A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an opioid pain medication PRN. The nurse is concerned that administering a dose of pain medication might hasten the client's death. Which of the following ethical principles should the nurse use to support the decision not to administer the medication?

Correct Answer: B

Rationale: The correct answer is B: Nonmaleficence. Nonmaleficence is the ethical principle of doing no harm or preventing harm to the patient. In this scenario, the nurse's primary duty is to relieve the client's pain and suffering without causing harm. Administering the pain medication as prescribed would align with the principle of nonmaleficence by ensuring the client's comfort and quality of life. Choice A, Utilitarianism, focuses on the greatest good for the greatest number, which may conflict with the individual's well-being in this case. Choice C, Fidelity, pertains to maintaining trust and being loyal to the client but does not directly address the issue of harm. Choice D, Veracity, involves telling the truth, which is important but not the primary concern when deciding whether to administer pain medication in end-of-life care.

Correct Answer: C

Rationale: The correct answer is C, the client asking about his PCA pump containing morphine. This client should be cared for first because the PCA pump is delivering a potent medication that requires close monitoring to prevent adverse effects. The nurse needs to assess the client's pain level, pump settings, and any signs of overdose or underdose. This situation requires immediate attention to ensure the client's safety. Choice A is incorrect because a client needing assistance with a bath can typically wait and does not pose an immediate risk to their health or safety. Choice B is incorrect as a client requesting a referral for home health services is important but can be addressed after the client with the PCA pump. Choice D is also incorrect because a client with questions about a new prescription can typically wait as long as it is not urgent.

Correct Answer: D

Rationale: The correct answer is D: Provide a clear description of the task to the AP. This is essential to ensure the task is understood and completed accurately. Assessing the AP's ability to follow a teaching plan (A) is not relevant to task delegation. Determining social skills (B) and evaluating ability to work with peers (C) are also not directly related to task delegation. Providing clear instructions (D) is crucial for effective delegation and ensuring the task is performed correctly.

Correct Answer: D

Rationale: The correct answer is D because according to HIPAA regulations, a client's medical records are confidential and can only be shared with the client's permission. The nurse should inform the family member that the client must provide permission to access the medical records. A: Asking the nursing supervisor to obtain the medical records is not appropriate as it bypasses the client's right to privacy. B: The health care provider cannot share the information without the client's consent. C: Involving the ethics committee is unnecessary and does not address the issue of the client's permission. In summary, choice D is correct as it upholds the client's right to privacy and follows legal and ethical guidelines. Choices A, B, and C are incorrect as they do not consider the client's autonomy and confidentiality.

Correct Answer: D

Rationale: Rationale for Correct Answer D: 1. Notify the nursing supervisor: This is the appropriate action to ensure patient safety and address the provider's behavior through the appropriate channels. 2. Counseling the provider (Option A) may not be effective as immediate action is needed. 3. Encouraging clients to change providers (Option B) does not address the underlying issue. 4. Informing the state medical board (Option C) could be premature without internal investigation.