While auditing the medical records of clients currently on an oncology unit, the nurse manager finds that six of the 15 records lack documentation regarding advance directives. Which of the following is the priority action for the nurse to take?

Choice A Reason:
Reinforcing dietary teaching with a client who has heart disease is incorrect. Dietary teaching typically requires a higher level of assessment and critical thinking, often involving interpretation of lab values, medication interactions, and individualized dietary plans. This task is best suited for a Registered Nurse (RN).
Choice B Reason:
Providing postmortem care for a client who has just died is incorrect. Providing postmortem care involves emotional support, respect for the deceased, and proper handling of the body. This task is within the scope of practice for an RN and may also involve collaboration with other healthcare team members.
Choice C Reason:
Accompanying a client who just had a wound debridement to physical therapy is incorrect. Accompanying a client to physical therapy may involve monitoring the client's condition, providing assistance during the transfer, and communicating with the physical therapist about the client's status. This task typically requires an RN or may be appropriate for an assistive personnel under RN supervision.
Choice D Reason:
Obtaining a urine specimen from an older adult client is correct. Obtaining a urine specimen is a task that falls within the scope of practice for an LPN. It involves performing a routine procedure that requires technical skills but does not involve complex assessment or critical thinking beyond following established protocols.

Choice A Reason:
Raising all four side rails on the bed of a confused client can be considered a form of restraint, which should be avoided unless necessary for the safety of the patient. It may infringe on the client's autonomy and dignity.
Choice B Reason:
Electing not to care for a client who had an abortion is discriminatory and violates the principle of nonmaleficence (doing no harm). Nurses have a professional obligation to provide care to all patients regardless of their personal beliefs or circumstances.
Choice C Reason:
Withholding nutrition from a client with a do-not-resuscitate (DNR) order without clear medical indications goes against the principle of beneficence and could be considered unethical. Nutritional support is a basic aspect of care that should not be withheld unless it is medically indicated or aligns with the patient's wishes.
Choice D Reason:
A nurse administers prescribed opioids to a client who has a terminal illness and respiratory rate of 8/min represents ethical practice because administering prescribed opioids to a client with a terminal illness and a respiratory rate of 8/min is appropriate and aligns with the principle of beneficence. The nurse's action aims to alleviate the client's pain and suffering, which is essential in end-of-life care.