote autonomy unless it involves client participation in deciding how and when the medication is administered.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Monitor the client for 1 hr after meals: Clients with anorexia nervosa are at high risk for purging behaviors such as vomiting or excessive exercise after meals. Monitoring them for at least 1 hour post-meal helps prevent these behaviors and supports the therapeutic goal of safe weight restoration.
B. Allow the client 2 hr to finish meals: Allowing 2 hours to complete meals is too long and may encourage food avoidance behaviors. Structured meal times with limits (usually around 30 to 45 minutes) are important to establish routine eating habits and prevent manipulation of eating times.
C. Weigh the client every 2 days: Clients with anorexia nervosa are typically weighed daily, often at the same time each morning, to closely monitor weight trends and assess the effectiveness of the treatment plan. Monitoring every 2 days may miss rapid changes that require immediate intervention.
D. Check the client's vital signs two times per week: Vital signs should be checked daily in clients with anorexia nervosa, especially early in treatment, because of the risks of bradycardia, hypotension, and hypothermia. Infrequent monitoring can delay recognition of life-threatening physiological instability.
Correct Answer is D
Explanation
A. Provide the client with low-calorie formula: The calorie content of the formula is not typically responsible for diarrhea. Diarrhea is more often related to formula intolerance, contamination, or rapid feeding rates rather than calorie density.
B. Increase the rate of the client's feeding: Increasing the rate can worsen diarrhea by overwhelming the gastrointestinal system, leading to poor absorption and increased fluid loss. Slower rates are often needed if diarrhea occurs.
C. Switch the client to a formula containing less protein: Protein content is usually not the cause of diarrhea. Specialized formulas may be needed for certain conditions, but protein itself is not typically a trigger for diarrhea.
D. Administer the client's formula at room temperature: Cold formula can cause gastric cramping and diarrhea. Administering the formula at room temperature helps reduce gastrointestinal irritation and promotes better tolerance of the feeding.
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