A nurse is caring for a client who has been hospitalized for 2 months.
Which of the following actions by the client indicates that professional boundaries have been blurred due to over-involvement by the nurse?
Lack of progress toward goals.
Increased requests for assistance.
Expressed feelings of isolation.
The client starts bringing the nurse gifts and treats.
The Correct Answer is D
Choice A rationale
Lack of progress toward goals is a clinical indicator of the client's condition or the effectiveness of the care plan, not necessarily a sign of blurred professional boundaries due to over-involvement by the nurse. It suggests a need for care plan revision or reassessment.
Choice B rationale
Increased requests for assistance can be a normal part of a client's hospitalization, especially in prolonged stays, indicating evolving needs or dependency. It does not inherently suggest blurred professional boundaries but rather a need for careful assessment of the client's actual requirements.
Choice C rationale
Expressed feelings of isolation are a common emotional response to prolonged hospitalization. This indicates a need for psychosocial support and interventions to enhance social interaction, rather than being a direct sign of blurred professional boundaries initiated by the nurse's over-involvement.
Choice D rationale
The client starting to bring the nurse gifts and treats is a clear indication that professional boundaries have been blurred due to over-involvement by the nurse. This behavior often suggests a personal rather than professional relationship, potentially compromising objectivity and professional distance.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Paternalism in healthcare involves a professional making decisions for a patient without their full consent, often justified by the belief that it is for the patient's own good. This approach can override patient autonomy and self-determination, potentially leading to ethical conflicts regarding individual rights and the role of the healthcare provider in decision-making processes, contrasting with upholding directives.
Choice B rationale
Altruism describes a selfless concern for the well-being of others, often involving personal sacrifice. While nurses generally act altruistically, this principle specifically refers to the motivation behind an action, not the adherence to a legal or ethical directive regarding patient care, which falls under different ethical frameworks focusing on patient rights.
Choice C rationale
Autonomy is the ethical principle recognizing an individual's right to self-determination and independent decision-making regarding their own healthcare. By upholding the client's advance directive, the nurse is respecting the client's previously expressed wishes, even when the client is currently unable to communicate them, thereby honoring their right to choose.
Choice D rationale
Beneficence is the ethical principle that obligates healthcare providers to act in the best interest of their patients, doing good and promoting well-being. While providing artificial nutrition could be seen as beneficial, the specific act of upholding a pre-existing directive directly relates to respecting the patient's autonomous wishes rather than simply acting beneficially.
Correct Answer is B
Explanation
Choice A rationale
While a formal meeting is necessary, scheduling it within 72 hours might not be immediate enough to address the potential danger posed by a chemically impaired nurse. The immediate priority is to ensure the safety of the nurse and clients, which necessitates prompt removal and ensuring safe transport.
Choice B rationale
Ensuring a safe way for the nurse to get home is an immediate and appropriate action. This prioritizes the nurse's safety and prevents potential harm, such as driving under the influence. It also demonstrates a duty of care, preventing the nurse from causing harm to themselves or others.
Choice C rationale
Searching a nurse's belongings for controlled substances without proper legal authorization or clear policy guidelines could violate the nurse's privacy rights and potentially lead to legal issues for the facility. This action is generally not the first or most appropriate step in such a situation.
Choice D rationale
Documenting the nurse's behavior in detail is crucial for subsequent actions, but it is not the immediate priority when removing a potentially impaired nurse. Documentation occurs concurrently or immediately after the primary action of ensuring safety and removing the nurse from the care environment.
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