A nurse is providing care to four clients in an acute care setting. The nurse should identify that which of the following client statements presents an ethical dilemma?

The correct answer is choice A: "I know that I can change my advance directives if I need to in the future."

Choice A rationale:

This statement indicates an understanding of advance directives. Advance directives are legal documents that allow individuals to communicate their preferences for medical treatment in case they become unable to make decisions themselves. It's important for clients to know that they can update or change their advance directives if their wishes or circumstances change over time.

Choice B rationale:

The statement that the health care surrogate will make decisions as soon as the power of attorney is signed is not accurate. Generally, a health care surrogate's authority to make decisions comes into effect when the primary individual is no longer able to make decisions themselves. Signing a power of attorney alone does not grant immediate decision-making power to the surrogate.

Choice C rationale:

The family generally cannot overrule the decisions made by a designated health care surrogate. Once an individual designates a surrogate and provides clear instructions through advance directives, the surrogate's decisions are legally binding and typically override the family's input.

Choice D rationale:

Advance directives are not universally valid across states. Laws and regulations regarding advance directives can vary significantly from state to state. It's important for clients to understand that if they relocate, they may need to update their advance directives to comply with the laws of the new state.

The correct answer is Choice C: "Do you consume pork products?"

Choice C rationale: Islamic dietary laws, also known as Halal, prohibit the consumption of pork and its by-products. By asking the client about their consumption of pork products, the nurse demonstrates cultural sensitivity and ensures that the client's dietary preferences and religious practices are respected while under the facility's care.

Choice A rationale: Asking the client if they receive Holy Communion is not appropriate, as this practice is associated with Christianity rather than Islam. This question does not effectively address the client's religious preferences or needs in relation to their Islamic faith.

Choice B rationale: Inquiring about adherence to a kosher diet is not relevant, as this dietary practice is specific to Judaism and does not pertain to the Islamic faith. The nurse should be aware of the distinctions between religious practices when providing culturally competent care.

Choice D rationale: There is no general prohibition against blood transfusions in Islam. Islamic teachings generally permit medical treatments, including blood transfusions, when deemed necessary for the well-being and preservation of life. Asking the client about opposition to blood transfusions would not be the most effective way to clarify their religious preferences in the context of Islam.