Asking whether the client would like to complete a health-care directive

Allowing the client’s family to leave tobacco leaves in a dish in the client’s room

Providing the spouse a chair that folds out into a bed to stay in the client’s room

Administering morphine sulfate when there are nonverbal and physiological signs of pain

A nurse is caring for an 85-year-old Native American client with heart failure who has an ejection fraction of 15%. Which nursing action indicates that the nurse needs further instruction on providing culturally competent care because the nurse’s action is in conflict with the ethical principle of nonmaleficence?