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 D
Explanation
Rationale:
A. Assisting a client to cough and deep breathe is a task that can be performed by an AP under supervision.
B. Application of antiembolic stockings is within the scope of APs, though it may be monitored by an RN.
C. Administration of an enema typically requires nursing judgment and assessment, making it more appropriate for the RN.
D. Assessing a client’s sacrum for edema requires clinical assessment skills and nursing judgment, which should be performed by an RN.
Correct Answer is C
Explanation
Rationale:
A. A child who is experiencing sickle cell crisis may require isolation to prevent infection and avoid complications related to sickle cell disease.
B. A child who has a head injury may require specific monitoring and precautions that are not suitable for a postoperative appendectomy patient.
C. A child who has a new diagnosis of type 1 diabetes mellitus generally has a stable condition that can be managed with routine care and would be an appropriate roommate for a postoperative appendectomy patient.
D. A child who has streptococcal pharyngitis could pose an infection risk to the postoperative appendectomy patient and is better kept separate to prevent the spread of infection.