A nurse is caring for a client who wants to stop receiving treatment for terminal cancer. The client's family asks the nurse if it is possible to continue the treatment without the client's knowledge. Which of the following responses should the nurse make?
"Your family member has the right to refuse care."
"To continue treatment, you must be appointed as your family member's health care surrogate."
"We should discuss different treatment options when your family member is not present."
"I can submit your request to the ethics committee."
The Correct Answer is A
A. "Your family member has the right to refuse care." Every competent adult has the legal and ethical right to make decisions about their own medical treatment, including the right to refuse care, even if it results in death.
B. "To continue treatment, you must be appointed as your family member's health care surrogate." The client is still competent and capable of making their own decisions, so a surrogate is not necessary or legally allowed to override their wishes.
C. "We should discuss different treatment options when your family member is not present." Discussing medical decisions behind the client’s back would be unethical and violate the principle of autonomy.
D. "I can submit your request to the ethics committee." There is no ethical dilemma here, as the client has the right to refuse treatment, and their decision must be respected.
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Related Questions
Correct Answer is C
Explanation
A. Report the incident to the pharmacy. While the pharmacy may need to be informed, client safety is the priority. The immediate concern is monitoring the client for opioid overdose effects.
B. Notify the client's provider. The provider should be notified, but assessing the client's condition comes first so that the nurse can provide accurate information about any potential adverse effects.
C. Measure the client's respiratory rate. The priority action is to assess the client for signs of opioid toxicity, especially respiratory depression. Morphine can cause decreased respiratory rate, sedation, and hypotension. If the respiratory rate is dangerously low (e.g., below 12 breaths per minute), interventions such as administering naloxone (Narcan) may be necessary.
D. Complete an incident report. An incident report should be completed, but client safety and assessment take priority before documentation.
Correct Answer is B
Explanation
A. The client cannot change their mind after signing consent. Clients have the right to withdraw consent at any time before the procedure begins.
B. The alternative treatments to the procedure should be explained. Informed consent includes information about alternative treatments and their risks/benefits so the client can make an informed decision.
C. The time of the procedure should be indicated on the form. The time of the procedure is not a required component of informed consent. The consent form should include the procedure details, risks, benefits, and alternatives
D. The charge nurse should review the form once it's signed. While nurses witness informed consent, they do not validate or review it. The provider performing the procedure is responsible for obtaining consent.
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