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The nurse is caring for a 14-year-old scheduled for an appendectomy. What is the nurse's role in obtaining informed consent before surgery? Select all that apply.
- A. Informing the parents that only the surgeon may withdraw the surgical consent
- B. Review the risks and benefits of the surgery with the parents
- C. Validate that the parents are competent to provide consent for the client
- D. Witness the signature on the informed consent
- E. Make sure that the consent is witnessed by two healthcare professionals instead of one
Correct Answer: C, D
Rationale: The nurse’s role includes validating parental competency (C) to ensure they understand the procedure and witnessing the signature (D) to confirm consent was given. Explaining risks/benefits (B) is the surgeon’s responsibility. Withdrawing consent (A) is not limited to the surgeon, and two witnesses (E) are not required.
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The nurse is reviewing tasks for assigned clients. Which action is a priority to implement?
- A. Visual acuity test for a client reporting blurred vision in one eye.
- B. 12-lead electrocardiogram for a client reporting chest pain.
- C. Orthostatic vital signs for a client complaining of syncope.
- D. Discharge teaching for a client newly diagnosed with hypertension.
Correct Answer: B
Rationale: A 12-lead ECG for chest pain (B) is the priority to rule out life-threatening cardiac events like myocardial infarction. Blurred vision (A), syncope (C), and discharge teaching (D) are less urgent, as they are not immediately life-threatening.
The nurse performs a handoff report to the oncoming nurse for an older adult male in the intensive care unit (ICU). Which information is a priority to share with the oncoming nurse? The client
- A. has clear lung fields bilaterally with unlabored respirations.
- B. is forgetful and was not requesting assistance before getting out of bed.
- C. has a 20-gauge peripheral vascular access device that is patent and saline locked.
- D. has an indwelling urinary catheter that is patent with clear urine and is secured to the upper thigh.
Correct Answer: B
Rationale: Forgetfulness and not requesting help (B) indicate a high fall risk, a priority to share to ensure safety measures are in place. Clear lungs (A), patent IV (C), and urinary catheter (D) are stable and less urgent.
Which statement about the placebo is the most accurate?
- A. Placebos are often used to determine if the client's reports of pain are valid.
- B. Placebos are not used in research because the client has not given consent.
- C. Placebo use is unethical unless they are used in research with the subject's consent.
- D. Placebo use is illegal according to all states and the federal government.
Correct Answer: C
Rationale: Placebo use is ethical in research with informed consent (C), as it ensures transparency. Using placebos to validate pain (A) is unethical, placebos are used in research (B), and they are not illegal (D).
The emergency department (ED) nurse cares for a client with diabetes mellitus (type one) with diabetic ketoacidosis (DKA). Which assessment finding requires immediate follow-up?
- A. Pulse 112/minute
- B. Nausea and vomiting
- C. Respiratory rate 21/minute
- D. Blood glucose 299 mg/dL (16.5 mmol/L) [70-110 mg/dL (4-6 mmol/L)]
Correct Answer: B
Rationale: Nausea and vomiting in DKA (B) can worsen dehydration and electrolyte imbalances, requiring immediate follow-up. Tachycardia (A) and tachypnea (C) are expected, and glucose of 299 (D) is consistent with DKA but less urgent.
The emergency department (ED) nurse cares for a client who presents with irritability, nuchal rigidity, and a fever. Which of the following actions should the nurse take first?
- A. Administer prescribed ibuprofen.
- B. Place the client on droplet precautions.
- C. Notify the public health department.
- D. Obtain prescribed blood cultures.
Correct Answer: B
Rationale: Placing the client on droplet precautions (B) is the first action for suspected meningitis (irritability, nuchal rigidity, fever) to prevent spread of infection. Administering ibuprofen (A), notifying public health (C), and obtaining blood cultures (D) are important but secondary to infection control.