A nurse is caring for a 19-year-old client who has just been informed that their cancer has metastasized. The client tells the nurse that they do not want to continue chemotherapy. Which of the following responses should the nurse make?

The correct answer is choice D.

Choice A rationale:

“A client who is in balanced skeletal traction.” This client requires specialized orthopedic knowledge to manage the traction and monitor for complications. A nurse without orthopedic experience may not be familiar with the care required.

Choice B rationale:

“A client who had a total hip arthroplasty 3 days ago.” This client is likely to require specialized post-operative care, including pain management, mobility assistance, and monitoring for complications such as infection or dislocation. These tasks typically require specific orthopedic training.

Choice C rationale:

“A client who has a fractured femur with a new cast.” This client will require specialized care to manage the cast, monitor for complications such as compartment syndrome, and provide pain management. These tasks typically require specific orthopedic training.

Choice D rationale:

“A client who had a right above-the-knee amputation 24 hours ago.” This is the correct answer. While this client will require post-operative care, the care is likely to be similar to the post-operative care provided on a medical unit, such as pain management, wound care, and monitoring for complications. Therefore, a nurse from a medical unit could likely provide appropriate care for this client.

Choice A rationale:

Beneficence. Beneficence refers to the ethical principle of doing what is best for the client's well-being and promoting their welfare. While returning with pain medication promptly does contribute to the client's well-being, this principle does not specifically address the nurse's commitment to keeping promises or being faithful to their word.

Choice B rationale:

Utility. Utility refers to the ethical principle of seeking the greatest benefit for the greatest number of people. Fulfilling a promise to provide pain medication within the agreed-upon time frame benefits the individual client but is not necessarily related to maximizing overall utility for a broader population.

Choice C rationale:

Justice. Justice involves fairness and equitable distribution of resources and care. While ensuring timely pain relief can be seen as a just action, the concept of justice is not directly tied to keeping promises or fidelity.

Choice D rationale:

Fidelity. Fidelity, also known as "non-maleficence," centers on being faithful to commitments and maintaining trust in the nurse-client relationship. Returning with the medication as promised within 15 minutes exemplifies fidelity, as the nurse is honoring their commitment to the client's well-being and building trust through their actions.