NCLEX · General

A dying client's family tells the nurse: 'We haven't told Mom she's dying — we don't want to upset her. Please don't tell her either.' How should the nurse respond?

Correct answer

Acknowledge the family's love and protective intent; explain that the client has the ethical and legal right to information about their own health condition — the nurse cannot ethically deceive the client; offer to facilitate a family meeting with the palliative care team to address everyone's needs

  1. A Agree to keep it secret from the client
  2. B Acknowledge the family's love and protective intent; explain that the client has the ethical and legal right to information about their own health condition — the nurse cannot ethically deceive the client; offer to facilitate a family meeting with the palliative care team to address everyone's needs
  3. C Tell the client immediately without any preparation
  4. D Side with the family to avoid conflict

Why this is the answer

TRUTH-TELLING AND PATIENT AUTONOMY: Clients have the ethical and legal right to information about their own health condition (autonomy). Withholding information from a competent client at the family's request violates this right and the nurse's ethical duty of veracity (truthfulness). CULTURAL CONTEXT: In some cultures, family rather than patient is the primary recipient of medical information — acknowledge this respectfully while still protecting patient autonomy; APPROACH: Acknowledge the family's love and protection motivation (don't dismiss it); explain the ethical obligation; offer a family meeting with social work, chaplain, and/or palliative care to find a culturally sensitive approach; ask the client directly whether they want information about their condition and to what detail — some clients prefer not to know; document the conversation. WHAT THE NURSE CANNOT DO: Actively lie to the client about their diagnosis or prognosis; tell the client that everything is fine when it is not.
Source: NCLEX-RN Test Plan: Psychosocial — End of Life, Truth-Telling and Family Requests

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