A nurse is caring for a client who is receiving chemotherapy.
The client tells the nurse, "I'm so tired of these treatments and don't want to continue them.”. Which of the following responses by the nurse is appropriate?
"I respect your decision. I will communicate your choice with the appropriate personnel.”.
"Why are you wanting to stop treatment? It provides the best chance for survival.”.
"You're going to do just fine. You need to continue with the treatments as prescribed.”.
"Have you discussed this with your family yet?"
The Correct Answer is A
Choice A rationale
This response demonstrates respect for the client's autonomy and their right to make informed decisions about their healthcare. Acknowledging their decision and committing to communicate it to the appropriate personnel upholds ethical principles of patient self-determination, even if the decision deviates from the recommended treatment plan, ensuring their wishes are honored.
Choice B rationale
This response is confrontational and uses a "why" question, which can make the client feel defensive. It also imposes the nurse's perspective on the client's treatment choices by emphasizing survival, potentially invalidating the client's feelings of fatigue and their right to refuse treatment, thereby undermining their autonomy in the decision-making process.
Choice C rationale
This response is dismissive of the client's stated feelings and attempts to coerce them into continuing treatment by minimizing their concerns. It fails to acknowledge their distress and implies that their desire to stop treatment is irrational, thereby disrespecting their emotional state and their right to make personal choices about their care.
Choice D rationale
While involving family can be part of the decision-making process, asking if they have discussed it with their family yet can be perceived as deferring the client's individual autonomy. The primary focus should be on the client's wishes first, and this question might imply that the client's decision is not valid without family consultation, which is not always the case.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Nurse-client ratios are typically regulated at the state level through state boards of nursing or state legislative bodies, reflecting variations in healthcare demands and resource allocations across different states. There is no nationwide federal mandate establishing specific nurse-client ratios for all healthcare settings, allowing states to adapt to their unique circumstances.
Choice B rationale
Clients' rights for advance directives, such as living wills and durable powers of attorney for healthcare, are mandated at the federal level primarily through the Patient Self-Determination Act (PSDA) of 1990. This legislation requires most healthcare institutions receiving federal funding to provide information to adult patients about their rights regarding advance directives.
Choice C rationale
Nursing malpractice insurance is generally a professional responsibility of individual nurses, often required by employers or professional organizations, and is regulated at the state level, not federally. While some federal programs might have requirements related to liability, the direct mandate for nurses to carry malpractice insurance is state-specific.
Choice D rationale
State boards of nursing regulations are established and enforced at the state level. Each state has its own board responsible for defining the scope of nursing practice, licensing nurses, establishing educational requirements, and investigating complaints, all within the legal framework of that specific state. These regulations vary significantly from state to state.
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale
Open and honest communication is a cornerstone of effective team collaboration. It fosters trust, transparency, and shared understanding among team members, enabling them to effectively exchange information, discuss client needs, and make collective decisions. Without it, miscommunication and fragmented care are likely to occur.
Choice B rationale
Involving the client as a team member is crucial for client-centered care. This ensures that the care plan aligns with the client's values, preferences, and goals, empowering them in their own healthcare journey and enhancing the effectiveness of interventions. Their perspective is invaluable to holistic care planning.
Choice C rationale
Promoting personal goals first contradicts the principle of collaboration, which emphasizes shared goals and collective responsibility for the client's well-being. Individual team members prioritizing their own agendas over the unified purpose of the team can lead to fragmentation of care, conflicts, and suboptimal outcomes for the client.
Choice D rationale
Respect for individual differences, including varying professional perspectives, expertise, and communication styles, is vital for a functional interprofessional team. Acknowledging and valuing these differences allows for a richer exchange of ideas and a more comprehensive approach to problem-solving, fostering a positive and inclusive team environment.
Choice E rationale
Dependence on electronic communication alone can hinder effective team collaboration. While electronic communication is a valuable tool, it lacks the nuances of face-to-face interaction, which can be essential for complex discussions, emotional support, and building strong interpersonal relationships within the team. A balanced approach is often most effective. .
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