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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Protective eyewear is primarily used to protect the eyes from splashes of bodily fluids during procedures like suctioning or surgeries. Since the pressure ulcer is nondraining, there is no risk of fluid exposure, making this precaution unnecessary in this scenario.
Choice B rationale
Wearing a mask is essential to prevent the spread of airborne infections like tuberculosis. MRSA spreads through direct contact or contaminated surfaces, not airborne transmission. Thus, a mask is not indicated for dressing changes of nondraining pressure ulcers.
Choice C rationale
HEPA filtration systems are used to remove airborne contaminants in controlled environments, such as isolation rooms for patients with tuberculosis. MRSA does not require airborne precautions, so turning on a HEPA filtration system is not relevant.
Choice D rationale
Dedicated equipment prevents cross-contamination between patients when managing infections like MRSA. Items like thermometers and stethoscopes should be exclusive to the infected patient, reducing the spread of resistant bacteria to others.
Correct Answer is D
Explanation
Choice A rationale
Teaching prescribed medications focuses on education rather than advocacy. Advocacy specifically involves representing or supporting the client’s unique needs and rights. While medication education is a valuable nursing function, it does not encompass the broader scope of advocacy that emphasizes active representation and championing of a client’s priorities.
Choice B rationale
Collaboration with team members highlights teamwork, which is essential but distinct from advocacy. Advocacy involves a nurse acting as an intermediary between the client and healthcare system, prioritizing the client’s voice. Collaboration, although beneficial for client outcomes, lacks the personalized focus inherent to advocacy.
Choice C rationale
Encouraging the expression of feelings is integral to emotional support and therapeutic communication but does not inherently constitute advocacy. Advocacy goes beyond emotional expression by actively ensuring that the client’s needs and preferences are addressed within the healthcare framework.
Choice D rationale
Advocacy involves actively supporting the client’s needs, which aligns with the concept of representing their best interests. It ensures their priorities and rights are addressed, particularly in situations where the client may feel vulnerable or unheard, making it the core aspect of advocacy.
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