An 18-year-old client in the emergency department is scheduled for an appendectomy. Although the client's parents advocate for the surgery, the client declines the procedure. Which of the following ethical principles is the nurse displaying by respecting the client's decision?

Nonmaleficence

Autonomy

Beneficence

Justice

Answer and Explanation

The Correct Answer is B

A. Nonmaleficence: Nonmaleficence refers to the obligation to do no harm and to avoid causing injury. While this principle is always important in healthcare, the central issue in this scenario involves respecting the client's decision-making rights rather than directly preventing harm.

B. Autonomy: Autonomy is the ethical principle that supports a client's right to make their own healthcare decisions, even if those decisions differ from the wishes of others, including family members. Respecting the 18-year-old client's choice to decline surgery honors their legal and moral right to self-determination.

C. Beneficence: Beneficence involves taking actions that promote the well-being and best interests of the client. While advocating for the surgery could be seen as promoting beneficence, the nurse’s primary ethical duty in this situation is to respect the client’s independent decision.

D. Justice: Justice is concerned with fairness and the equitable distribution of healthcare resources. Although justice is a core ethical principle, it does not directly apply to an individual’s right to refuse treatment as seen in this situation.

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Correct Answer is ["B","C","D","E"]

Explanation

Lung assessment: The client's lungs are clear bilaterally with no signs of respiratory distress or abnormal breath sounds. There is no indication of pulmonary complications, so no further immediate action is needed regarding the lung assessment.
Vertigo: Vertigo is a common complication following a stapedectomy due to disturbance of the inner ear structures. However, it still requires monitoring because severe or worsening vertigo can increase the risk of falls and indicate inner ear trauma or dysfunction.
Facial nerve assessment: The presence of left facial droop and asymmetrical smile indicates possible injury to the facial nerve during surgery. This finding is abnormal and requires immediate provider notification for further neurological evaluation and management.
Pain rating: A pain rating of 5 out of 10 is moderate and, following ear surgery, it should be addressed. Proper pain control is important not only for comfort but also to reduce the risk of increased intracranial pressure from straining or agitation.
Diminished hearing: Some decrease in hearing can occur temporarily after a stapedectomy due to packing or swelling, but it still needs further monitoring. Persistent or worsening hearing loss could suggest a surgical complication, such as prosthesis dislocation.
Pupils: The pupils are equal, smaller postoperatively but still reactive to light, which is expected following anesthesia and is not concerning. No immediate intervention is necessary based on pupil assessment findings.

A. Inject 15 units of air into the regular insulin vial B. Withdraw 10 units of NPH insulin C. Verify the dosage with another nurse D. Place the cap over the needle.

Correct Answer is A

Explanation

A. Inject 15 units of air into the regular insulin vial: After injecting air into the NPH vial without drawing up the medication, the next step is to inject air into the regular insulin vial. This maintains the correct order and prevents contamination of the regular insulin with the cloudy NPH insulin.

B. Withdraw 10 units of NPH insulin: NPH insulin should not be withdrawn first because it is cloudy and could contaminate the regular insulin if mixed incorrectly. Regular insulin, which is clear, should always be drawn up before NPH when mixing in the same syringe.

C. Verify the dosage with another nurse: Verifying insulin doses with another nurse is necessary but is typically done after the insulin is prepared and drawn up. At this stage, the immediate step is to complete proper air injection into both vials before drawing any insulin.

D. Place the cap over the needle: Recapping needles increases the risk of accidental needlestick injuries and should be avoided unless absolutely necessary. There is no need to recap at this stage in the insulin preparation process.

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An 18-year-old client in the emergency department is scheduled for an appendectomy. Although the client's parents advocate for the surgery, the client declines the procedure. Which of the following ethical principles is the nurse displaying by respecting the client's decision?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following findings requires further action by the nurse? Select all that apply.

Correct Answer is ["B","C","D","E"]

Explanation

A nurse is caring for a client who has a prescription for NPH insulin 10 units and regular insulin 15 units subcutaneously. After injecting 10 units of air into the NPH insulin vial, which of the following actions should the nurse take next?

Correct Answer is A

Explanation

The nurse has reviewed the Vital Signs at 1000. For each potential provider prescription, click to specify if the prescription is anticipated or non-anticipated for the client.

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