A nurse is caring for a client who has refused medications. Which of the following actions should the nurse take? (Select all that apply.)

Document the client's statement in the medical record.

Reinforce teaching about the purposes of the medications.

Tell the client they can take their medications later in the day.

Record non administration in the client's medication administration record.

Inform the pharmacy the client's medications will be wasted.

Answer and Explanation

Correct Answer : A,B,D

A.   Document the client's statement in the medical record. Accurate documentation is essential to provide a complete record of the client's care and decisions.
B.   Reinforce teaching about the purposes of the medications. Providing information can help the client make informed decisions and reconsider their refusal.
C.   Tell the client they can take their medications later in the day. This may not be appropriate, depending on the medication schedule and therapeutic requirements.
D.   Record non-administration in the client's medication administration record (MAR). This ensures an accurate medication history and alerts other providers to the missed dose.
E.   Inform the pharmacy the client's medications will be wasted. Medications are not automatically wasted upon refusal; they can often be returned or rescheduled.

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Correct Answer is B

Explanation

A. Asking the client about the presence of pain. This is part of the assessment phase, as it involves gathering data.
B. Reinforcing teaching about the client's diagnosis. Teaching is part of the implementation phase, where planned interventions are carried out.
C. Establishing the priorities of client care. This is part of the planning phase, where care priorities are determined.
D. Comparing the client's current laboratory values to previous results. This is part of the evaluation phase, where the nurse assesses progress toward goals.

A. A nurse contacts a client's family member upon the client's request. B. A nurse returns to a client's room within a specified time frame. C. A nurse provides the same care to clients regardless of their socioeconomic status. D. A nurse reinforces education and evaluates a client's understanding. E. A nurse administers pain medication prior to ambulating a postoperative client.

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

Explanation

A. A nurse contacts a client's family member upon the client's request. Fidelity involves keeping promises or fulfilling client requests.
B. A nurse returns to a client's room within a specified time frame. Keeping a promise to return demonstrates fidelity.
C. A nurse provides the same care to clients regardless of their socioeconomic status. This exemplifies the ethical principle of justice, not fidelity.
D. A nurse reinforces education and evaluates a client's understanding. This reflects the ethical principle of beneficence (doing good) rather than fidelity.
E. A nurse administers pain medication prior to ambulating a postoperative client. Administering pain medication as promised demonstrates fidelity.

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A nurse is caring for a client who has refused medications. Which of the following actions should the nurse take? (Select all that apply.)

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