A nurse is caring for a client who is comatose and has advance directives that indicate the client does not want life-sustaining measures. The client's family wants the client to have life-sustaining measures. Which of the following actions should the nurse take?
Arrange for an ethics committee meeting to address the family's concerns.
Complete an incident report.
Support the family's decision and initiate life-sustaining measures.
Encourage the family to contact an attorney.
The Correct Answer is A
A. Arrange for an ethics committee meeting to address the family's concerns. An ethics committee can provide guidance in situations where there is conflict between advance directives and family wishes. This supports ethical decision-making while honoring the client’s autonomy and legal rights.
B. Complete an incident report. An incident report is used for errors or unusual events, not ethical dilemmas or conflicts over advance directives. It is not appropriate in this scenario.
C. Support the family's decision and initiate life-sustaining measures. The nurse is legally and ethically bound to follow the client’s advance directives, not the family’s wishes, especially when the client’s decisions are documented and clear.
D. Encourage the family to contact an attorney. While families have legal rights, referring them directly to an attorney does not address the immediate ethical issue or facilitate collaborative resolution in the care setting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "Rise slowly when getting out of bed." Furosemide can lead to significant fluid and electrolyte loss, causing orthostatic hypotension. Clients may experience dizziness or lightheadedness when changing positions. Rising slowly helps prevent falls and promotes safety.
B. “Taking furosemide can cause you to be overhydrated." Furosemide is a potent diuretic that promotes fluid excretion, not retention. The risk of dehydration and electrolyte imbalance is much higher than overhydration. Monitoring intake and output is essential.
C. "Eat foods that are high in sodium." High sodium intake increases fluid retention, which can worsen heart failure symptoms. Furosemide is often prescribed to manage fluid overload, and sodium-rich foods would counteract its effects. A low-sodium diet is recommended.
D. “Taking furosemide can cause your potassium levels to be high." Furosemide increases the excretion of potassium through the kidneys, often leading to hypokalemia. Low potassium levels can result in muscle weakness or cardiac arrhythmias.
Correct Answer is B
Explanation
A. "Administer this medication as needed for symptom control." Fluticasone is an inhaled corticosteroid used for long-term control, not for acute symptom relief. It should be administered on a regular schedule, not as needed.
B. "Rinse mouth and gargle with water after each use." Rinsing the mouth helps prevent oral thrush (candidiasis), a common side effect of inhaled corticosteroids like fluticasone. It reduces residual medication in the mouth and supports good oral hygiene.
C. “Administer this medication before any other inhaled medications.” Fluticasone should be given after bronchodilators, such as albuterol, if both are prescribed. Administering a bronchodilator first opens the airways and allows the corticosteroid to work more effectively.
D. "Growth may be accelerated while using this medication?” Inhaled corticosteroids may cause slowed growth in some children with long-term use, though the effect is generally small and outweighed by the benefits of asthma control.
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