A nurse is caring for a client who is comatose and has advance directives that indicate the client does not want life-sustaining measures. The client's family wants the client to have life-sustaining measures. Which of the following actions should the nurse take?
Arrange for an ethics committee meeting to address the family's concerns.
Complete an incident report.
Support the family's decision and initiate life-sustaining measures.
Encourage the family to contact an attorney.
The Correct Answer is A
A. Arrange for an ethics committee meeting to address the family's concerns. An ethics committee can provide guidance in situations where there is conflict between advance directives and family wishes. This supports ethical decision-making while honoring the client’s autonomy and legal rights.
B. Complete an incident report. An incident report is used for errors or unusual events, not ethical dilemmas or conflicts over advance directives. It is not appropriate in this scenario.
C. Support the family's decision and initiate life-sustaining measures. The nurse is legally and ethically bound to follow the client’s advance directives, not the family’s wishes, especially when the client’s decisions are documented and clear.
D. Encourage the family to contact an attorney. While families have legal rights, referring them directly to an attorney does not address the immediate ethical issue or facilitate collaborative resolution in the care setting.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "The proxy should manage legal issues for the client." Legal matters are outside the scope of a health care proxy’s role. The proxy is authorized only to make medical decisions and does not handle legal or court-related concerns on behalf of the client.
B. "The proxy can make treatment decisions if the client is under anesthesia." The health care proxy is activated when the client is temporarily or permanently incapacitated, such as during surgery under anesthesia. At that point, the proxy can make treatment decisions aligned with the client’s values and previously expressed wishes.
C. "The proxy can make financial decisions if the need arises." Financial decisions are the responsibility of a financial power of attorney, not a health care proxy. A DPAHC limits the proxy’s authority strictly to medical and treatment-related decisions.
D. "The proxy should make health care decisions for the client regardless of the client's ability to do so." The health care proxy is not active while the client is competent and able to make decisions. The proxy only assumes responsibility when the client lacks decision-making capacity due to illness, unconsciousness, or cognitive impairment.
Correct Answer is D
Explanation
A. Naltrexone. This medication is used for opioid and alcohol use disorders. It helps reduce cravings and the pleasurable effects of those substances but is not indicated for smoking cessation.
B. Chlordiazepoxide. This is a benzodiazepine used to manage alcohol withdrawal symptoms, such as anxiety, tremors, and agitation. It is not appropriate for treating nicotine dependence.
C. Clonidine. Although primarily used for hypertension, clonidine has been used off-label to manage symptoms of opioid or nicotine withdrawal. However, it is not the first-line agent for smoking cessation.
D. Bupropion. This is an antidepressant also approved for smoking cessation. It helps reduce nicotine cravings and withdrawal symptoms and is often prescribed under the brand name Zyban for this purpose.
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