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 B rationale
The immediate priority following a medication error, even without harm, is to notify the prescribing provider. This allows the provider to assess the situation, determine if any interventions are necessary for the client, and make informed decisions about the client's ongoing care. Prompt communication ensures client safety and facilitates timely adjustments.
Choice A rationale
Documenting the error in the client's medical record is crucial for legal and professional accountability, and for continuity of care. However, it should occur after the provider has been notified and any immediate client safety concerns have been addressed. The initial focus is on client well-being and assessment.
Choice C rationale
Contacting risk management is an important step in the institutional process for addressing errors, facilitating analysis and prevention of future incidents. However, direct notification of the provider takes precedence because it directly impacts the client's immediate care and allows for prompt clinical assessment and decision-making regarding the client's condition.
Choice D rationale
Completing an incident report is a procedural step for internal tracking, analysis, and quality improvement. While essential for organizational learning and preventing recurrence, it is secondary to ensuring the immediate safety and clinical management of the client by notifying the provider first.
Correct Answer is C
Explanation
Choice A rationale
Caring for additional clients due to another nurse's absence is an example of workload redistribution or staffing adjustment, not delegation. Delegation involves entrusting a task that is within the scope of practice of the delegator to another individual who is competent to perform it, not simply taking on more tasks oneself.
Choice B rationale
Providing a shift report to oncoming staff is a fundamental communication responsibility of a professional nurse. This involves transferring essential client information to ensure continuity of care and is not considered a delegated task. It is an act of professional accountability.
Choice C rationale
Asking an assistive personnel (AP) to assist a client to the bathroom is a classic example of delegation. The nurse retains accountability for the client's overall care but can appropriately assign this task, which falls within the AP's scope of practice and does not require complex nursing judgment, while maintaining supervision.
Choice D rationale
Administering medications is a core responsibility of a licensed nurse and typically cannot be delegated to assistive personnel due to the high level of nursing judgment, assessment, and critical thinking required to ensure client safety and therapeutic outcomes. This falls within the licensed nurse's professional scope.
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