A facility provides annual staff education regarding ethical practice. A charge nurse recognizes a need for further education when which of the following behaviors is observed?
A nurse refuses to actively participate during an elective abortion procedure scheduled for her client.
A nurse gives prescribed opioids to a client who has a terminal illness and respirations of B/min.
A nurse explains to a client's family that a DNR order does not include withholding comfort measures.
A nurse informs a confused client who wants to go home that he is going to stay at the facility until he is better.
The Correct Answer is D
Rationale:
A. Refusing to participate in an elective abortion is an example of exercising conscientious objection, which is ethically and legally permitted, provided the nurse ensures the client’s care is not compromised and appropriate staff take over. This behavior does not indicate a need for further education.
B. Administering opioids to a terminally ill client is ethically appropriate under the principle of double effect, where the primary intent is pain relief, not hastening death. This is standard palliative care practice and does not indicate a need for further education.
C. Explaining that a DNR order does not include withholding comfort measures demonstrates correct ethical understanding. Comfort measures, such as pain relief and emotional support, are always provided, regardless of resuscitation status. This behavior is correct.
D. Informing a confused client that he must stay at the facility until he is better violates the ethical principle of autonomy. Even if the client lacks full decision-making capacity, coercion or providing false information is unethical. This behavior indicates a need for further education on respecting client rights, informed consent, and ethical care practices.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C"]
Explanation
Rationale:
A. Informing a friend of the client about their condition is a direct breach of confidentiality, as client information should only be shared with authorized personnel or as legally required.
B. Discussing a client’s condition in a public area where a visitor is present compromises confidentiality because unauthorized individuals can overhear private health information.
C. Reviewing an electronic list of all admitted clients without a clinical need is a breach of confidentiality. Access to electronic health records should be limited to information necessary for providing care.
D. Faxing data to a referred provider is appropriate as long as secure transmission and the intended recipient are ensured. This does not constitute a breach.
E. Logging out of the computer prior to responding to a call light demonstrates proper protection of client information and prevents unauthorized access, so this action supports confidentiality.
Correct Answer is ["B","C"]
Explanation
Rationale:
A. Nurse 3 was providing CPR at the family's request and following the client’s wishes regarding DNR status. There is no breach of confidentiality in this action.
B. Nurse 2 left a computer logged in, which allowed another provider to access client information using the nurse’s active login. This is a breach of confidentiality because it allowed unauthorized access to protected health information (PHI). Nurses should always log off or lock computers when unattended.
C. Nurse 1 disclosed information about a client admitted from the emergency department to another client, sharing details about their injury. This is a breach of confidentiality because the nurse shared private client information with someone not involved in the client’s care.
D. Nurse 5 administered pre-operative medication and explained surgery details without ensuring the client’s questions were answered. While this is a consent and patient rights issue, it does not constitute a breach of confidentiality.
E. Nurse 4 allowed a roommate to interpret medication instructions instead of using a professional interpreter. This is a violation of patient rights and informed consent, but it is not primarily a breach of confidentiality since the client’s information was communicated to someone already in the room with them, with consent implied.
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