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RN Nursing · Ethics and Decision Making · Practice question

A facility provides annual staff education regarding ethical practice. A charge nurse recognizes a need for further education when which of the following behaviors is observed?

Answer & explanation

Correct: A nurse explains to a client's family that a DNR order includes withholding comfort measures.

The behavior that indicates a need for further education about ethical practice is explaining to a client's family that a do-not-resuscitate (DNR) order includes withholding comfort measures. This is factually incorrect and therefore unethical because it misinforms the family. A DNR order only directs that cardiopulmonary resuscitation will not be initiated in the event of cardiac or respiratory arrest; it does not withhold pain management, hygiene, nutrition, emotional support, or any other comfort-focused interventions. Misrepresenting the scope of a DNR order may cause unnecessary distress and could lead families to make decisions based on false information. Administering prescribed opioids to a terminally ill client even with slow respirations reflects the ethical principle of double effect — symptom relief takes priority in palliative care, and this is acceptable nursing practice. A nurse refusing to actively participate in an elective abortion exercise conscientious objection, which is an ethical and legal right as long as the client still receives care. Telling a confused client he will stay until he is better may reflect necessary therapeutic communication given impaired decision-making capacity, which is ethically justifiable in context. Therefore, only the DNR statement demonstrates a knowledge deficit requiring further education.

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