A nurse is collecting data from a client who is at the end of life. Which of the following findings should the nurse expect?

Explanation:

A. Whisper to the patient that she will be saved.

This action is inappropriate and does not address the underlying issues of the patient's condition or the presence of the family friend. Whispering such a statement may also be confusing or alarming to the patient.

B. Confront the family friend to allow the patient to ask questions.

While it's important to facilitate open communication with the patient, confronting the family friend directly may not be the most effective approach initially. It's crucial to first assess the patient's comfort level and safety before addressing the situation with the friend.

C. Consult the healthcare team about the suspicions and call local authorities to investigate.

Jumping to conclusions and involving authorities without gathering more information or assessing the patient's feelings directly could escalate the situation unnecessarily. It's important to handle such concerns with sensitivity and professionalism, involving appropriate resources only when needed.

D. Ask the patient if she feels safe, while the friend is in the room.

This is the most appropriate action initially. By directly asking the patient about her feelings of safety, the nurse can gauge the patient's comfort level and assess any potential concerns or risks. This approach allows the nurse to gather information and address any issues in a supportive and patient-centered manner. If the patient expresses concerns or discomfort, further assessment and appropriate interventions can be implemented, which may include involving other members of the healthcare team or authorities if necessary.

Explanation:

A. Expert opinions:

Expert opinions are valuable in clinical practice and decision-making, but they are considered a lower level of evidence compared to systematic reviews and meta-analyses. Expert opinions are often classified as Level V evidence in the hierarchy.

B. Systematic review

A systematic review is a comprehensive and rigorous synthesis of multiple studies on a particular topic, and it often includes a meta-analysis that statistically combines the results of these studies to provide a high level of evidence. This type of evidence is considered Level I because it provides a strong foundation for making clinical decisions due to its methodological rigor and ability to summarize findings from multiple studies.

C. Credible websites:

Credible websites can provide valuable information, but they are not classified as Level I evidence. The evidence hierarchy typically places systematic reviews and meta-analyses at the highest level due to their methodological rigor and synthesis of multiple studies.

D. Qualitative studies:

Qualitative studies are valuable for exploring complex phenomena and understanding individuals' experiences, beliefs, and perspectives. However, they are generally considered lower in the hierarchy of evidence compared to systematic reviews and RCTs, which are categorized as Level I evidence.