A nurse is caring for a client who is being treated for acute opioid toxicity. The client has a do-not-resuscitate (DNR) prescription, but the family would like to remove it. Which of the following responses should the nurse make?
"The care team will discuss how to change the DNR prescription."
"I will ask the client's provider to change the prescription."
"A family member can change a DNR prescription once it has been signed."
"These are the client's wishes, and we must respect them."
The Correct Answer is D
Rationale:
A. "The care team will discuss how to change the DNR prescription.": While discussions about code status may occur, the care team cannot override the client’s documented wishes. Focusing on changing the DNR for the family disregards the ethical and legal principle of patient autonomy.
B. "I will ask the client's provider to change the prescription.": The provider cannot unilaterally change a DNR order without the client’s consent. Doing so would violate the client’s legal rights and established advance directive.
C. "A family member can change a DNR prescription once it has been signed.": Only the client has the authority to modify or revoke a DNR unless the client is incapacitated and has legally designated a healthcare proxy. Family members do not have the right to override the client’s documented wishes arbitrarily.
D. "These are the client's wishes, and we must respect them.": The nurse’s response acknowledges the ethical and legal obligation to honor the client’s autonomy. DNR orders reflect the client’s informed decisions about life-sustaining treatments, which must be respected even if family members disagree.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Administer pancreatic enzymes with meals: Pancreatic enzymes are used to aid digestion in clients with pancreatic insufficiency, not for epiglottitis. This intervention is unrelated to the acute respiratory management required for this condition.
B. Carefully suction the child's oropharynx to remove secretions: Suctioning the oropharynx in a child with epiglottitis can trigger laryngospasm and complete airway obstruction. Suctioning should be avoided unless absolutely necessary and performed only by experienced personnel with emergency airway equipment ready.
C. Continuously monitor the child's respiratory status: Epiglottitis can rapidly progress to airway obstruction. Continuous assessment of respiratory rate, effort, oxygen saturation, and signs of distress is critical to detect deterioration early and initiate emergency interventions, making this a priority nursing action.
D. Instill normal saline drops to nares before meals: Nasal saline drops are used to relieve mild nasal congestion and facilitate feeding in children but do not address the life-threatening airway risk in epiglottitis. This is a supportive measure, not a priority intervention.
Correct Answer is C
Explanation
Rationale:
A. Decide which clients should be transported for a higher level of care: Determining transport priorities is usually the responsibility of the incident command or emergency response team, not individual unit nurses. Unit nurses provide patient assessments and recommendations but do not independently make these critical decisions.
B. Act as a spokesperson to provide information to the media: Communication with the media is handled by designated hospital public relations or administration personnel to ensure consistent and accurate information. Unit nurses are not responsible for media interactions during a disaster.
C. Recommend to the provider a list of clients for early discharge: Unit nurses are familiar with clients’ conditions, stability, and care needs, making them well-suited to recommend which clients can be safely discharged early. This helps prioritize resources and bed availability during a disaster while maintaining patient safety.
D. Determine the need for additional providers: Assessing staffing needs is the responsibility of the nurse manager or disaster coordinator. Unit nurses provide information about patient care demands but do not make staffing deployment decisions during an emergency.
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