A nurse is reviewing the medical record of a client who has a do-not-resuscitate (DNR) order. The nurse notes that the order was written by the physician after consulting with the client's health care proxy, who is the client's adult daughter. The nurse also notes that the client is alert and oriented and has not expressed any objections to the DNR order.
What is the appropriate action by the nurse in this situation?
Confirm the DNR order with the client and document the conversation in the medical record.
Contact the physician and request that the DNR order be revoked, as the client has not given consent.
Respect the DNR order and provide palliative care to the client, as the health care proxy has authority to make decisions.
Ignore the DNR order and initiate resuscitation measures if the client experiences cardiac or respiratory arrest, as the order is invalid.
The Correct Answer is A
Rationale: The appropriate action by the nurse in this situation is to confirm the DNR order with
the client and document the conversation in the medical record. The nurse should ensure that
the client understands what a DNR order means and that they agree with it. The nurse should
also respect the client's right to change their mind at any time and revoke the DNR order if they wish.
Incorrect options:
B) Contact the physician and request that the DNR order be revoked, as the client has not given consent. - This is an inappropriate action, as it would violate the client's autonomy and dignity. The nurse should not assume that the client has not given consent, as they may have discussed their wishes with their health care proxy or physician beforehand. The nurse should confirm the DNR order with the client instead of requesting its revocation.
C) Respect the DNR order and provide palliative care to the client, as the health care proxy has authority to make decisions. - This is a partially correct action, as the nurse should respect the DNR order and provide palliative care to the client. However, the nurse should not rely solely on the health care proxy's authority to make decisions, asthe client is alert and oriented and may have their own preferences and opinions. The nurse should confirm the DNR order with the client as well.
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Related Questions
Correct Answer is A
Explanation
Rationale: The appropriate action by the nurse in this situation is to confirm the DNR order with
the client and document the conversation in the medical record. The nurse should ensure that
the client understands what a DNR order means and that they agree with it. The nurse should
also respect the client's right to change their mind at any time and revoke the DNR order if they wish.
Incorrect options:
B) Contact the physician and request that the DNR order be revoked, as the client has not given consent. - This is an inappropriate action, as it would violate the client's autonomy and dignity. The nurse should not assume that the client has not given consent, as they may have discussed their wishes with their health care proxy or physician beforehand. The nurse should confirm the DNR order with the client instead of requesting its revocation.
C) Respect the DNR order and provide palliative care to the client, as the health care proxy has authority to make decisions. - This is a partially correct action, as the nurse should respect the DNR order and provide palliative care to the client. However, the nurse should not rely solely on the health care proxy's authority to make decisions, asthe client is alert and oriented and may have their own preferences and opinions. The nurse should confirm the DNR order with the client as well.
Correct Answer is C
Explanation
Rationale: The nurse should empathize with the client's situation, but refuse to help them with their request to end their life by taking an overdose of medication. The nurse should explain that it is against their scope of practice and code of ethics to assist the client in ending their life, as this violates the principle of nonmaleficence, which states that nurses should do no harm or allow harm to occur.
Incorrect options:
A) "I understand that you are suffering, but I cannot help you with that. It is illegal and unethical for me to assist you in ending your life." - This is an incorrect response, as it does not show empathy or compassion for the client's situation. The nurse should not use legal or ethical terms that may sound harsh or judgmental to
the client.
B) "I respect your decision, but I cannot help you with that. It is against my personal and professional values to assist you in ending your life." - This is an incorrect response, as it does not show empathy or compassion for the client's situation. The nurse should not use personal or professional values that may sound biased or insensitive to
the client.
D) "I appreciate your honesty, but I cannot help you with that. It is against my moral and religious beliefs to assist you in ending your life." - This is an incorrect response, as it does not show empathy or compassion for the client's situation. The nurse should not use moral or religious beliefs that may sound intolerant or disrespectful to
the client.
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