The family members of an older adult client are expressing disagreement over whether the client should have surgery that is recommended by the provider. The oldest adult child has durable power of attorney. The client is oriented to person, place, and time. Which of the following people has the legal authority to make the care decision?

Choice A reason: A nurse refusing to actively participate during an elective abortion procedure scheduled for their client is not a behavior that indicates a need for further education. The nurse has the right to conscientious objection, which means they can decline to perform or assist in a procedure that violates their moral or religious beliefs. The nurse should inform the charge nurse of their objection and request to be reassigned to another client.

Choice B reason: A nurse explaining to a client's family that a DNR order includes withholding comfort measures is a behavior that indicates a need for further education. The nurse is providing false and misleading information that can cause harm and distress to the client and the family. A DNR order only means that no cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS) will be initiated in the event of a cardiac or respiratory arrest. A DNR order does not affect the provision of other treatments, such as pain management, hydration, nutrition, oxygen, or emotional support.

Choice C reason: A nurse informing a confused client who wants to go home that they are going to stay at the facility until they are better is not a behavior that indicates a need for further education. The nurse is using therapeutic communication and providing reassurance to the client. The nurse is also respecting the client's autonomy and right to refuse treatment, as long as the client is competent and informed. The nurse should assess the client's mental status and decision-making capacity, and involve the client's family or surrogate decision-maker if needed.

Choice D reason: A nurse giving prescribed opioids to a client who has a terminal illness and respirations of 8/min is not a behavior that indicates a need for further education. The nurse is following the principle of beneficence, which means doing good and preventing harm to the client. The nurse is also following the principle of double effect, which means that an action that has both a good and a bad effect is morally permissible if the good effect outweighs the bad effect. The nurse is providing adequate pain relief to the client, even if it may hasten their death. The nurse should monitor the client's vital signs and level of consciousness, and adjust the opioid dose as prescribed.

Choice A reason: Suggesting that the client read articles that recommend specific treatments for Crohn's disease is not an action the nurse should take. This is an inappropriate and potentially harmful action, as the nurse should not endorse any treatments that are not prescribed by the provider. The nurse should also avoid giving the client unreliable or biased sources of information.

Choice B reason: Recommending podcasts that discuss Crohn's disease to the client is not an action the nurse should take. This is an ineffective and insufficient action, as the nurse should not rely on podcasts as the primary source of education for the client. The nurse should also assess the quality and credibility of the podcasts before suggesting them to the client.

Choice C reason: Encouraging the client to research Crohn's disease on websites that have a .gov address is an action the nurse should take. This is an appropriate and helpful action, as the nurse should promote the client's self-education and empowerment. The nurse should also guide the client to use websites that have a .gov address, as they are more likely to provide accurate and evidence-based information.

Choice D reason: Asking a licensed practical nurse to explain Crohn's disease to the client is not an action the nurse should take. This is an irresponsible and unprofessional action, as the nurse should not delegate the task of client education to a licensed practical nurse. The nurse should provide the client with clear and comprehensive information about their condition and answer any questions they may have.