A nurse is caring for a client who is requesting assistance with smoking cessation. The nurse should anticipate a prescription for which of the following medications?

A. Fidelity: Fidelity involves keeping promises and honoring commitments made to the client. By returning to administer pain medication within the timeframe promised, the nurse demonstrates reliability and maintains trust in the nurse–client relationship.

B. Justice: Justice refers to fairness and equal treatment of all clients. Although important in care delivery, it does not specifically address keeping a promise or following through on a commitment to an individual client.

C. Autonomy: Autonomy supports the client’s right to make informed decisions about their care. While requesting pain medication reflects autonomy, the nurse’s action of returning on time aligns more directly with honoring a commitment.

D. Beneficence: Beneficence involves acting in the client’s best interest by promoting comfort and well-being. Administering pain medication supports beneficence, but the defining ethical principle in this scenario is the nurse’s follow-through on a promise.

A. “Are you thinking of hurting yourself?”: This response directly and calmly assesses for suicidal ideation, which is essential when a client expresses feelings of worthlessness or passive death wishes. Asking clearly about self-harm allows the nurse to determine risk and initiate appropriate safety interventions.

B. “What would your family do without you?”: This response may increase guilt or emotional distress rather than encouraging open communication. It does not assess the client’s immediate safety or suicidal thoughts.

C. “When you get better you will not feel this way.”: This response minimizes the client’s current feelings and may make the client feel unheard or dismissed. It does not address potential suicidal risk or provide emotional support.

D. “Why would you think a thing like that?”: Asking “why” can sound judgmental and may discourage the client from sharing further. It does not assess for suicidal intent and may increase defensiveness or withdrawal.