A nurse is caring for a client who has a living will on file stating no feeding tube insertion. The client's durable power of attorney for health care, their sibling, requests a feeding tube to prolong life, refusing to honor the living will. What is the nurse's best action?
Proceed with inserting the feeding tube since the proxy's decision overrides the living will.
Ignore both the living will and proxy and provide comfort care only.
Consult the hospital ethics committee before taking any action regarding feeding tube insertion,
Inform the health care provider of the conflict and advocate for honoring the client's living will
The Correct Answer is D
Rationale:
A. Proceeding with inserting the feeding tube is incorrect because the living will is a legal document that expresses the client’s wishes regarding life-sustaining treatments. A durable power of attorney for health care (proxy) cannot override explicit instructions in a valid living will. Ignoring the living will could violate the patient’s autonomy and legal rights.
B. Ignoring both the living will and proxy and providing comfort care only is incorrect because the nurse cannot make unilateral decisions about life-sustaining treatments. Care must follow legal documents, the provider’s orders, and established ethical guidelines.
C. Consulting the hospital ethics committee is incorrect as the first action. While involving the ethics committee can provide guidance in complex situations, the immediate priority is to ensure the client’s legally documented wishes are respected and communicated to the provider. Ethics consultation may follow if further clarification is needed.
D. Informing the health care provider of the conflict and advocating for honoring the client’s living will is correct. The nurse’s responsibility is to uphold the client’s autonomy and legal rights. The nurse should ensure that the provider is aware of the living will, communicate the client’s previously expressed wishes, and advocate for care that aligns with those directives. This action protects patient rights, supports ethical practice, and provides a clear, legally compliant plan for care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C,D,A,F,B,E
Explanation
Rationale:
- Assess the client's airway (C) – The first priority is always airway assessment, especially when the client presents with symptoms of anaphylaxis (hoarseness, lip/tongue swelling) that can rapidly progress to airway obstruction. According to the ABC framework (Airway, Breathing, Circulation), airway compromise is life-threatening and requires immediate evaluation.
- Call the emergency response team (D) – Activating the emergency team ensures rapid access to additional resources and support for anaphylactic management, including advanced airway interventions and medications. Early team involvement is crucial in preventing deterioration.
- Apply high-flow oxygen (A) – Once the airway is assessed and help is summoned, administering high-flow oxygen supports oxygenation and tissue perfusion, addressing potential hypoxia caused by airway edema or bronchospasm.
- Initiate IV access (F) – Establishing IV access provides a route for rapid medication administration and fluid resuscitation, which is critical in anaphylaxis for both epinephrine delivery and hypotension management.
- Administer IV epinephrine (B) – Epinephrine is the first-line treatment for anaphylaxis. It should be given promptly via the IV or intramuscular route once IV access is established, to reverse airway edema, bronchospasm, and hypotension.
- Administer IV antihistamines (E) – Antihistamines help control ongoing histamine-mediated symptoms, such as urticaria and pruritus, but are adjunctive therapy and should not delay epinephrine administration.
Correct Answer is A
Explanation
Rationale:
A. "Malpractice insurance helps cover legal expenses and damages in case of a lawsuit" is correct because malpractice insurance provides financial protection for nurses if they are sued for negligence, errors, or omissions in patient care. It typically covers legal defense costs, settlements, or judgments, allowing nurses to defend themselves without bearing the full financial burden.
B. "It is not necessary for nurses to have malpractice insurance" is incorrect because nurses can be held personally liable for negligence or errors in practice. Having malpractice insurance protects the nurse in case of a lawsuit, regardless of employment status.
C. "Malpractice insurance is provided by the employer for all nurses" is incorrect because not all employers provide coverage, and even when they do, it may not fully protect the nurse personally or cover actions outside the scope of employment. Nurses are often encouraged to carry individual malpractice insurance.
D. "Malpractice insurance only covers nurses in certain specialties" is incorrect because malpractice insurance is available to all nurses across specialties. Coverage depends on the policy, not the specialty.
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