A nurse is instructing a client who has a new diagnosis of Raynaud's disease about preventing the onset of manifestations. Which of the following client statements should indicate to the nurse the need for additional teaching?

Answer: B. Non-maleficence

Rationale:

A. Utility:
The principle of utility refers to actions that maximize the overall good or benefit for the greatest number of people. In this scenario, the nurse’s refusal to share the surgeon's medical diagnosis does not directly relate to maximizing benefits, so this principle is not applicable.

B. Non-maleficence:
Non-maleficence is the ethical principle that involves the obligation to avoid causing harm to others. By not disclosing the surgeon's medical diagnosis, the nurse is protecting the surgeon's privacy and confidentiality, thereby preventing potential harm that could arise from sharing sensitive health information without consent.

C. Paternalism:
Paternalism refers to making decisions for others with the belief that it is in their best interest, often overriding their autonomy. The nurse's action of withholding information is not based on deciding what is best for the other nurse but rather on adhering to confidentiality principles.

D. Justice:
Justice in healthcare refers to fairness in the distribution of resources and treatment. The situation does not pertain to equitable treatment or allocation of resources, so this principle is not relevant in this context.

A. Complete an incident report: While completing an incident report is important for documentation purposes, it should not be the first action taken after a needle stick injury. Immediate attention to the wound by washing it with soap and water takes precedence to minimize the risk of infection.
B. Consent to postexposure treatment with antiretroviral medications: Postexposure prophylaxis (PEP) with antiretroviral medications may be indicated after a needle stick injury, particularly if there is a risk of exposure to HIV or other bloodborne pathogens. However, obtaining consent for PEP should follow immediate wound care.
C. Request the risk manager obtain consent for HIV testing from the client: While HIV testing may be necessary for the client involved in the incident, it is not the nurse's responsibility to obtain consent for testing. The priority is to address the nurse's own immediate health and safety by cleaning the wound and seeking appropriate medical evaluation and treatment.
D. Wash the site of injury with soap and water: The first action the nurse should take after experiencing a needle stick injury is to immediately wash the site of the injury with soap and water. This helps reduce the risk of infection by removing any potentially infectious material from the wound.