NCLEX-PN® ExaminationCoordinated CareMedium
An LPN is caring for a client who is alert and oriented but refuses to take their prescribed oral medication, stating, 'I don't think it's helping me.' The LPN has already explained the medication's purpose. What is the MOST appropriate next action for the LPN?
- ADiscard the medication and document that the client refused it.
- BCrush the medication and mix it in food or drink to administer it discreetly.
- CInsist the client take the medication, explaining the potential negative consequences of refusal.
- DDocument the client's refusal, notify the charge nurse, and inform the prescribing physician.
Show answer & explanationAnswer & explanation
Correct answer: D. Document the client's refusal, notify the charge nurse, and inform the prescribing physician.
Clients who are alert and oriented have the right to refuse treatment. The LPN's responsibility is to respect this right, document the refusal thoroughly, and inform the appropriate members of the healthcare team (charge nurse and physician) so that the client's plan of care can be re-evaluated.
Why the other options are wrong
- A. While documenting is correct, simply discarding the medication without notifying the charge nurse or physician is incomplete. The team needs to be aware to address the refusal and potentially revise the care plan.
- B. Administering medication surreptitiously is a violation of ethical principles and client rights, and can be considered battery.
- C. Insisting on medication administration infringes on the client's right to refuse treatment and can be considered assault.
Client Rights: Right to Refuse Treatment
Competent adult clients have the legal and ethical right to refuse any medical treatment, even if that refusal could lead to serious harm or death.
- Applies to alert and oriented adults.
- Healthcare providers must respect this decision.
- Requires thorough documentation and communication to the healthcare team.
Memory trick: Refusal means report, right, and respect.