Nokea
A nurse is caring for a client who is terminally ill and has a do-not-resuscitate (DNR) order. The client's family requests that the nurse withhold pain medication to hasten death. Which of the following responses by the nurse is appropriate?
- A. I'll discuss this with the provider to see what we can do.
- B. Withholding medication to hasten death is not ethical or legal.
- C. Let me get the hospital chaplain to talk with you about this.
- D. I understand your wishes, but I need to follow the client's care plan.
Correct Answer: B
Rationale: Correct Answer: B. Withholding medication to hasten death is not ethical or legal.
Rationale: As a nurse, it is important to uphold ethical principles and follow legal guidelines. Withholding pain medication to hasten death goes against the principle of beneficence, which focuses on doing good for the patient. It also contradicts the principle of nonmaleficence, which emphasizes avoiding harm. Additionally, hastening death through medication is illegal and violates the client's right to receive appropriate care. By choosing this response, the nurse demonstrates ethical integrity and ensures the client's well-being is prioritized.
Summary:
A: Involving the provider is important but does not address the ethical and legal issues at hand.
C: Involving the chaplain may offer emotional support but does not address the ethical dilemma.
D: Following the client's care plan is essential, but in this case, the care plan should not include hastening death.
Overall, response B is the most appropriate as it
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A nurse is caring for four clients who are postoperative from surgery 24 hr ago. At 1200 the nurse assesses the clients. Which of the following clients is the nurse's priority?
- A. A client who reports pain as 4 on a scale of 1 to 10 at 0800 now reports pain as 6
- B. A client whose wound drainage at 0800 was sanguineous and now it is serosanguineous
- C. A client who has a prescription for insulin and his premeal capillary blood glucose was 110 mg/dL and his post-meal capillary blood glucose is now 160 mg/dL
- D. A client whose blood pressure at 0800 was 138/86 mm Hg and at 1200 is 106/60 mm Hg
Correct Answer: D
Rationale: The correct answer is D because a significant drop in blood pressure from 138/86 mm Hg at 0800 to 106/60 mm Hg at 1200 indicates potential hypotension, which could be a sign of hemorrhage or shock postoperatively. Hypotension can lead to inadequate tissue perfusion and organ damage. Monitoring and addressing the client's blood pressure promptly is crucial to prevent further complications.
Choice A is not the priority because an increase in pain from 4 to 6 is significant but does not indicate as immediate risk as hypotension. Choice B, a change in wound drainage consistency, may require monitoring but is not as urgent as addressing hypotension. Choice C, an increase in post-meal blood glucose, is important but does not pose an immediate threat to the client's life compared to hypotension in Choice D.
A nurse is caring for a client who is dying. The nurse should incorporate the principle of nonmaleficence into practice by taking which of the following actions?
- A. Withholding a dose of narcotic pain medication when the client has respiratory depression
- B. Discussing advance directives with the client and the client's family
- C. Providing comfort care measures to the client
- D. Allowing the client's family unlimited visitation at the time of death
Correct Answer: A
Rationale: Correct Answer: A
Rationale: Nonmaleficence is the ethical principle of doing no harm. In this scenario, withholding a dose of narcotic pain medication when the client has respiratory depression aligns with this principle as administering the medication could further compromise the client's respiratory status and potentially harm them. By withholding the medication, the nurse is prioritizing the client's safety and well-being.
Summary of Incorrect Choices:
B: Discussing advance directives is important but does not directly relate to nonmaleficence in this context.
C: Providing comfort care measures is essential but does not specifically demonstrate the principle of nonmaleficence.
D: Allowing unlimited visitation may support emotional well-being but does not directly address the principle of nonmaleficence.
A nurse is providing discharge teaching for a client who has a new prescription for home oxygen. Which of the following instructions should the nurse include in the teaching?
- A. Use wool blankets on your bed.
- B. Store unused oxygen tanks horizontally.
- C. Check your oxygen equipment once each week.
- D. Do not adjust the oxygen flow rate.
Correct Answer: D
Rationale: The correct answer is D: Do not adjust the oxygen flow rate. This is crucial to prevent complications such as hypoxia or oxygen toxicity. Adjusting the flow rate without medical guidance can be dangerous. A: Using wool blankets can increase the risk of fire hazard. B: Storing unused oxygen tanks horizontally can cause leaks due to the pressure change. C: Checking equipment weekly is important, but not adjusting the flow rate is more critical for safety.
A nurse is preparing a report for the quality improvement committee about medication errors. Which of the following data should the nurse include to evaluate the effectiveness of current interventions?
- A. The number of staff trained on medication safety protocols.
- B. The cost of implementing new medication scanners.
- C. The percentage of medication errors before and after interventions.
- D. The satisfaction scores from staff using new medication systems.
Correct Answer: C
Rationale: The correct answer is C, the percentage of medication errors before and after interventions. This data is crucial for evaluating the effectiveness of current interventions because it directly measures the impact of the interventions on reducing medication errors. By comparing the percentage of errors before and after the interventions, the nurse can determine if the interventions have been successful in improving medication safety.
Choice A is incorrect because while staff training is important, it does not directly measure the effectiveness of interventions on reducing errors.
Choice B is incorrect as the cost of implementing new scanners is not a direct indicator of effectiveness in reducing medication errors.
Choice D is incorrect as staff satisfaction scores do not necessarily reflect the actual impact on medication error reduction.
In summary, monitoring the percentage of medication errors before and after interventions provides a clear, objective measure of the effectiveness of current interventions in improving medication safety.
A nurse is triaging clients following a mass casualty event. Which of the following clients should the nurse assess first?
- A. A client who has a small circular partial-thickness burn of the left calf
- B. A client who has a massive head injury and is experiencing seizures
- C. A client who has a splinted open fracture of left medial malleolus
- D. A client who has severe respiratory stridor and a deviated trachea
Correct Answer: D
Rationale: The correct answer is D: A client who has severe respiratory stridor and a deviated trachea. This client should be assessed first because stridor indicates airway obstruction, which can rapidly progress to respiratory failure. A deviated trachea suggests a possible tension pneumothorax, a life-threatening condition requiring immediate intervention to prevent further deterioration. Assessing and managing the airway takes priority over other injuries.
Incorrect choices:
A: A small circular partial-thickness burn of the left calf is a lower priority as it does not pose an immediate threat to life compared to airway compromise.
B: A massive head injury with seizures is serious but managing the airway is the priority in this scenario.
C: A splinted open fracture of the left medial malleolus is important but does not pose an immediate threat to life compared to airway and breathing concerns.