A charge nurse provides an annual in-service for the nursing staff regarding ethical practice. Which of the following actions should the nurse include as an example of ethical practice?

A nurse raises all four side rails on the bed of a client who is confused.

A nurse administers prescribed opioids to a client who has a terminal illness and respiratory rate of 8/min.

A nurse elects not to care for a client who had an abortion.

A nurse withholds nutrition from a client who has a do-not-resuscitate (DNR) order.

Answer and Explanation

The Correct Answer is B

A. Raising all four side rails on a confused client’s bed is considered a restraint and violates the principle of autonomy. Restraints should only be used as a last resort and require a provider’s order. Ethical practice involves finding less restrictive alternatives, such as using a sitter or bed alarms.

B. Administering opioids to a terminally ill client, even with a low respiratory rate, aligns with ethical nursing principles such as beneficence (relieving suffering) and nonmaleficence (preventing harm) when used for palliative care. In end-of-life care, the priority is comfort, and pain management is considered ethical even if it may impact respiration. This aligns with the principle of double effect, which justifies an action intended for good (pain relief) even if it has potential negative side effects (respiratory depression).

C. Electing not to care for a client due to personal beliefs is an example of bias and does not adhere to the ethical principle of fidelity, which requires nurses to provide care regardless of personal beliefs.

D. Withholding nutrition from a client with a DNR order is not ethical unless there is a clear directive regarding the client's wishes, and it may cause harm.

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Correct Answer is C

Explanation

A. While a client's religious beliefs can influence their decisions, the refusal of treatment takes precedence, making this an insufficient factor alone.

B. The facility ethics committee can provide guidance but does not have the authority to override a client's autonomy in medical decisions.

C. The client has the right to refuse treatment, but the nurse must ensure that the client fully understands the risks and consequences of refusing surgery. This aligns with the ethical principle of autonomy, which allows individuals to make informed decisions about their healthcare. If the client is competent and understands the risks, their choice must be respected—regardless of their partner’s wishes.

D. A durable power of attorney for health care (DPOA-HC) can only make decisions if the client is incapacitated. If the client is mentally competent and understands the risks, their decision is final—even if their partner has legal authority for healthcare decisions in other circumstances.

A. Make arrangements to take over the client's care. B. Recommend that both nurses be terminated. C. Contact the house supervisor to mediate the conflict. D. Escort the nurses to the nurses' lounge to continue the discussion.

Correct Answer is D

Explanation

A. Taking over the client's care may temporarily solve the problem but does not address the conflict or facilitate a resolution between the two nurses.

B. Termination is an extreme action and is not warranted in this situation. Conflict resolution should be attempted before considering disciplinary actions.

C. While mediation may be helpful, it is not the most immediate solution in this situation. The charge nurse can initially intervene directly to de-escalate the situation.

D. Escorting the nurses to the lounge allows them to continue the conversation in a more private setting, away from patients and other staff, reducing disruption to the work environment. It also gives the charge nurse a chance to mediate and calm the situation.

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A charge nurse provides an annual in-service for the nursing staff regarding ethical practice. Which of the following actions should the nurse include as an example of ethical practice?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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