A client who has end-stage renal disease has decided to discontinue dialysis treatments. The client has a living will that states no artificial hydration or nutrition should be provided in case of a terminal condition. The client's spouse asks the nurse if they can give the client some ice chips or water to moisten their mouth. What is the best response by the nurse?
"Yes, you can give them some ice chips or water, as this will not prolong their life or interfere with their decision."
"No, you cannot give them any ice chips or water, as this will violate their living will and cause them more discomfort."
"Yes, you can give them some ice chips or water, but only if they ask for it or indicate that they are thirsty."
"No, you cannot give them any ice chips or water, but you can use a moist sponge or swab to gently clean their mouth."
The Correct Answer is D
Rationale: The best response by the nurse is to inform the spouse that they cannot give any ice chips or water to the client, as this would constitute artificial hydration and nutrition, which is against the client's living will. However, the nurse should also offer an alternative way of providing comfort to the client, such as using a moist sponge or swab to gently clean their mouth. This would help to relieve dryness and prevent cracking of the lips and tongue.
Incorrect options:
A) "Yes, you can give them some ice chips or water, as this will not prolong their life or interfere with their decision." - This is an incorrect response, as giving ice chips or water to a terminally ill client who has refused artificial hydration or nutrition would be unethical and potentially harmful. Ice chips or water could cause aspiration pneumonia, fluid overload, electrolyte imbalance, or increased blood pressure in a client who has end-stage renal disease.
B) "No, you cannot give them any ice chips or water, as this will violate their living will and cause them more discomfort." - This is a partially correct response, as giving ice chips or water to a terminally ill client who has refused artificial hydration or nutrition would violate their living will. However, this response does not offer any alternative way of providing comfort to the client, such as using a moist sponge or swab to gently clean their mouth.
C) "Yes, you can give them some ice chips or water, but only if they ask for it or indicate that they are thirsty." - This is an incorrect response, as giving ice chips or water to a terminally ill client who has refused artificial hydration or nutrition would be unethical and potentially harmful, regardless of whether they ask for it or not. Ice chips or water could cause aspiration pneumonia, fluid overload, electrolyte imbalance, or increased blood pressure in a client who has end-stage renal disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale: The nurse should empathize with the client's situation, but refuse to help them with their request to end their life by taking an overdose of medication. The nurse should explain that it is against their scope of practice and code of ethics to assist the client in ending their life, as this violates the principle of nonmaleficence, which states that nurses should do no harm or allow harm to occur.
Incorrect options:
A) "I understand that you are suffering, but I cannot help you with that. It is illegal and unethical for me to assist you in ending your life." - This is an incorrect response, as it does not show empathy or compassion for the client's situation. The nurse should not use legal or ethical terms that may sound harsh or judgmental to
the client.
B) "I respect your decision, but I cannot help you with that. It is against my personal and professional values to assist you in ending your life." - This is an incorrect response, as it does not show empathy or compassion for the client's situation. The nurse should not use personal or professional values that may sound biased or insensitive to
the client.
D) "I appreciate your honesty, but I cannot help you with that. It is against my moral and religious beliefs to assist you in ending your life." - This is an incorrect response, as it does not show empathy or compassion for the client's situation. The nurse should not use moral or religious beliefs that may sound intolerant or disrespectful to
the client.
Correct Answer is D
Explanation
Rationale: The nurse should refer the client to a hospice program that can provide them with palliative care at home, as this aligns with their wish to die at home and their advance directive that states they do not want any life-sustaining treatments. Hospice care focuses on improving the quality of life and comfort of clients who have a life expectancy of six months or less.
Incorrect options:
A) "I will make sure that your advance directive is followed by all members of your health care team." - This is a correct statement, but it does not indicate an understanding of legal and ethical principles related to end-of-life care. The nurse has a legal and ethical duty to follow the client's advance directive, but this does not address their wish to die at home or their need for palliative care.
B) "I will consult with your family members before making any decisions about your care." - This is an incorrect statement, as it violates the client's autonomy and right to self-determination. The nurse should respect the client's wishes and decisions regarding their end-of-life care, unless there is evidence of a durable power of attorney for health care or a court order that states otherwise.
C) "I will administer pain medication as needed, even if it may hasten your death." - This is an incorrect statement, as it implies that the nurse intends to cause or hasten the client's death, which is illegal and unethical. The nurse should administer pain medication as needed, following the principle of double effect, which states that an action that has both good and bad effects is morally permissible if the good effect is intended and outweighs
the bad effect.
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