A nurse responds to the room of a client who is recovering from a cardiac arrest where CPR was performed. The client's child is distraught and tells the nurse that their parent has a do-not-resuscitate (DNR) prescription in their medical record. Which of the following actions should the nurse take first?

Report the occurrence to the nursing supervisor,

Complete an incident report stating the facts of the situation.

Verify the DNR prescription is current in the medical record.

Request a meeting with the ethics committee.

Answer and Explanation

The Correct Answer is C

A. Report the occurrence to the nursing supervisor:

While reporting the occurrence is important, verifying the DNR status takes precedence. The nurse needs to gather information and confirm whether the patient has a current DNR order before escalating the issue to a higher authority.

B. Complete an incident report stating the facts of the situation:

Completing an incident report is a part of the process, but it should not be the first action. The immediate concern is to determine if the patient has a valid DNR order. An incident report can be completed later to document the situation and any actions taken.

C. Verify the DNR prescription is current in the medical record.

Verifying the DNR (do-not-resuscitate) prescription is the first and most immediate action the nurse should take. It is crucial to confirm the current status of the DNR order to ensure that the healthcare team is following the patient's wishes. If the DNR is indeed valid and up-to-date, it means the resuscitation efforts, including CPR, were contrary to the patient's expressed wishes.

D. Request a meeting with the ethics committee:

Contacting the ethics committee may be necessary depending on the circumstances, but it is not the first step. Verifying the DNR status is an immediate action that can guide subsequent decisions. If there are ethical concerns or conflicts, involving the ethics committee can be considered after confirming the facts surrounding the DNR order.

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Correct Answer is C

Explanation

The client's provider cannot provide informed consent on behalf of the client. The provider's role is to explain the procedure, its risks and benefits, and answer any questions the client may have to help the client make an informed decision.

The client's mother may have a supportive role in the decision-making process, especially if the client desires their involvement. However, unless the client has been legally deemed unable to make decisions (for example, due to lack of decision-making capacity), the client's consent should be sought directly.

The client is the primary individual who should provide informed consent for their own medical procedure, assuming they have decision-making capacity. They have the right to accept or refuse the treatment after being fully informed about the procedure, risks, benefits, and alternatives.

The client's sibling does not have the authority to provide informed consent for the client's medical procedure unless they have been legally designated as the client's healthcare proxy or legally authorized decision-maker.

A. Ask the APs to discontinue the conversation. B. Inform the client what has occurred. C. Notify the client's provider. D. Schedule a disciplinary conference for the APS.

Correct Answer is A

Explanation

Ask the APs to discontinue the conversation:

This is the most appropriate immediate action. Discussing a client's care in a public area violates the principle of patient confidentiality. The nurse should intervene promptly and ask the assistive personnel to stop the conversation.

Inform the client what has occurred:

While transparency with the client is important, it may not be the first action to take in this situation. The priority is to address the breach of confidentiality by stopping the conversation.

Notify the client's provider:

Notifying the client's provider is not the initial action to take in this situation. First, the nurse should address the immediate issue by stopping the inappropriate conversation. The provider may be informed later, if necessary.

Schedule a disciplinary conference for the APs:

Scheduling a disciplinary conference is a step that may be taken after addressing the immediate issue. The priority is to stop the inappropriate conversation and address confidentiality concerns before considering disciplinary actions.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for an adult client who has a history of mental illness and is scheduled for a total hip arthroplasty. The nurse should Identify that which of the following people can provide informed consent for the procedure?

Correct Answer is C

Explanation

A nurse overhears two assistive personnel (AP) in the cafeteria discussing a client's care during lunch. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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