Which situations are early signs of an ethical dilemma? (Select all that apply)

Disagreements among health care team members.

Failure to discuss end-of-life issues with patient.

Aggressive pain management.

Belief that treatment is harmful.

Following the patient’s advance directive despite family objections.

Providing hope to the patient’s family.

Answer and Explanation

Correct Answer : A,B,D,E

Choice A reason: Disagreements among team members signal conflicting values, an early ethical dilemma indicator. This aligns with healthcare ethics, making it a correct situation, as it highlights potential ethical tensions that the nurse should recognize as requiring resolution in patient care.

Choice B reason: Failure to discuss end-of-life issues with the patient violates autonomy, creating an ethical dilemma. This aligns with ethical principles of patient involvement, making it a correct early sign the nurse should identify in healthcare decision-making processes.

Choice C reason: Aggressive pain management is a clinical decision, not inherently an ethical dilemma unless harm is suspected. Disagreements or belief in harm are clearer signs, making this incorrect, as it lacks the ethical conflict context in the nurse’s evaluation.

Choice D reason: Believing treatment is harmful raises ethical concerns about beneficence and nonmaleficence, indicating a dilemma. This aligns with ethical care standards, making it a correct situation the nurse should recognize as an early sign of an ethical issue in treatment decisions.

Choice E reason: Following an advance directive despite family objections creates an ethical conflict between patient autonomy and family wishes. This aligns with end-of-life ethics, making it a correct early sign of a dilemma the nurse should identify in patient care.

Choice F reason: Providing hope to the family is supportive and not inherently an ethical dilemma unless it involves deception. Failure to discuss end-of-life issues is a clearer sign, making this incorrect, as it lacks the ethical conflict context in the nurse’s assessment.

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Correct Answer is C

Explanation

Choice A reason: Encouraging fluid intake is inappropriate post-hemodialysis, as fluid overload is a risk. A fever of 101.2°F requires provider notification, making this incorrect, as it’s unsafe compared to the nurse’s priority of addressing a potential infection promptly.

Choice B reason: Monitoring vital signs is useful but doesn’t address the urgency of a 101.2°F fever post-hemodialysis, which may indicate infection. Notifying the provider is critical, making this incorrect, as it delays the nurse’s action to manage a serious complication.

Choice C reason: Notifying the provider is most appropriate for a fever of 101.2°F post-hemodialysis, as it may signal infection, a serious complication. This aligns with post-dialysis care priorities, making it the correct action for the nurse to take immediately.

Choice D reason: Monitoring the shunt site is relevant but less urgent than notifying the provider about a fever, which may indicate systemic infection. This is incorrect, as it delays the nurse’s priority of addressing the client’s elevated temperature post-hemodialysis.

A. The student nurse flushes the gastrostomy tube with 15 mL water between medications. B. The student nurse reinserts 50 mL stomach contents after aspiration of the gastrostomy tube. C. The student nurse checks the pH of the gastric aspirate prior to flushing the gastrostomy tube. D. The student nurse reconnects the enteral feeding immediately after the medication is given.

Correct Answer is D

Explanation

Choice A reason: Flushing with 15 mL water between medications is correct to prevent clogging and ensure delivery. Immediate feeding reconnection risks phenytoin absorption, making this incorrect, as it’s a proper action unlike the error requiring the nurse’s immediate intervention.

Choice B reason: Reinserting 50 mL of aspirated stomach contents is acceptable to maintain fluid balance. Reconnecting feeding immediately affects phenytoin efficacy, making this incorrect, as it’s a correct action compared to the student’s error needing the nurse’s urgent correction.

Choice C reason: Checking gastric aspirate pH confirms tube placement, a safety step. Immediate feeding reconnection reduces phenytoin absorption, making this incorrect, as it’s a proper action unlike the student’s mistake requiring the nurse’s immediate intervention for medication administration.

Choice D reason: Reconnecting enteral feeding immediately after phenytoin reduces its absorption, as feedings should be held for 1-2 hours. This requires immediate intervention, aligning with medication administration protocols, making it the correct action for the nurse to address in the student’s care.

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Which situations are early signs of an ethical dilemma? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chronic kidney disease returns to the nursing unit following a hemodialysis treatment. On assessment, the nurse notes that the client’s temperature is 101.2°F (38.5°C). Which nursing action is most appropriate?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

The nurse is taking care of a 60-year-old client who is scheduled for open reduction internal fixation of the left femur. Which ethical principle is most important when soliciting informed consent from the patient?

After receiving the change-of-shift report, which client does the nurse assess first?

The client newly diagnosed with chronic kidney disease recently has begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse would assess the client during dialysis for which associated manifestations?

You are taking care of 4 clients who are receiving opioid analgesics for pain management. Which patient is MOST likely to be experiencing a life-threatening opioid side effect?

The nurse is reviewing a client’s record and notes that the primary health care provider has documented that the client has chronic kidney disease. On review of the laboratory results, the nurse most likely would expect to note which finding?

Which client electrocardiography (ECG) change from baseline will alert the nurse to possible development of hypercalcemia?