The nurse encounters a client crying in her room. Upon talking to the client, it is discovered that she is upset because a new nursing assistant made her go out for a walk with the group even though the client informed her that she waits for her daughter to go for her walk. This is a potential violation of which ethical principle?

Confidentiality

Autonomy

Beneficence

Nonmaleficence

Answer and Explanation

The Correct Answer is B

A.   This principle relates to protecting patient information. It is not relevant to this scenario.
B.   This principle respects the patient's right to self-determination. By disregarding the client's preference for walking with her daughter, the nursing assistant violated the client's autonomy.
C.   This principle involves doing good for the patient. While the nursing assistant might have intended to benefit the client by encouraging exercise, it was done at the expense of the client's autonomy.
D.   This principle involves avoiding harm to the patient. While the client was upset, there is no evidence of physical harm in this situation.

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Correct Answer is D

Explanation

A. It is not the immediate priority during a panic attack. The client is currently in a state of heightened distress, and trying to teach new techniques at this moment may not be effective or practical.
B. Although administering PRN (as needed) antianxiety medication can be beneficial for managing symptoms, the immediate priority should be to ensure the client feels safe and supported. Medication may be used later in the process, but addressing the immediate needs and providing a calming environment is crucial first.
C. While understanding the client’s thought process can be helpful for therapeutic purposes and future treatment planning, asking about thoughts during an acute panic attack can be overwhelming and may not be the most supportive approach at that moment.
D. The first priority during a panic attack is to ensure the client feels safe and supported. Staying with the client in a quiet place helps reduce stimuli that could exacerbate the panic attack and provides reassurance.

A. To prevent symptoms of toxicity B. To identify early signs and symptoms of relapse C. To establish baseline liver function tests D. To ensure the client is within the therapeutic range

Correct Answer is A

Explanation

A. Lithium has a narrow therapeutic index, meaning the difference between a therapeutic dose and a toxic dose is small. Frequent monitoring allows for early detection of rising lithium levels, preventing toxicity.
B. While monitoring lithium levels is important for overall treatment, it's not primarily used to identify relapse.
C. Lithium primarily affects the kidneys, not the liver. Liver function tests are important for overall health monitoring but are not the primary reason for frequent lithium level checks.
D. While this is a goal, the primary reason for such frequent monitoring is to prevent toxicity, which can occur rapidly.

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Naxlex Comprehensive Predictor Exams

A nurse in an acute care mental health facility is caring for a client who begins to have a panic attack. Which of the following actions should the nurse take first?

Correct Answer is D

Explanation

What is the primary reason for monitoring lithium levels every two to three days until a therapeutic level is obtained?

Correct Answer is A

Explanation

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