A nurse is caring for a client who is dying. The nurse should incorporate the principle of nonmaleficence into practice by taking which of the following actions?
Withholding a dose of narcotic pain medication when the client has respiratory depression
Discussing advance directives with the client and the client's family
Providing comfort care measures to the client
Allowing the client's family unlimited visitation at the time of death
The Correct Answer is A
Rationale:
A. Withholding a dose of narcotic pain medication when there is respiratory depression aligns with nonmaleficence, as it prevents further harm by not exacerbating the client's respiratory issues.
B. Discussing advance directives is important but is more related to autonomy and respect for the client’s wishes rather than nonmaleficence.
C. Providing comfort care is a supportive measure but does not specifically address nonmaleficence in terms of preventing harm.
D. Allowing unlimited visitation respects family wishes but does not directly relate to the principle of nonmaleficence regarding the client’s immediate medical needs.
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Correct Answer is B
Explanation
Rationale:
A. Acute pancreatitis may require specialized medical management that might be beyond the RN’s experience from a different unit.
B. A client one-day postoperative following a total abdominal hysterectomy is appropriate for an RN with general surgical experience, as it involves standard postoperative care.
C. A client who had a stroke may require more specialized neuro care and assessment than the RN might be familiar with.
D. Terminal end-stage renal disease requires specialized care and experience in managing complex chronic conditions.
Correct Answer is A
Explanation
Rationale:
A. Encouraging clients to receive an annual flu immunization is a cost-effective measure to prevent illness and reduce overall healthcare costs.
B. Waiting to empty a drainable colostomy until it is three-fourths full might not be the best practice for client comfort or prevention of leakage.
C. Recommending sterile technique for home care is important for infection prevention but not necessarily a cost-reduction strategy in the healthcare setting.
D. Delegating closed irrigation to AP may not be appropriate if it involves tasks beyond their scope of practice and does not directly relate to cost reduction.