NCLEX-PN® ExaminationCoordinated CareHard
An LPN is assisting with the care of a client who has been diagnosed with a terminal illness and wishes to receive palliative care at home. The client's family is struggling to accept this decision and wants aggressive treatment. Which of the following actions is the most appropriate for the LPN to take?
- AAdvise the family that the client's decision is final and must be respected.
- BSuggest the client appoint a durable power of attorney for healthcare to make decisions.
- CEncourage the client to reconsider their decision in light of the family's wishes.
- DFacilitate a family meeting with the healthcare team to discuss the client's wishes and palliative care options.
Show answer & explanationAnswer & explanation
Correct answer: D. Facilitate a family meeting with the healthcare team to discuss the client's wishes and palliative care options.
When a conflict arises between a client's wishes and family desires, the most appropriate action is to facilitate open communication and education. A family meeting allows the healthcare team to clarify the client's wishes, explain palliative care, and address the family's concerns in a supportive environment.
Why the other options are wrong
- A. While true, this approach can be confrontational and may alienate the family, hindering constructive dialogue and support.
- B. This action is premature; the client has already expressed their wishes. The issue is family acceptance and understanding, not the client's decision-making capacity or legal representation.
- C. Encouraging the client to change their mind undermines their autonomy and right to self-determination.
Ethical Practice: Client Autonomy vs. Family Wishes
The ethical dilemma that arises when a client's autonomous healthcare decisions conflict with the wishes or beliefs of their family, requiring careful navigation to uphold client rights while supporting families.
- Client autonomy is primary.
- Facilitate communication and education.
- Support both client and family.
Memory trick: When 'CONFLICTS' arise, 'COMMUNICATE' and 'CLARIFY' patient 'CHOICES'.