The emergency department nurse administers a prescribed narcotic for a client with renal colic and then discharges the client without ensuring the client has a designated driver. The client is subsequently involved in a motor vehicle collision on their way home, causing injury to self and others. Which ethical principle did the nurse violate?

Veracity

Autonomy

Beneficence

Nonmaleficence

Answer and Explanation

The Correct Answer is D

Choice A reason: Veracity is the principle of truthfulness and honesty. It involves providing accurate information to clients and being truthful in communication. While important in healthcare, veracity does not specifically address the nurse's failure to ensure the client's safety after administering a narcotic.

Choice B reason: Autonomy refers to respecting the client's right to make their own decisions about their care. While autonomy is a fundamental ethical principle, the scenario involves the nurse's responsibility to ensure safety, which falls under a different principle.

Choice C reason: Beneficence is the principle of acting in the best interest of the client by promoting good and preventing harm. Although related to the scenario, beneficence focuses more on the proactive aspect of providing care rather than preventing harm resulting from inaction.

Choice D reason: Nonmaleficence is the ethical principle of "do no harm." The nurse violated this principle by discharging the client without ensuring they had a designated driver, leading to a motor vehicle collision and injuries. The nurse's action indirectly caused harm, violating the principle of nonmaleficence.

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Correct Answer is A

Explanation

Choice A reason: Documenting the client's fingerstick blood glucose is a task that can be safely delegated to the UAP. This task involves recording a numeric value from a glucometer reading, which does not require clinical judgment or decision-making. UAPs are trained to perform and document such routine measurements accurately.

Choice B reason: Monitoring vital signs during a blood transfusion should not be delegated to a UAP. This task requires clinical judgment to identify and respond to potential adverse reactions, such as transfusion reactions, which is within the scope of practice for licensed nurses, not UAPs.

Choice C reason: Examining output from a client's surgically placed drain involves assessing the amount, color, and type of drainage, which requires clinical judgment to determine the significance of the findings. This task should be performed by a licensed nurse who can evaluate the client's condition and respond appropriately.

Choice D reason: Obtaining central venous pressure (CVP) measurements is a complex procedure that requires specialized knowledge and skills. It involves understanding hemodynamic monitoring and interpreting the measurements, which falls within the scope of practice for licensed nurses, not UAPs.

A. The client sits up and leans over the night table. B. The client's respiratory rate is 8 breaths/min. C. The client is noted to have a large barrel chest. D. The client's lungs have fine bibasilar crackles on auscultation.

Correct Answer is B

Explanation

Choice A reason: This posture, known as the tripod position, is common among clients with emphysema as it helps them breathe more easily by using accessory muscles. While it indicates respiratory distress, it is not immediately life-threatening.

Choice B reason: A respiratory rate of 8 breaths/min is significantly below the normal range (12-20 breaths/min) and indicates hypoventilation, which can lead to life-threatening conditions such as hypercapnia (elevated carbon dioxide levels in the blood). This finding needs immediate attention from the provider.

Choice C reason: A barrel chest is a common physical finding in clients with chronic emphysema. It develops over time due to hyperinflation of the lungs but is not an urgent finding that needs immediate reporting.

Choice D reason: Fine bibasilar crackles can indicate fluid accumulation in the lungs or other lung pathology, but this finding alone does not necessarily require immediate intervention unless accompanied by other critical symptoms.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for clients in the intensive care unit (ICU). Which task could the nurse safely delegate to the unlicensed assistive personnel (UAP)?

Correct Answer is A

Explanation

The nurse is assessing a client with a diagnosis of acute emphysema. The client is receiving oxygen at a flow rate of 5 L/min by nasal cannula. Which assessment findings should be reported to the provider immediately?

Correct Answer is B

Explanation

The nurse is teaching a class on bioterrorism. What is the scientific rationale for designating a specific area for decontamination?

A family in the emergency department is overwhelmed at the loss of several family members due to a shooting incident in the community. Which intervention should the nurse complete first?

The nurse manager of the emergency department arranges for critical incident stress debriefing for the staff after a mass casualty incident. Which statement by the debriefing team leader is most appropriate for this situation?

The nurse working on the medical-surgical unit has delegated several patient care tasks to the unlicensed assistive personnel. What is the nurse's primary responsibility after the delegation of tasks?

A charge nurse notes that a staff nurse delegates a large number of tasks to the assistive personnel (AP). The nurses on the next shift also report that the staff nurse frequently leaves tasks uncompleted. Which of the following statements should the charge nurse make to resolve this conflict?

The nurse is working on the neurological unit. Which task would be most appropriate to delegate to the unlicensed assistive personnel assigned to the unit?

The nurse is assessing a newly admitted client who appears upset and agitated. What would be the best action for the nurse to best assist this client?