A nurse is caring for a client who has gone into cardiac arrest.
The client's chart indicates refusal of life-sustaining measures in a living will signed 10 years ago, but a do-not-resuscitate (DNR) prescription has not been written by the provider.
Which of the following actions by the nurse is appropriate?
Consult with the client's family regarding resuscitation efforts.
Comply with the living will and let the client expire naturally.
Call a code because a DNR prescription has not been written.
Contact the provider for instructions regarding a DNR.
The Correct Answer is C
Choice A rationale
Consulting with the client’s family would delay critical actions in an emergency. Additionally, family members cannot override the legal documentation of the client's wishes, such as a living will. Ethical guidelines prioritize the client's autonomy, but without a written DNR, the nurse should prioritize immediate life-saving efforts.
Choice B rationale
A living will outlines patient preferences, but it is not legally enforceable without a corresponding provider’s order. Complying with it without a written DNR could violate legal and professional standards. The nurse must initiate life-saving actions unless explicitly instructed otherwise by the provider.
Choice C rationale
Without a written DNR, the nurse must take measures to preserve life as per standard resuscitation guidelines. Legal protection applies to actions taken during a cardiac arrest to avoid negligence. This ensures that the client receives immediate care until proper clarification is made.
Choice D rationale
Contacting the provider during a cardiac arrest introduces a delay, increasing the risk of irreversible damage or death. While it is essential to clarify orders, emergency protocol dictates acting promptly to save the client’s life in the absence of clear documentation.
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Related Questions
Correct Answer is B
Explanation
Choice A rationale
Assignment abandonment involves leaving patients without care, which isn’t the nurse’s action here. The nurse stayed responsible and notified the charge nurse about equipment unfamiliarity to maintain ethical and safe practice standards.
Choice B rationale
Legal risks arise when a nurse uses medical equipment without validation, breaching competency and risking harm. Standards by regulatory bodies like the Joint Commission highlight the need for appropriate training, ensuring safe, error-free patient care.
Choice C rationale
Refusal of neonatal assignments does not connect to the case's circumstances. The legal concerns stem from equipment unfamiliarity, not from declining to work in specific units, which falls under staffing policies rather than individual liability.
Choice D rationale
Scope-of-practice violations occur when nurses exceed their authorized duties, but this doesn’t apply. The central issue involves patient safety risks due to equipment use beyond competence, aligning more closely with training and validation requirements.
Correct Answer is A
Explanation
Choice A rationale
Autonomy supports the client’s decision-making capacity, allowing them to determine their care preferences, including discontinuing enteral feedings. Respecting autonomy aligns with ethical nursing practice, prioritizing the client’s informed choices and independence.
Choice B rationale
Fidelity relates to maintaining commitments and professional promises but does not directly address respecting client decisions regarding care. While trust is essential, autonomy is more applicable in this context.
Choice C rationale
Justice emphasizes fairness and equal treatment, which is vital in resource distribution and ethical practice. However, it does not directly pertain to honoring a client’s individual decisions.
Choice D rationale
Beneficence involves promoting the client’s well-being, which might conflict with their decision to discontinue treatment. Supporting autonomy takes precedence when clients make informed choices. .
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