Nokea
Josie is the mother of a healthy 19-year-old having surgery tomorrow. After the surgeon discusses the surgery, risks, and benefits with the patient and her mother, the mother wants to sign the consent form. The most appropriate response to this would be
- A. Of course she can sign the consent form; after all, the patient is her daughter.
- B. While you appreciate the concern for her daughter, the patient is a consenting adult and legally has to sign her own consent form.
- C. No consent form must be signed.
- D. Why do not both the patient and her mother sign the form?
Correct Answer: B
Rationale: Adult patients have the legal right to consent to their own medical procedures.
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A client is going to be admitted for a scheduled surgical procedure. Which action does the nurse explain is the most important thing the client can do to protect against errors?
- A. Bring a list of all medications and their purposes.
- B. Keep the doctor's phone number close by.
- C. Ensure all providers wash their hands before entering the room.
- D. Document the name of each caregiver who enters the room.
Correct Answer: A
Rationale: The correct answer is A: Bring a list of all medications and their purposes. This is important as it helps prevent medication errors during the surgical procedure. By having a list of medications and their purposes, the healthcare team can ensure they are administering the correct medications and dosages. This also helps in preventing drug interactions or allergies.
Option B (Keep the doctor's phone number close by) may be helpful in case of emergencies, but it does not directly address preventing errors during the surgical procedure. Option C (Ensure all providers wash their hands before entering the room) is important for infection control but is not specifically related to preventing errors. Option D (Document the name of each caregiver who enters the room) is not as critical as having a list of medications, as it does not directly impact the safety and well-being of the client during the surgical procedure.
Place the steps for removal of a foreign body from the ear canal in the correct order.
- A. Refer for treatment of external otitis.
- B. Inspect the tympanic membrane for trauma.
- C. Obtain history for type of object.
- D. Choose appropriate fluid for irrigation or instillation.
Correct Answer: C
Rationale: Obtaining a history helps determine the safest method for removing the foreign body and prevents further injury.
A client had a hemicolectomy performed two days ago. Today, the nurse assessed the incision and discovered a small part of the abdominal viscera protruding through the incision. This complication of wound healing is known as:
- A. excoriation.
- B. dehiscence.
- C. decortication.
- D. evisceration.
Correct Answer: D
Rationale: Excoriation is an abrasion of the epidermis, or of any organ coating of the body, caused by trauma, chemicals, burns, or other causes. Dehiscence is a partial to complete separation of the wound edges with no abdominal tissue protrusion. Decortication is removal of the surface layer of an organ or structure, such as removing the fibrinous peel from the visceral pleura in thoracic surgery. Evisceration occurs when the incision separates and the contents of the cavity spill out.
Patients returning from the operating room (OR) should be monitored for atelectasis. Why is this important?
- A. Immobility, anesthesia, and lack of deep breathing place the patient at risk for collapsed lung.
- B. All postoperative patients are at risk for infection.
- C. Postoperative patients might have received too much oxygen during surgery.
- D. Postoperative patients do not receive enough oxygen during surgery.
Correct Answer: A
Rationale: Anesthesia and immobility can lead to atelectasis, where parts of the lung collapse.
While on a hiking trip, Mr. Jones states that a branch of a tree struck his eye. Part of the branch remains lodged in the eye, and the eyelid is bleeding. Appropriate emergency treatment would include
- A. covering the eye with a protective shield
- B. encouraging Mr. Jones to hold his eye closed tightly
- C. applying a pressure dressing to the eye
- D. removing the foreign body and applying a sterile dressing
Correct Answer: A
Rationale: Covering the eye with a protective shield prevents further injury while awaiting professional medical evaluation and removal of the foreign object.