A nurse is caring for a client who is starting treatment for substance use disorder. Which of the following actions indicates the nurse is practicing the ethical principle of nonmaleficence?
Withholding a prescribed medication that is causing adverse effects for the client
Educating the client about legal rights concerning treatment
Providing the client with quality care regardless of ability to pay for treatment
Being truthful with the client about the manifestations of withdrawal.
The Correct Answer is A
A. Withholding a prescribed medication that is causing adverse effects for the client
The principle of nonmaleficence, often summarized as "do no harm," emphasizes the nurse's duty to prevent harm and to remove existing harm. If a medication prescribed to a client is causing adverse effects, the nurse should withhold the medication to prevent harm to the client.
B. Educating the client about legal rights concerning treatment
Educating the client about their legal rights falls under providing information and ensuring the client's autonomy but does not directly address the principle of non-maleficence.
C. Providing the client with quality care regardless of ability to pay for treatment
Providing quality care regardless of the client's ability to pay is an ethical practice, but it aligns more with the principles of justice and beneficence rather than nonmaleficence.
D. Being truthful with the client about the manifestations of withdrawal
Being truthful and providing accurate information to the client about withdrawal symptoms is crucial, but it doesn't directly address the principle of nonmaleficence.
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Correct Answer is B
Explanation
A. Obtain a prescription for restraints on an as-needed basis:
Restraints should never be used on an as-needed basis without a specific, individualized order from a healthcare provider. Restraints are a significant intervention that should only be used when necessary, and they require a clear prescription outlining the duration, reason, and method of application.
B. Have the provider assess the client within 1 hour after applying the restraints:
This option is the correct choice. It is crucial to involve the healthcare provider promptly after restraints are applied. The provider needs to assess the patient's physical and mental status, and the appropriateness of the restraints, and consider alternatives or modifications to the intervention. Regular assessments ensure the patient's safety and well-being while addressing the initial reason for applying restraints.
C. Request that the provider renew the prescription for restraints every 8 hours:
Restraining a patient every 8 hours without ongoing assessment and a clear clinical rationale is inappropriate and goes against best practices. Restraints should only be used when absolutely necessary and should be reevaluated frequently. Requesting a renewal on a fixed schedule without considering the patient's changing condition is not a safe or ethical approach.
D. Evaluate the client hourly while the restraints are applied:
While regular monitoring of a patient in restraints is essential, evaluating the patient every hour might not be sufficient, especially in the early stages after the application of restraints. The patient should be continuously monitored, with assessments conducted more frequently, especially immediately after applying the restraints, to ensure their safety and well-being.
Correct Answer is A
Explanation
A. Encourage participants to express conflicts and work toward resolution:
Explanation: During the working phase of therapy, the nurse encourages participants to express their conflicts, fears, and concerns openly. The working phase is characterized by active participation and problem-solving. Encouraging clients to express their feelings and conflicts helps them work through their issues and promotes resolution. It's a crucial step in the therapeutic process, allowing clients to explore their emotions and gain insight into their anxieties.
B. Inform participants about principles for listening to and respecting each other:
Explanation: Setting ground rules for respectful communication is typically done in the initial or pre-working phase of therapy. While maintaining a respectful environment is important throughout the therapeutic process, it's not specific to the working phase.
C. Suggest that participants reflect on their progress as individuals and as a group:
Explanation: Reflection and assessment of progress can occur throughout therapy, not just in the working phase. It's essential for clients to evaluate their progress, but this action is not exclusive to the working phase.
D. Ask participants to become acquainted with and talk to each other:
Explanation: Building rapport and getting acquainted with other group members often occurs in the initial phase of therapy. During the working phase, the focus shifts more toward discussing and resolving specific issues and conflicts rather than introductory activities.
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