A nurse is caring for a client who has made the decision to refuse treatment. Which of the following ethical principles is demonstrated when the nurse respects the client's decision?

Beneficence

Autonomy

Nonmaleficence

Justice

Answer and Explanation

The Correct Answer is B

A. Beneficence: Beneficence refers to the ethical principle of promoting good and acting in the best interest of the client. While this guides nursing actions to provide beneficial care, it does not directly involve respecting a client’s decision to refuse treatment.

B. Autonomy: Autonomy is the ethical principle that recognizes the client’s right to make independent decisions about their own healthcare. Respecting the client’s decision to refuse treatment honors their personal values, beliefs, and right to self-determination, even if the nurse disagrees with the choice.

C. Nonmaleficence: Nonmaleficence involves the obligation to avoid causing harm to the client. While important in all nursing actions, it focuses on preventing harm rather than specifically supporting a client’s right to make healthcare decisions.

D. Justice: Justice refers to fairness in the distribution of healthcare resources and treatment. It ensures equitable care for all clients but is not directly related to respecting an individual client’s choice to accept or refuse treatment.

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Free Nursing Study Resources

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

Explanation

A. Headache: Disulfiram causes an aversive reaction when alcohol is consumed, leading to vasodilation and increased acetaldehyde levels. This often results in a severe, throbbing headache as one of the earliest and most common manifestations. The symptom appears quickly after alcohol intake and signals a disulfiram–alcohol interaction.

B. Vomiting: Accumulation of acetaldehyde triggers gastrointestinal distress, including nausea and profuse vomiting. These symptoms occur because the body is unable to metabolize alcohol properly while on disulfiram. Vomiting is a classic indicator that alcohol was consumed after starting therapy.

C. Confusion: Neurological effects such as confusion can develop during a disulfiram–alcohol reaction due to hypotension, decreased cerebral perfusion, and heightened toxin buildup. This change in mental status is especially concerning and suggests significant physiological stress after alcohol ingestion.

D. Sedation: Sedation is not a typical effect of a disulfiram–alcohol reaction. It is more commonly associated with other CNS depressants or alcohol intoxication alone. Because it does not reflect the vasodilatory or metabolic effects produced by disulfiram, it is not a reliable indicator of concurrent alcohol use.

E. Sweating: Sweating results from the sympathetic surge that occurs when acetaldehyde levels rise during a disulfiram–alcohol reaction. Clients may experience flushing, tachycardia, and diaphoresis as part of the acute response. This strongly supports that alcohol was consumed while taking disulfiram.

A. Urine protein B. Report of headache C. Urine ketones D. Fetal activity E. Blood pressure

Correct Answer is ["A","B","D","E"]

Explanation

A. Urine protein: The presence of 3+ protein in the urine is abnormal and indicates significant proteinuria, which is a key sign of preeclampsia. Monitoring protein levels is essential for detecting kidney involvement and assessing maternal and fetal risk.

B. Report of headache: A severe headache unrelieved by acetaminophen in a pregnant client with elevated blood pressure is a concerning symptom of preeclampsia. It can indicate cerebral involvement and increased risk for complications such as eclampsia or stroke.

D. Fetal activity: Decreased fetal movement is an important sign of potential fetal compromise. Reduced activity may indicate fetal distress or hypoxia, requiring prompt assessment and possible intervention.

E. Blood pressure: A blood pressure reading of 162/112 mm Hg is significantly elevated and meets criteria for severe preeclampsia. Hypertension during pregnancy can lead to maternal and fetal complications, making this a critical finding to address immediately.

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A nurse is caring for a client who has made the decision to refuse treatment. Which of the following ethical principles is demonstrated when the nurse respects the client's decision?

Nursing Test Bank

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Correct Answer is ["A","B","D","E"]

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