A nurse preceptor is observing a newly licensed nurse caring for a client on a medical-surgical unit. Which of the following actions by the newly licensed nurse requires further instruction by the preceptor?

Choice A reason: Beneficence, acting for patient benefit, is not breached, as both clients receive care and supplies, albeit differently. Unequal distribution reflects access issues, not failure to promote well-being, making beneficence less relevant than justice in addressing this ethical concern.
Choice B reason: Nonmaleficence, avoiding harm, is not violated, as both clients access supplies without direct harm. The inequality in delivery method raises fairness concerns, not harm, making justice the primary ethical principle breached in this scenario of differential treatment.
Choice C reason: Justice, ensuring fair treatment, is breached when one client receives supplies directly and another must seek them externally due to insurance status. This inequality in resource access violates equitable care principles, critical in healthcare ethics to ensure fairness across patient populations.
Choice D reason: Autonomy, respecting patient choices, is not breached, as both clients receive care consistent with their needs. The issue lies in unequal resource access, not decision-making restrictions, making justice the relevant ethical principle over autonomy in this scenario.

Choice A reason: Using two identifiers (e.g., name and medical record number) ensures the correct client receives the medication, preventing errors. This aligns with safety protocols, reducing risks of administering drugs to the wrong person. Verification confirms identity before administration, safeguarding against adverse events and ensuring compliance with standards like The Joint Commission.
Choice B reason: Checking the medication label twice is part of the “rights” of administration but is less specific than using two identifiers for client verification. While important, it addresses medication accuracy, not client identity, which is the primary safety concern to prevent errors, making it less critical in this context.
Choice C reason: Administering medication within 3 hours of the scheduled time relates to timing protocols, not the core action of ensuring safe administration. While timely administration is important, verifying client identity is the priority to prevent errors, as incorrect patient identification can lead to severe adverse events, making this less relevant.
Choice D reason: Administering medications to treat a condition to the actual prescriptions is vague and not a standard safety action. The focus is on verifying client identity and medication accuracy, not a general treatment alignment. This statement does not address a specific, actionable step in safe medication administration, making it incorrect.