The nurse is caring for a client just admitted with pneumonia. Which assessment finding is of greatest concern to the nurse?

Choice A reason: HIPAA is a federal law that protects patient privacy and confidentiality of health information. While HIPAA is critical in nursing practice, it is a legal requirement rather than an ethical principle. Ethical principles are broader moral guidelines such as autonomy, beneficence, nonmaleficence, and justice. Therefore, HIPAA does not qualify as an ethical principle in this context.

Choice B reason: Duty to Warn is a legal and ethical obligation in specific circumstances, such as when a patient poses a danger to themselves or others. While it is related to ethical practice, it is considered more of a legal duty tied to safety rather than a foundational ethical principle guiding everyday nursing practice. Thus, it is not the best answer here.

Choice C reason: Beneficence is indeed an ethical principle that requires nurses to act in ways that benefit patients, promoting their well-being and preventing harm. However, the Question asks for the principle most directly emphasized in teaching new nurses, and autonomy is often prioritized because it underpins patient-centered care and informed consent. Beneficence is correct in general but not the best choice in this specific Question .

Choice D reason: Autonomy is a core ethical principle in nursing practice. It emphasizes respecting the patient’s right to make their own decisions about their care, even if those decisions differ from the nurse’s recommendations. Teaching new nurses about autonomy ensures they understand the importance of informed consent, patient rights, and shared decision-making. This principle is foundational to ethical nursing practice, making it the correct answer.

Choice A reason: Increasing the oxygen level may seem appropriate because the saturation is 89%, but in clients with COPD, oxygen therapy must be carefully titrated. These patients rely on hypoxic drive to stimulate breathing, and excessive oxygen can suppress respiratory drive, leading to CO2 retention and respiratory failure. Since the client is resting comfortably and not in distress, increasing oxygen is not the immediate action.

Choice B reason: Administering PRN furosemide is indicated for fluid overload in congestive heart failure, typically when there are signs such as pulmonary edema, crackles, or dyspnea. In this case, the client is resting comfortably without evidence of acute fluid overload, so furosemide is not warranted.

Choice C reason: Delivering PRN albuterol is appropriate for acute bronchospasm or wheezing. The client is not showing signs of respiratory distress, wheezing, or bronchospasm. Therefore, albuterol is not necessary at this time.

Choice D reason: Continuing to monitor is the most appropriate action. The client’s oxygen saturation of 89% is acceptable for a COPD patient, as their target range is often 88–92%. Since the client is comfortable and stable, the nurse should continue monitoring while avoiding unnecessary interventions that could destabilize the patient’s condition.