A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an opioid pain medication PRN. The nurse is concerned that administering a dose of pain medication might hasten the client's death. Which of the following ethical principles should the nurse use to support the decision not to administer the medication?

Fidelity

Veracity

Utilitarianism

Non-maleficence

Answer and Explanation

The Correct Answer is D

A. Fidelity: Fidelity refers to the duty to fulfill one's commitments and obligations. While important in nursing practice, fidelity is not directly applicable to the decision not to administer pain medication in this scenario.
B. Veracity: Veracity refers to truthfulness and honesty in communication. While it is important for the nurse to communicate honestly with the client and their family about the risks and benefits of pain management, the decision not to administer pain medication is primarily based on the principle of non-maleficence.
C. Utilitarianism: Utilitarianism is an ethical theory that emphasizes the greatest good for the greatest number of people. While pain relief may contribute to the overall well-being of the client, the decision not to administer pain medication in this scenario is more closely aligned with the principle of non-maleficence, as it focuses on avoiding harm to the individual client.
D. Non-maleficence: Non-maleficence is the ethical principle that emphasizes the duty to do no harm. In this situation, the nurse's primary concern is to avoid causing harm to the client. Administering pain medication to relieve suffering, even if it might hasten death, aligns with the principle of non-maleficence because the intent is to alleviate suffering and provide comfort to the dying client.

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Correct Answer is C

Explanation

A. Activate the fire alarm: While activating the fire alarm is important in alerting others to the fire, the priority is ensuring the safety of clients in the immediate vicinity. Moving clients away from the potential danger takes precedence over activating the alarm.
B. Use a fire extinguisher to put out the fire: While extinguishing the fire is necessary to prevent its spread, it should only be attempted after ensuring the safety of clients nearby. Attempting to use a fire extinguisher without first moving clients could put them at risk of injury or smoke inhalation.
C. Move any clients in the immediate vicinity: This is the priority action. Moving clients away from the potential danger of the smoldering fire helps protect them from smoke inhalation and potential burns. It ensures their safety while allowing the nurse to assess the situation and determine further actions.
D. Close the fire doors on the unit: Closing fire doors can help contain the fire and prevent its spread, but it is not the immediate priority when clients are in close proximity to the smoldering fire. Moving clients to safety should be the first action taken.

A. "I can change who I designate as my health care proxy at any time." B. "I have to choose a family member as my health proxy." C. "I become incapacitated, end-of-life choices will be made by my proxy" D. "The health care proxy does not go into effect until 1 am incapable of making decisions,"

Correct Answer is B

Explanation

A. "I can change who I designate as my health care proxy at any time": This statement is correct. Clients have the right to change their designated health care proxy at any time as long as they are competent to do so. It's important for clients to know that they have flexibility in selecting their proxy based on their preferences and trust in the individual's ability to represent their wishes.
B. "I have to choose a family member as my health proxy": This statement requires clarification. While many clients may choose a family member as their health care proxy, it is not a requirement. Clients have the autonomy to choose any individual they trust to make medical decisions on their behalf, whether it's a family member, friend, or even a legal representative. It's crucial to ensure that the chosen proxy understands the client's wishes and is willing and able to advocate for them.
C. "If I become incapacitated, end-of-life choices will be made by my proxy": This statement is accurate. A health care proxy is designated to make medical decisions on behalf of the client if they become incapacitated and are unable to make decisions for themselves. The proxy is responsible for advocating for the client's wishes, including end-of-life preferences, if outlined in the advance directive or communicated to the proxy beforehand.
D. "The health care proxy does not go into effect until I am incapable of making decisions": This statement is generally correct. Health care proxies typically become active only when the client is deemed incapacitated and unable to make decisions for themselves, as determined by a healthcare provider. However, the specifics may vary depending on state laws and the language of the advance directive document. It's essential for clients to understand when the proxy's authority begins and how it transitions based on their capacity to make decisions.

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Naxlex Comprehensive Predictor Exams

A client smoking in his bathroom has dropped a cigarette butt into a wastepaper basket, which begins to smolder. Which of the following actions is the nurse's priority?

Correct Answer is C

Explanation

A nurse is caring for a client who has named a person to serve as his health care proxy. The client talks about this type of advance directives. Which of the following statements by the client indicates a need for clarification?

Correct Answer is B

Explanation

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