A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?

Continue the medication dosages that relieve the client’s pain

Contact the provider about replacing the opioid with an NSAID

Administer the benzodiazepine but withhold the opioid

Withhold the benzodiazepine but continue the opioid

Answer and Explanation

The Correct Answer is A

A. Continue the medication dosages that relieve the client’s pain:
Opioids and benzodiazepines are commonly used for pain and anxiety management in terminally ill patients. Somnolence is an expected side effect and does not necessarily warrant withholding medication unless the client shows signs of respiratory depression.

B. Contact the provider about replacing the opioid with an NSAID: NSAIDs are not sufficient for severe pain in terminal illness. Opioids are the gold standard for palliative pain management, and switching to an NSAID would likely lead to uncontrolled pain and unnecessary suffering.

C. Administer the benzodiazepine but withhold the opioid: This would leave the client in severe pain, which is unethical in hospice care. Pain relief should not be withheld solely due to sedation.

D. Withhold the benzodiazepine but continue the opioid: Benzodiazepines are often used to relieve anxiety, dyspnea, and agitation in end-of-life care. Withholding it could cause increased distress for the client. Instead of discontinuing the medication, the nurse should monitor for respiratory depression and adjust doses only if necessary.

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Correct Answer is B

Explanation

a. A visitor experiences a minor burn after spilling coffee:

This situation does not present an ethical dilemma. It is a minor accident that can be addressed through appropriate first aid and safety measures.

b. A parent wants her 14-year-old adolescent to receive radiation treatment against his will:

This situation involves a conflict between parental authority and the autonomy of the adolescent. It raises questions about the adolescent's capacity to make medical decisions, the role of parental consent, and the rights of the adolescent to refuse treatment. Therefore, it represents an ethical dilemma.

c. A nurse witnesses another nurse administer an incorrect medication:

While this situation involves patient safety and professional responsibility, it does not inherently pose an ethical dilemma. It is a matter of patient safety and adherence to professional standards rather than conflicting moral principles.

d. A client receives an operation on the wrong side of her body:

This situation represents a serious medical error and a violation of patient safety protocols. While it may have ethical implications related to accountability, negligence, and patient harm, it primarily involves issues of medical error rather than a true ethical dilemma.

A. “I will ask your mother’s primary care provider to speak with you.” B. “You will have to speak directly to your mother about her treatment.” C. “What would you like to know about your mother’s treatment.” D. “I cannot provide this information to you without your mother’s consent.”

Correct Answer is D

Explanation

a. "I will ask your mother's primary care provider to speak with you."This response does not address the issue of confidentiality and consent. The nurse should not assume that the provider will discuss the treatment without the client's consent.

B.“You will have to speak directly to your mother about her treatment.”This response correctly redirects the child to the client but does not fully explain the importance of consent and confidentiality, which are crucial in maintaining professional and ethical standards.

C.“What would you like to know about your mother’s treatment.”This response might imply a willingness to share information without the client’s consent, which would be a violation of confidentiality and privacy laws.

D.“I cannot provide this information to you without your mother’s consent.”Correct. This response clearly states the need for the client’s consent before any information can be shared, adhering to the principles of confidentiality and the Health Insurance Portability and Accountability Act (HIPAA) regulations.

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A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse manager is leading a discussion about ethical dilemmas. Which of the following situations should the nurse manager include as an example of an ethical dilemma?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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