NCLEX-PN® ExaminationCoordinated CareHard
An LPN is assigned to care for a client who is a Jehovah's Witness and has refused a blood transfusion due to religious beliefs, documented in their advance directives. The client's condition deteriorates, and the physician orders an emergency blood transfusion. What is the LPN's ethical responsibility in this situation?
- AAdminister the blood transfusion as ordered, as it is an emergency and life-saving.
- BAttempt to persuade the client to accept the transfusion by explaining the risks of refusal.
- CDocument the client's refusal and notify the registered nurse (RN) and physician of the conflict with the advance directive.
- DSeek a court order to override the client's refusal based on medical necessity.
Show answer & explanationAnswer & explanation
Correct answer: C. Document the client's refusal and notify the registered nurse (RN) and physician of the conflict with the advance directive.
Respecting a client's autonomy and their right to refuse treatment, even life-sustaining treatment, is a fundamental ethical principle. An LPN's role is to advocate for the client's wishes as expressed in their advance directive and ensure proper communication within the healthcare team.
Why the other options are wrong
- A. Administering a transfusion against a client's documented wishes and religious beliefs, even in an emergency, is a violation of autonomy and could lead to legal repercussions.
- B. While education about risks is part of informed consent, once a decision is clearly made and documented in an advance directive, attempting to persuade the client violates their autonomy.
- D. Seeking a court order is not within the LPN's scope of practice or responsibility; this is a legal action that would involve the healthcare facility's legal team, not individual nursing staff.
Client Autonomy and Advance Directives
The ethical principle of respecting a client's right to make decisions about their own healthcare, including refusal of treatment, as formally documented in advance directives.
- Advance directives guide care when client cannot decide.
- Autonomy is a fundamental ethical principle.
- Healthcare providers must respect documented wishes.
Memory trick: When 'CHOICES' clash, 'CONSULT' and 'COMMUNICATE' the patient's will.