A nurse on an inpatient unit is caring for a group of clients who have depression. When planning care, which of the following clients should the nurse see first?

A. Beneficence involves actions that promote the well-being of clients, such as administering effective treatments, providing comfort measures, or implementing interventions that improve health outcomes. While the nurse’s question may indirectly support well-being, beneficence focuses more on actively doing good rather than offering choice.

B. Nonmaleficence is the principle of avoiding harm or preventing injury to clients. It guides nurses to consider potential risks of interventions and minimize harm, but it does not directly relate to offering clients options about scheduling.

C. Justice pertains to fairness, equality, and equitable distribution of healthcare resources and services. Ensuring all clients have equal access to therapy is an example, but the nurse asking about preference is not addressing fairness or allocation of resources.

D. Autonomy is the client’s right to make informed decisions about their own care. By asking the client whether they prefer a morning or afternoon session, the nurse is respecting the client’s personal preferences and supporting self-determination, which is a direct application of the principle of autonomy. This allows the client to feel empowered and involved in their care plan.

A. Splitting is a defense mechanism in which the client perceives people or situations as all good or all bad, with no middle ground. This can create conflict and division among healthcare team members, as the client may idealize one staff member while devaluing another, potentially disrupting team cohesion and continuity of care.

B. Regression involves reverting to earlier developmental behaviors (e.g., childish or dependent actions) under stress, but it does not typically cause division among staff.

C. Denial is the refusal to acknowledge reality or facts of a situation. While it can affect treatment adherence, it does not usually create interpersonal conflict among caregivers.

D. Reaction formation is the expression of behavior that is opposite to true feelings (e.g., acting overly friendly toward someone the client dislikes). While it may be confusing, it generally does not have the same divisive effect on the healthcare team as splitting.