A nurse caring for a client at the end of life receives notification of the client's eligibility for organ donation. Which action should the nurse take?
Advocate for the client to donate their organs.
Consult the client to determine their wishes.
Discuss the organ donation with the client's family.
Prioritize comfort care measures for the client.
The Correct Answer is D
Choice A reason:
Advocating for organ donation places the nurse’s values or the healthcare system’s needs above the client’s autonomy. Ethical nursing practice requires that organ donation decisions remain voluntary and free from pressure. The nurse must not promote or persuade the client to donate organs, especially at the end of life, as this may compromise ethical boundaries and trust.
Choice B reason:
While determining a client’s wishes is important, initiating discussions about organ donation is not the nurse’s responsibility unless the client independently expresses interest. Conversations about organ donation are typically handled by designated personnel to avoid coercion and ensure ethical compliance. The nurse should not independently consult the client about donation eligibility at the end of life.
Choice C reason:
Discussing organ donation with the family is also not the nurse’s role unless specifically directed by institutional policy and coordinated through the appropriate organ procurement organization. Introducing the topic directly may cause emotional distress and may be perceived as pressure during a vulnerable time.
Choice D reason:
The nurse’s primary responsibility at the end of life is to prioritize comfort care measures, including pain management, emotional support, and preservation of dignity. End-of-life nursing care focuses on alleviating suffering and supporting the client and family, regardless of organ donation eligibility. This action aligns with ethical principles of beneficence and nonmaleficence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Asking the healthcare provider to speak with the client implies an attempt to change or challenge the client’s decision. The client has expressed acceptance of their prognosis and a clear preference for hospice care. In this situation, the issue is not lack of understanding or need for further medical clarification, but rather the nurse’s internal disagreement. Therefore, involving the provider is not the most appropriate initial action.
Choice B reason:
Collaborating with the team to convince the client to stay violates the ethical principle of autonomy. Clients with decision-making capacity have the right to refuse further treatment and choose hospice care. Attempting to persuade or pressure the client to continue treatment disregards their expressed wishes and may cause emotional distress.
Choice C reason:
When a nurse disagrees with a client’s end-of-life decision, the appropriate action is self-reflection. Examining one’s own values and beliefs about death and dying allows the nurse to provide nonjudgmental, client-centered care. This promotes professional boundaries, respects client autonomy, and ensures that personal beliefs do not interfere with ethical nursing practice.
Choice D reason:
Consulting the ethics committee is appropriate when there is an ethical conflict, uncertainty about decision-making capacity, or disagreement among parties regarding care. In this case, the client’s wishes are clear and ethically sound. The conflict exists within the nurse, not the care plan, making an ethics consultation unnecessary.
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason:
A chest x-ray is required before using a PICC line to ensure proper placement and prevent complications such as pneumothorax or malposition, which could result in ineffective therapy or injury.
Choice B reason:
Applying a sterile dressing per facility protocol prevents infection at the insertion site and maintains catheter integrity. This is critical for preventing bloodstream infections.
Choice C reason:
Scheduling daily blood draws from the PICC is unnecessary and may increase the risk of infection. Blood should only be drawn as clinically indicated.
Choice D reason:
Flushing the PICC line with 0.9% sodium chloride before and after each use maintains patency, prevents clot formation, and ensures the line remains functional for medication administration or fluid therapy.
Choice E reason:
Regular monitoring of the insertion site for redness, swelling, pain, or discharge allows early identification of infection, phlebitis, or infiltration, ensuring timely intervention and client safety.
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