Nokea
The condition of a critically ill patient with a living will has deteriorated. The patient’s partner wants “everything done,” regardless of the patient’s wishe s. Which ethical principle is the partner violating?
- A. Autonomy
- B. Beneficence
- C. Justice
- D. Nonmaleficence
Correct Answer: A
Rationale: The correct answer is A: Autonomy. Autonomy is the ethical principle that respects an individual's right to make decisions about their own care and treatment. In this scenario, the partner wanting "everything done" regardless of the patient's wishes violates the patient's autonomy by not honoring their previously expressed wishes outlined in the living will. This decision disregards the patient's right to make choices about their own healthcare. Choices B, C, and D are incorrect because:
B: Beneficence focuses on doing good for the patient, but in this case, the partner's actions are not necessarily in the patient's best interest.
C: Justice pertains to fairness and equal treatment, which is not directly relevant to the situation described.
D: Nonmaleficence is the principle of doing no harm, but in this scenario, the harm is not necessarily physical but rather a violation of the patient's autonomy.
You may also like to solve these questions
On their first visit to a critically ill patient, family members stand in the doorway of the room, making no effort to approach the patient. What is the most appropriate nursing action?
- A. Instruct the family where the patient can be touched and what to say.
- B. Engage the family in social conversation to ease them into the milieu.
- C. Use visiting hours to explain to the family the general status of the patient.
- D. Leave the family to adjust to the situation when they are ready.
Correct Answer: A
Rationale: The correct answer is A because instructing the family on where the patient can be touched and what to say helps empower them to interact appropriately with the patient. This action promotes the family's involvement in the patient's care, encourages communication, and fosters a supportive environment. Choice B is incorrect as engaging in social conversation may not address the family's hesitance to approach the patient directly. Choice C is incorrect because waiting for visiting hours to provide information may delay necessary support for the family. Choice D is incorrect as leaving the family without guidance may perpetuate their discomfort and hinder their ability to provide emotional support to the patient.
A 54-year-old patient arrives in the emergency department (ED) after exposure to powdered lime at work. Which action should the nurse take first?
- A. Obtain the patient’s vital signs.
- B. Obtain a baseline complete blood count.
- C. Decontaminate the patient by showering with water.
- D. Brush off any visible powder on the skin and clothing.
Correct Answer: D
Rationale: The correct answer is D because brushing off any visible powder on the skin and clothing is the first step in managing exposure to powdered lime. This action helps to remove the source of exposure and prevent further absorption through the skin. It is crucial to prevent additional contact and reduce the risk of further harm. Obtaining vital signs (choice A) and a complete blood count (choice B) can be important but should come after the initial decontamination. Decontaminating the patient by showering with water (choice C) is not recommended for lime exposure as it can react with water and cause further injury.
The nurse notes that the patient’s arterial blood gas levels indicate hypoxemia. The patient is not intubated and has a respiratory rate of 22 breaths/min. what is the nurse’s first intervention to relieve hypoxemia?
- A. Call the physician for an emergency intubation proced ure.
- B. Obtain an order for bilevel positive airway pressure (BiPAP).
- C. Provide for oxygen administration.
- D. Suction secretions from the oropharynx.
Correct Answer: C
Rationale: The correct answer is C: Provide for oxygen administration. The first intervention for hypoxemia is to increase oxygen levels to improve oxygen saturation in the blood. Oxygen administration can be achieved through various devices such as nasal cannula, face mask, or non-rebreather mask. This intervention helps to increase the oxygen supply to the patient's tissues and organs, addressing the underlying cause of hypoxemia. Calling for emergency intubation (choice A) is not the first step unless the patient's condition deteriorates. Obtaining an order for BiPAP (choice B) may be beneficial in some cases but is not the initial intervention for hypoxemia. Suctioning secretions (choice D) may be necessary if airway obstruction is present but is not the first step in addressing hypoxemia.
A male client who has been taking propranolol (Inderal) for 18 months tells the nurse that the healthcare provider discontinued the medication because his blood pressure has been normal for the past three months. Which instruction should the nurse provide?
- A. Obtain another antihypertensive prescription to avoid withdrawal symptoms.
- B. Stop the medication and keep an accurate record of blood pressure.
- C. Report any uncomfortable symptoms after stopping the medication.
- D. Ask the healthcare provider about tapering the drug dose over the next week.
Correct Answer: D
Rationale: The correct answer is D: Ask the healthcare provider about tapering the drug dose over the next week. This answer is correct because propranolol is a beta-blocker, and abrupt discontinuation can lead to rebound hypertension, angina, or even myocardial infarction due to the sudden withdrawal of the medication. Tapering the drug dose over time allows the body to adjust gradually and reduces the risk of these adverse effects.
Choice A is incorrect because obtaining another antihypertensive prescription is not necessary if the client's blood pressure has been normal for the past three months. Choice B is incorrect because abruptly stopping the medication without tapering can lead to withdrawal symptoms. Choice C is incorrect because simply reporting uncomfortable symptoms without taking appropriate action (tapering the drug dose) is not addressing the potential risks associated with abrupt discontinuation of propranolol.
The patient is in need of immediate hemodialysis, but has no vascular access. The nurse prepares the patient for insertion of
- A. a percutaneous catheter at the bedside.
- B. a percutaneous tunneled catheter at the bedside.
- C. an arteriovenous fistula.
- D. an arteriovenous graft.
Correct Answer: A
Rationale: The correct answer is A: a percutaneous catheter at the bedside. This is the most appropriate option for immediate hemodialysis when the patient has no vascular access. A percutaneous catheter can be quickly inserted at the bedside, allowing for immediate initiation of hemodialysis.
Choice B, a percutaneous tunneled catheter, involves a more complex insertion process and is not typically done at the bedside. Choices C and D, arteriovenous fistula and arteriovenous graft, require advanced planning and surgical procedures, making them unsuitable for immediate hemodialysis in this scenario.