A nurse is preparing to administer testosterone gel to a client who has hypogonadism. Which of the following actions should the nurse take?

Choice A reason: A 10-year budget is impractical for cost containment, as healthcare costs fluctuate due to economic and technological changes. Long-term budgets lack flexibility for staffing or equipment needs, making them ineffective for ensuring cost-effective care delivery in dynamic healthcare environments.
Choice B reason: Hiring travel nurses increases costs due to high salaries and agency fees compared to permanent staff. While addressing short-term shortages, it does not promote long-term savings, as temporary labor is expensive, contrasting with strategies like workforce planning for cost containment.
Choice C reason: Reducing training programs may lower short-term costs but risks errors and lawsuits, increasing long-term expenses. Well-trained staff improve efficiency and outcomes, reducing readmissions. Training is critical for cost containment, as it enhances care quality in healthcare settings.
Choice D reason: Electronic health records (EHRs) reduce long-term costs by streamlining documentation and improving care coordination. EHRs enhance billing accuracy and reduce errors, offsetting initial costs with decreased administrative burdens and better patient outcomes, aligning with evidence-based cost containment strategies in healthcare.

Choice A reason: Encouraging a final hemodialysis treatment contradicts the client’s advance directives, which refuse life-sustaining treatments. Respecting autonomy is paramount, and persuading the client undermines their decision, making this action unethical and inappropriate in this end-of-life scenario.
Choice B reason: Contacting the family to discuss the decision is unnecessary unless the client is incapacitated, which is not indicated. The client’s advance directives guide care, and family input is secondary to the client’s wishes, making this action incorrect and irrelevant.
Choice C reason: Discussing treatment options with the surrogate is inappropriate, as the client is competent and has clear advance directives refusing treatment. The surrogate’s role applies only if the client cannot decide, making this action misaligned with the client’s autonomy and directives.
Choice D reason: Discussing discharge options respects the client’s refusal of treatment and advance directives, focusing on palliative care or home arrangements. This supports autonomy and aligns with end-of-life care principles, ensuring comfort and dignity, making it the correct action.