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A client scheduled for surgery cannot sign the operative consent form because he has been sedated with opioid analgesics. The nurse should take which best action regarding the informed consent?
- A. Obtain a court order for the surgery
- B. Sign the informed consent on behalf of the client
- C. Send the client to surgery without the consent form being signed
- D. Obtain a telephone consent from a family member, with the consent being witnessed by two healthcare providers
Correct Answer: D
Rationale: In situations where a client is unable to sign the consent form, obtaining a telephone consent from a family member witnessed by two healthcare providers is the appropriate action to ensure informed consent is obtained. Option A is not necessary and involves legal proceedings. Option B is not ethical as the nurse cannot sign the consent on behalf of the client. Option C is unsafe and violates the client's rights by proceeding without proper consent.
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Which intervention should the nurse implement for the client who has an ileal conduit?
- A. Pouch the stoma with a one-inch margin around the stoma
- B. Refer the client to the United Ostomy Association for discharge teaching
- C. Report to the healthcare provider any decrease in urinary output
- D. Monitor the stoma for signs and symptoms of infection every shift
Correct Answer: C
Rationale: The correct intervention for a client with an ileal conduit is to report to the healthcare provider any decrease in urinary output. A decrease in urinary output can be indicative of a blockage or other complication, necessitating immediate attention. Choice A is incorrect because pouching the stoma with a margin around it is not directly related to managing complications. Choice B is incorrect as referring the client to an ostomy association may be beneficial for education but is not the immediate action needed for decreased urinary output. Choice D is incorrect because monitoring for infection, although important, is not the priority when dealing with a potential complication like decreased urinary output.
Which of the following nursing interventions is important for a client scheduled to have a Guaiac Test?
- A. Avoid turnips, radish, and horseradish 3 days before
- B. Continue iron preparation to prevent further loss
- C. Do not consume meat 12 hours before the procedure
- D. Encourage consumption of caffeine and dark-colored foods
Correct Answer: A
Rationale: The correct answer is A. Turnips, radish, and horseradish are known to cause false-positive results in a Guaiac Test, which is used to detect blood in the stool. Avoiding these foods is crucial to ensure accurate test results. Choice B is incorrect as iron preparation is not directly related to the Guaiac Test. Choice C is incorrect because avoiding meat is not specifically necessary before a Guaiac Test. Choice D is incorrect as caffeine and dark-colored foods can potentially interfere with test results, so they should not be encouraged.
What type of diet is recommended for patients with diverticulitis during an acute flare-up?
- A. High-fiber
- B. Low-residue
- C. Low-fat
- D. High-protein
Correct Answer: B
Rationale: During an acute flare-up of diverticulitis, a low-residue diet is recommended. This diet helps reduce bowel movements and minimize irritation to the digestive tract, allowing the inflamed diverticula to heal. High-fiber foods are usually avoided during flare-ups as they can exacerbate symptoms. Low-fat and high-protein diets are not specifically recommended for diverticulitis flare-ups. Therefore, option B is the correct choice.
The two members of the health care team who work closely to monitor drug-nutrient interactions are:
- A. Physician and nurse
- B. Physician and pharmacist
- C. Nurse and clinical dietitian
- D. Clinical dietitian and pharmacist
Correct Answer: D
Rationale: Clinical dietitians and pharmacists are the key members of the healthcare team responsible for monitoring drug-nutrient interactions. Clinical dietitians assess patients' nutritional needs and develop appropriate diets that consider medication effects, while pharmacists provide expertise on medications and their interactions with nutrients. Physicians and nurses are essential healthcare providers but typically do not have the specialized knowledge required to manage drug-nutrient interactions, making choices A, B, and C incorrect.
The nurse is teaching basic cardiopulmonary resuscitation (CPR) to individuals in the community. What is the correct order of basic CPR steps?
- A. Ensure the scene is safe, assess responsiveness, call for help, begin chest compressions, give two rescue breaths
- B. Give two rescue breaths
- C. Look, listen, and feel for breathing
- D. Begin chest compressions
Correct Answer: A
Rationale: The correct order of basic CPR steps is as follows: first, ensure the scene is safe to approach, then assess the individual's responsiveness. After confirming the need for help, start chest compressions, then provide two rescue breaths. Option B, 'Give two rescue breaths,' is incorrect as chest compressions should be initiated before giving rescue breaths. Option C, 'Look, listen, and feel for breathing,' is also incorrect as immediate chest compressions are crucial in CPR. Option D, 'Begin chest compressions,' is partially correct but misses the crucial initial steps of ensuring scene safety and assessing responsiveness.