The nurse is reviewing the client's medical record.

Exhibits

The nurse is assisting with the care of the client prior to a blood transfusion. Which of the following actions should the nurse take? Select all that apply.

A. Beneficence. Beneficence refers to the ethical obligation to promote the well-being of clients and take actions that benefit them. While providing medication education supports the client's health, the primary ethical principle demonstrated in truthfully explaining adverse effects is veracity, not beneficence.
B. Justice. Justice involves fairness in the distribution of resources, treatment, and care. It ensures that all clients receive equitable care regardless of personal or socioeconomic differences. While justice is a fundamental ethical principle, it does not directly relate to truthfulness in medication education.
C. Veracity. Veracity is the ethical principle of honesty and truthfulness in communication with clients. By truthfully informing the client about the adverse effects of their prescribed medications, the nurse upholds veracity, ensuring the client has accurate information for informed decision-making.
D. Autonomy. Autonomy refers to the client’s right to make informed decisions about their care. While providing truthful information supports autonomy, the ethical concept the nurse demonstrates in this scenario is veracity, as the focus is on truthfully sharing medication information.

A chest x-ray is an essential diagnostic tool for evaluating a client with symptoms such as a productive cough, blood-tinged sputum, weight loss, night sweats, and a low-grade fever. These findings raise suspicion for tuberculosis (TB), particularly given the client’s recent travel to South Africa, where TB is more prevalent. A chest x-ray can help identify characteristic abnormalities such as upper lobe infiltrates, cavitations, or pleural effusions that are consistent with pulmonary TB.

A nasopharyngeal swab is primarily used to detect viral respiratory infections, such as influenza or COVID-19. While the client presents with a cough and fever, the chronic nature of symptoms and presence of hemoptysis make a viral infection less likely. Furthermore, viral infections typically present with acute onset symptoms rather than a prolonged illness with weight loss and night sweats.

Blood cultures are used to identify systemic bacterial infections, such as bacteremia or sepsis. Although the client has a fever, there are no indications of severe systemic infection, such as hypotension or signs of shock, making blood cultures a lower priority in this case.

A pulmonary function test evaluates lung function in conditions such as asthma or chronic obstructive pulmonary disease (COPD). The client has no history of these conditions, and their primary complaint involves symptoms suggestive of an infectious process rather than an obstructive pulmonary disease. Pulmonary function testing is not indicated for diagnosing TB or other respiratory infections.

A Mantoux test (tuberculin skin test) is a key diagnostic tool in assessing tuberculosis exposure. Given the client’s symptoms and travel history, this test helps determine prior exposure to Mycobacterium tuberculosis and the likelihood of latent or active infection. A positive test would support further diagnostic testing, such as sputum cultures, to confirm active TB disease.