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. Dilated pupils are typically associated with stimulant use, not opioids.
B. Euphoria is a common effect of opioid use and can indicate misuse or diversion of these medications.
C. Rhinorrhea is usually associated with withdrawal from opioids rather than their use.
D. Hallucinations can occur with certain drugs but are less commonly associated with opioid use compared to euphoria.
Correct Answer is C
Explanation
Rationale:
A. Informing the staff member of her appraisal time for that day prior to change-of-shift report is not ideal as it may disrupt the shift handover process.
B. Scheduling the appraisal interview as early in the shift as possible might not be feasible or considerate, especially if it impacts patient care or the staff member's workflow.
C. Providing the staff member with a copy of the appraisal form in advance is best practice as it allows the staff member to prepare for the discussion and address any concerns or achievements.
D. Providing a chair directly across the desk for the staff member to sit in is not as important as preparing the staff member by sharing the appraisal criteria in advance.