A nurse is caring for a client who has a terminal illness and states that they wish to discontinue their enteral feedings. The nurse responds by saying, "You have a right to refuse treatment." This response by the nurse demonstrates which of the following ethical principles?
Autonomy
Fidelity
Beneficence
Justice
The Correct Answer is A
A. Autonomy refers to the right of individuals to make their own decisions regarding their healthcare, including the right to refuse treatment, which the nurse has supported in their response.
B. Fidelity involves being faithful to commitments made to patients, such as providing care and support, but does not directly pertain to the client's right to refuse treatment.
C. Beneficence focuses on promoting the well-being of the client, which may not align with the client’s decision to refuse treatment in this context.
D. Justice refers to fairness in healthcare and ensuring equitable treatment, but it does not address the specific right of the client to refuse treatment.
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Correct Answer is A
Explanation
A. Ecchymoses (bruising) over the buttocks and lower back in an older adult could be a sign of physical abuse or an underlying bleeding disorder, and it should be reported immediately.
B. Hirsutism, or increased facial and chest hair, is a common age-related change and does not usually require reporting unless it indicates an endocrine disorder.
C. Reduced skin elasticity is a normal age-related finding due to decreased collagen and elastin in aging skin.
D. Increased macules, or age spots, are benign and typical with aging, especially with prolonged sun exposure, and do not require reporting.
Correct Answer is D
Explanation
A. Identifying clients by room number instead of name does not adequately protect client confidentiality, as room numbers can still be linked to specific patients.
B. Logging assistive personnel into unit computers for documentation undermines security measures, as each user should have their unique login credentials.
C. Placing the client's name on the cover sheet when faxing protected health information violates confidentiality and can lead to unauthorized access to sensitive data.
D. Conducting change-of-shift reports in a designated staff-only area ensures that client information is not overheard by unauthorized individuals, maintaining confidentiality.