A nurse is caring for a client who complains about sleep apnea.
Which delivery device would the nurse expect to use to administer oxygen to this client while sleeping?

Choice A rationale

Deception involves intentionally misleading someone. Applying physical restraints for the client's safety, while ethically complex, is a transparent intervention intended to prevent harm, not to deceive the client. The intent is protective, even if the client resists.

Choice B rationale

Advocacy involves supporting the client's best interests and rights. While the nurse's concern for the client's safety is a form of advocacy, the act of physical restraint itself can be seen as limiting the client's autonomy, potentially conflicting with a purely advocacy-based approach.

Choice C rationale

Harm, in an ethical context, refers to physical or psychological injury or damage. While the intention of restraints is to prevent falls and physical harm, the application of restraints can itself cause physical injury (e.g., skin breakdown, nerve damage) or psychological distress (e.g., fear, humiliation, loss of control). Therefore, it is a measure that carries the potential for harm.

Choice D rationale

Paternalism involves making decisions for a client that the healthcare professional believes are in the client's best interest, even against the client's wishes. Applying restraints to prevent the client from harming themselves, despite their resistance, aligns with the concept of paternalism, prioritizing safety over autonomy in this specific situation.

Choice A rationale

An older adult client without family support who is uncertain about a significant life change like moving to assisted living is particularly vulnerable. The nurse advocate can help this client understand their options, express their concerns, and ensure their wishes are considered, as they may lack the resources or confidence to navigate this process independently, making advocacy crucial for their well-being and autonomy.

Choice B rationale

A client who makes an informed decision to refuse chemotherapy is exercising their autonomy. While the nurse supports this decision, the client is already empowered and making their own choices based on understanding, thus requiring less direct advocacy in the sense of ensuring their voice is heard or their rights are upheld against potential opposition.

Choice C rationale

A client undergoing a repeat procedure is likely familiar with the process and has presumably consented previously. While the nurse ensures they are still informed and comfortable, the need for strong advocacy to ensure their wishes are respected against external pressures is less pronounced compared to a vulnerable client facing a new and uncertain situation.

Choice D rationale

A client who chooses alternative treatments after being educated on conventional options is also exercising their autonomy based on their values and understanding. The nurse's role is to ensure this decision is informed, but the client is already acting as their own advocate by making a conscious choice, reducing the immediate need for external advocacy.