An older adult client experiences a change in mental status. Which assessment finding represents a critical thinking approach?

A. Be available to the client: This is the most appropriate action for the nurse to take. The client's question reflects existential distress and a search for meaning in the face of suffering. Being available to listen to the client's concerns, offering emotional support, and providing a safe space for the client to express their feelings can be comforting and therapeutic. The nurse should demonstrate empathy, validate the client's emotions, and encourage open communication without imposing personal beliefs or judgments.

B. Call the physician for an antianxiety medication: While the client may be experiencing anxiety or distress, immediately resorting to medication is not the most appropriate response to the client's existential question. Antianxiety medication may provide temporary relief of symptoms but does not address the underlying spiritual or existential distress. It is essential for the nurse to explore the client's concerns and provide holistic support rather than solely relying on pharmacological interventions.

C. Advise the client to pray for answers: This response imposes the nurse's religious or spiritual beliefs onto the client and may not be appropriate for individuals who do not share the same beliefs. It is essential for the nurse to respect the client's autonomy and beliefs while providing support and guidance. Instead of advising the client to pray, the nurse should focus on active listening, empathy, and providing nonjudgmental support.

D. Share personal religious beliefs with the client: Sharing personal religious beliefs with the client is not appropriate in this situation. Doing so may impose the nurse's beliefs onto the client, which can be perceived as intrusive or insensitive. It is essential for the nurse to maintain professional boundaries and respect the client's autonomy, beliefs, and preferences. The focus should be on providing empathetic support and addressing the client's emotional and existential concerns.

A. Justice: Justice refers to fairness and equitable distribution of resources and treatment. While it is important in healthcare decision-making, it is not directly applicable in this scenario, where the focus is on respecting the client's autonomy in decision-making.

B. Nonmaleficence: Nonmaleficence is the principle of doing no harm. While it is essential for healthcare professionals to avoid causing harm to clients, it does not directly address the client's right to make autonomous decisions about their care.

C. Beneficence: Beneficence refers to the duty to do good and act in the best interest of the client. While it is important for nurses to promote the well-being of their clients, in this scenario, the client's autonomous decision not to undergo surgery or chemotherapy takes precedence over the nurse's desire to promote beneficence.

D. Respect for autonomy: This is the correct answer. Respect for autonomy is the ethical principle that recognizes individuals' right to make their own decisions and choices regarding their healthcare, based on their values, beliefs, and preferences. In this scenario, the nurse respects the client's autonomous decision not to pursue surgery or chemotherapy, even though it may conflict with the nurse's personal beliefs about preserving life.