A client nearing the end of life requests that he be given no food or fluids.
The physician orders the insertion of a nasogastric tube to feed the client.
What situation does this create for the nurse providing care?
The nurse must follow the physician's orders.
The physician's order creates a barrier to establishing an effective nurse-client relationship.
The nurse faces an ethical dilemma about inconsistent courses of action.
The nurse is unable to provide care for the client.
The Correct Answer is C
Choice A rationale
While nurses are generally expected to follow physician's orders, they also have a professional and ethical responsibility to advocate for their patients. In situations where an order conflicts with the patient's wishes and ethical principles, blindly following the order can lead to moral distress.
Choice B rationale
The physician's order, which contradicts the patient's explicit request, can indeed create a barrier to establishing an effective nurse-client relationship built on trust and respect for the patient's autonomy. The nurse may feel conflicted in carrying out an unwanted intervention.
Choice C rationale
The situation creates an ethical dilemma for the nurse because there are conflicting courses of action with moral implications. The nurse faces a conflict between the duty to follow the physician's order and the ethical principle of respecting the patient's autonomy and right to refuse treatment, even life-sustaining measures at the end of life.
Choice D rationale
The nurse is not unable to provide care but faces a complex ethical challenge in determining the most appropriate and ethical course of action that respects the patient's wishes while navigating the physician's order.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
"If I could just live long enough to attend my son's graduation, I would be satisfied" represents bargaining, the third stage of grief according to Kübler-Ross. In this stage, the individual attempts to negotiate or make deals to postpone the inevitable.
Choice B rationale
"I believe there has been a mistake. I should have gotten a second opinion" is a classic example of denial, the first stage of grief. Denial is a defense mechanism where the individual refuses to accept the reality of the situation, often seeking alternative explanations or contradicting information.
Choice C rationale
"I know I am depressed and I can't stop crying" exemplifies depression, the fourth stage of grief. This stage is characterized by feelings of sadness, hopelessness, and withdrawal as the reality of the loss begins to sink in.
Choice D rationale
"I am very angry and mad. This is not fair" represents anger, the second stage of grief. In this stage, the individual expresses frustration, resentment, and outrage at the situation and may direct these feelings towards others. .
Correct Answer is A
Explanation
Choice A rationale
The nurse practice act and agency policy provide the legal and organizational framework for nursing practice and delegation. Determining if the delegation of topical medication administration is permissible under these guidelines is the foundational first step to ensure legality and adherence to established protocols.
Choice B rationale
Assessing the UAP's training is crucial for safe delegation, but it's secondary to ensuring that the task is delegable in the first place according to legal and policy guidelines. Training is irrelevant if the task cannot be delegated.
Choice C rationale
Ensuring appropriate supervision is essential for delegated tasks, but again, it's contingent on whether the task can be legally and organizationally delegated. Supervision protocols come into play after the initial permissibility of delegation is established.
Choice D rationale
Evaluating the client's past response to the treatment is important for ongoing care but doesn't determine the initial delegability of the task to a UAP. The focus of the first question is on the legal and policy aspects of delegation. .
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