A nurse in a mental health facility caring for a client who expresses anxiety about exercising in the outdoor courtyard. The nurse promises to walk with the client in the courtyard each day. Which of the following ethical principles is the nurse demonstrating?

Autonomy

Fidelity

Justice

Nonmalefcence

Answer and Explanation

The Correct Answer is B

A) Autonomy: Autonomy refers to the right of individuals to make their own choices and decisions. While the nurse’s actions may promote the client’s independence in the future, the nurse’s promise to walk with the client does not directly address or uphold the client’s autonomy. The nurse is offering support rather than encouraging the client to make independent decisions about their participation in the exercise.

B) Fidelity: Fidelity involves being faithful and keeping promises or commitments. In this scenario, the nurse promises to walk with the client in the courtyard each day, and this promise demonstrates the ethical principle of fidelity. The nurse is demonstrating trustworthiness and loyalty by committing to help the client overcome their anxiety and follow through with the daily exercise.

C) Justice: Justice is the ethical principle that focuses on fairness and equal treatment for all individuals. While justice is important in providing equal care to all clients, it is not the primary principle in this scenario. The nurse’s actions focus on meeting the specific needs of the individual client, which is more aligned with fidelity.

D) Nonmaleficence: Nonmaleficence means “do no harm.” While the nurse’s goal is to prevent harm by helping the client address their anxiety, the primary ethical principle at play here is fidelity, as the nurse is keeping their promise to provide consistent support. Nonmaleficence would be more relevant if the nurse were directly addressing potential harm or risk associated with the client’s situation, but the promise to walk with the client focuses more on the nurse’s commitment.

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Correct Answer is C

Explanation

A) Use a moisturizing soap to clean the skin around the client's stoma:
Using a moisturizing soap is not recommended for cleaning the skin around the stoma. Moisturizing soaps can leave a residue that may interfere with the adhesion of the ostomy appliance. The skin around the stoma should be cleaned with warm water and mild soap that does not contain lotions, fragrances, or oils. This helps ensure the skin is clean and dry, promoting better adhesion of the skin barrier.

B) Create an opening on the skin barrier that is 1.27 cm (0.5 in) larger than the client's stoma:
The opening in the skin barrier should be about 1/8 inch (approximately 0.32 cm) larger than the stoma's diameter, not 1.27 cm (0.5 in) larger. A larger opening can cause the skin barrier to fit too loosely, leading to leakage and skin irritation. The skin barrier should fit snugly around the stoma to prevent any leakage and protect the surrounding skin.

C) Empty the client's ostomy pouch before removing the skin barrier:
It is essential to empty the ostomy pouch before removing the skin barrier to prevent fecal material from spilling or leaking during the appliance change. This helps maintain cleanliness, reduces the risk of skin irritation, and makes the procedure more comfortable for both the client and the nurse.

D) Change the client's ostomy appliance 1 hour after breakfast:
There is no specific time required after breakfast to change the ostomy appliance. The timing of appliance changes should be based on the client's individual needs and lifestyle, and it is more important to change the appliance when necessary (e.g., when the pouch is full or when the skin barrier is no longer intact) rather than adhering to a specific time after meals.

A. The client’s vital signs are checked every 8 hr B. The client has developed difficulty ambulating C. The client has state-sponsored health insurance D. The client's next dressing change is scheduled in 4 hr.

Correct Answer is B

Explanation

A) The client’s vital signs are checked every 8 hr: While vital signs are an important aspect of the client's health, this information is routine and doesn't provide new insights that would impact the overall plan of care during an interprofessional team meeting. It’s important to focus on changes in the client’s condition or specific concerns that require collaboration.

B) The client has developed difficulty ambulating: This is critical information to share during the interprofessional team meeting because it may require input from physical therapists, occupational therapists, or other specialists. Difficulty ambulating can indicate a need for reassessment of the client's mobility plan, and other team members need to be informed to develop appropriate interventions.

C) The client has state-sponsored health insurance: While the client’s insurance status is relevant for financial and discharge planning, it is not directly related to the clinical management or care coordination that would be discussed in an interprofessional team meeting. The focus should be on the client’s clinical condition and needs.

D) The client's next dressing change is scheduled in 4 hr: Although the dressing change is important for continuity of care, this is more of a task-related detail rather than critical clinical information that requires interprofessional discussion. The focus in a team meeting should be on the client's progress, challenges, and needs, not just routine care tasks.

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A nurse in a mental health facility caring for a client who expresses anxiety about exercising in the outdoor courtyard. The nurse promises to walk with the client in the courtyard each day. Which of the following ethical principles is the nurse demonstrating?

Nursing Test Bank

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