A nurse is caring for a client who is comatose. The client has a living will that declines the use of artificial enteral nutrition as a life-sustaining measure, but the client's family has requested that the staff begin tube feedings. Which of the following actions should the nurse take?
Insert the tube and begin feedings per the family's request.
Ask the provider to discuss the issue with the family.
Report the dilemma to the facility's dietitian.
Review the client's request with the family.
The Correct Answer is D
The correct answer is Choice D: Review the client's request with the family.
Choice D rationale: Reviewing the client's request with the family respects the client's autonomy and the directives stated in their living will. It allows the nurse to communicate and clarify the client's wishes with the family, helping them understand the decisions made by the client when they were competent. This action promotes open communication and may facilitate resolution of the conflict.
Choice A rationale: Inserting the tube and beginning feedings per the family's request disregards the client's living will, which explicitly declines the use of artificial enteral nutrition as a life-sustaining measure. This action goes against the ethical principle of autonomy and could have legal implications.
Choice B rationale: While asking the provider to discuss the issue with the family could be a subsequent step, it is not the primary action to take in this situation. The nurse should first review the client's request with the family to emphasize the importance of the living will and facilitate understanding between the parties involved.
Choice C rationale: Reporting the dilemma to the facility's dietitian does not address the ethical and legal concerns at hand. The dietitian's role is to manage nutritional needs, not to resolve ethical dilemmas or interpret legal documents such as living wills. Involving the dietitian may not be helpful in addressing the conflict between the client's wishes and the family's request.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Determining the swallowing ability of a client who has had a stroke requires clinical judgment and assessment skills that fall within the scope of a registered nurse's practice. This task involves assessing potential risks and complications related to the client's condition.
Choice B rationale:
Providing an enteral feeding to a client who has Crohn's disease is within the scope of an LPN's practice. LPNs are trained to administer enteral feedings and manage stable clients with chronic conditions, such as Crohn's disease, under the supervision of a registered nurse.
Choice C rationale:
Developing a teaching plan for a client with a new diagnosis of type 2 diabetes mellitus involves comprehensive assessment, education, and planning. This task requires the expertise of a registered nurse, as it encompasses various aspects of disease management and requires tailored education based on individual client needs.
Choice D rationale:
Weighing a client who is 3 days postoperative following coronary artery bypass grafting involves monitoring for postoperative complications and assessing the client's stability. This task requires clinical judgment and the ability to recognize potential issues, making it more appropriate for a registered nurse to perform.
Correct Answer is D
Explanation
Choice A rationale:
A client who has a penetrating head injury and a respiratory rate of 4/min requires immediate attention due to the critical nature of the head injury and the dangerously low respiratory rate. However, in an emergency situation like this, the priority would be a condition that could be rapidly fatal if not addressed promptly.
Choice B rationale:
A client with a comminuted fracture of the femur has a serious injury that requires assessment and treatment, but it is not an immediately life-threatening condition. It falls lower in the priority compared to conditions that directly impact respiratory and cardiovascular function.
Choice C rationale:
A client with a 15.2-cm laceration to the scalp with clotted blood visible also requires attention, but it is not as time-sensitive as a life-threatening condition. Controlling bleeding and cleaning the wound can be addressed after addressing more critical cases.
Choice D rationale:
Correct. A client with a sucking chest wound has a high risk of tension pneumothorax, a condition where air accumulates in the pleural space, leading to lung collapse and compromised circulation. This condition can be rapidly fatal. Immediate intervention is required to seal the wound and prevent further air from entering the pleural space.
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