An 18-year-old client in the emergency department is scheduled for an appendectomy. Although the client's parents advocate for the surgery, the client declines the procedure. Which of the following ethical principles is the nurse displaying by respecting the client's decision?
Nonmaleficence
Autonomy
Beneficence
Justice
The Correct Answer is B
A. Nonmaleficence: Nonmaleficence refers to the obligation to do no harm and to avoid causing injury. While this principle is always important in healthcare, the central issue in this scenario involves respecting the client's decision-making rights rather than directly preventing harm.
B. Autonomy: Autonomy is the ethical principle that supports a client's right to make their own healthcare decisions, even if those decisions differ from the wishes of others, including family members. Respecting the 18-year-old client's choice to decline surgery honors their legal and moral right to self-determination.
C. Beneficence: Beneficence involves taking actions that promote the well-being and best interests of the client. While advocating for the surgery could be seen as promoting beneficence, the nurse’s primary ethical duty in this situation is to respect the client’s independent decision.
D. Justice: Justice is concerned with fairness and the equitable distribution of healthcare resources. Although justice is a core ethical principle, it does not directly apply to an individual’s right to refuse treatment as seen in this situation.
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Related Questions
Correct Answer is D
Explanation
A. A client who has hearing loss with a friend interpreting: A friend interpreting does not meet the legal standards for ensuring accurate communication during informed consent. A licensed medical interpreter should be used to avoid misunderstandings and to ensure that the client fully understands the risks, benefits, and alternatives of the procedure before consenting.
B. A client who has not spoken with the provider yet: Informed consent requires that the provider explain the procedure, risks, benefits, and alternatives directly to the client. Without this discussion, the client lacks the necessary information to make an educated decision and cannot legally or ethically provide informed consent.
C. A 15-year-old client whose caregiver is not at the bedside: Minors generally cannot give legal informed consent without a parent or legal guardian present, unless specific exceptions apply (such as for emancipated minors). A 15-year-old without their caregiver present does not meet the criteria for giving valid informed consent for surgical procedures.
D. A married 16-year-old client accompanied by their spouse: A married minor is considered emancipated in most jurisdictions and can legally make healthcare decisions, including providing informed consent. Their marital status grants them the legal autonomy needed to consent to medical treatments without requiring parental involvement.
Correct Answer is A
Explanation
A. Take vital signs on clients as they are admitted: Taking vital signs is within the scope of practice for assistive personnel (AP) and is an essential task during a mass casualty event. It provides critical baseline information that the licensed staff can use to prioritize care and identify urgent needs.
B. Respond to family members about a client's condition: Communicating about a client's medical condition requires clinical judgment and is the responsibility of licensed nursing staff or healthcare providers. APs are not trained or authorized to give out clinical information to family members.
C. Clean and dress client abdominal wounds: Wound care, especially for open or surgical wounds like those on the abdomen, involves assessment and sterile technique, which must be performed by licensed personnel, not assistive personnel.
D. Determine which clients should be seen first: Determining client priority, also known as triage, requires nursing knowledge, critical thinking, and clinical assessment skills. It is a responsibility that falls to licensed nurses, not assistive personnel.
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