A nurse is caring a client who is unconscious and whose partner is their health care surrogate. The partner wishes to discontinue the client’s feeding tube, but another family member tells the nurse that they want the client to continue receiving treatment. Which of the following responses should the nurse make?
“You should contact the provider about your wishes to your family member.”
“You should speak with the facility’s ethics committee about your concerns.”
“We’ll need to have the nursing supervisor review the client’s advance directives.”
“As the health care surrogate, the client’s partner can make this decision.”
The Correct Answer is D
a. "You should contact the provider about your wishes for your family member."
While the provider may ultimately be involved in decision-making, it's important for the nurse to address the conflicting wishes and provide guidance on the appropriate steps to take in such situations.
b. "You should speak with the facility’s ethics committee about your concerns."
In cases of conflicting wishes or ethical dilemmas, involving the ethics committee can be beneficial. However, this response might not address the immediate need for clarification and guidance.
c. "We’ll need to have the nursing supervisor review the client’s advance directives."
Reviewing advance directives with the nursing supervisor is a reasonable step to ensure that the client's wishes are documented and followed. However, it might not directly address the conflicting wishes or provide immediate resolution.
d. "As the health care surrogate, the client’s partner can make this decision."
This is the correct response. The health care surrogate, appointed by the client or legally recognized as such, has the authority to make medical decisions on behalf of the unconscious client. It's important to follow the client's advance directives and legal designations regarding
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
a. A visitor experiences a minor burn after spilling coffee:
This situation does not present an ethical dilemma. It is a minor accident that can be addressed through appropriate first aid and safety measures.
b. A parent wants her 14-year-old adolescent to receive radiation treatment against his will:
This situation involves a conflict between parental authority and the autonomy of the adolescent. It raises questions about the adolescent's capacity to make medical decisions, the role of parental consent, and the rights of the adolescent to refuse treatment. Therefore, it represents an ethical dilemma.
c. A nurse witnesses another nurse administer an incorrect medication:
While this situation involves patient safety and professional responsibility, it does not inherently pose an ethical dilemma. It is a matter of patient safety and adherence to professional standards rather than conflicting moral principles.
d. A client receives an operation on the wrong side of her body:
This situation represents a serious medical error and a violation of patient safety protocols. While it may have ethical implications related to accountability, negligence, and patient harm, it primarily involves issues of medical error rather than a true ethical dilemma.
Correct Answer is A
Explanation
A. Continue the medication dosages that relieve the client’s pain:
Opioids and benzodiazepines are commonly used for pain and anxiety management in terminally ill patients. Somnolence is an expected side effect and does not necessarily warrant withholding medication unless the client shows signs of respiratory depression.
B. Contact the provider about replacing the opioid with an NSAID: NSAIDs are not sufficient for severe pain in terminal illness. Opioids are the gold standard for palliative pain management, and switching to an NSAID would likely lead to uncontrolled pain and unnecessary suffering.
C. Administer the benzodiazepine but withhold the opioid: This would leave the client in severe pain, which is unethical in hospice care. Pain relief should not be withheld solely due to sedation.
D. Withhold the benzodiazepine but continue the opioid: Benzodiazepines are often used to relieve anxiety, dyspnea, and agitation in end-of-life care. Withholding it could cause increased distress for the client. Instead of discontinuing the medication, the nurse should monitor for respiratory depression and adjust doses only if necessary.
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