Nokea
The surgical nurse is preparing to send a patient from the presurgical area to the OR and is reviewing the patients informed consent form. What are the criteria for legally valid informed consent? Select all that apply.
- A. Consent must be freely given
- B. Consent must be notarized
- C. Consent must be signed on the day of surgery
- D. Consent must be obtained by a physician
- E. Signature must be witnessed by a professional staff member
Correct Answer: A,D,E
Rationale: Valid consent must be freely given, without coercion. Consent must be obtained by a physician and the patients signature must be witnessed by a professional staff member. It does not need to be signed on the same day as the surgery and it does not need to be notarized.
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An OR nurse will be participating in the intraoperative phase of a patients kidney transplant. What action will the nurse prioritize in this aspect of nursing care?
- A. Monitoring the patients physiologic status
- B. Providing emotional support to family
- C. Maintaining the patients cognitive status
- D. Maintaining a clean environment
Correct Answer: A
Rationale: During the intraoperative phase, the nurse is responsible for physiologic monitoring. The intraoperative nurse cannot support the family at this time and the nurse is not responsible for maintaining the patients cognitive status. The intraoperative nurse maintains an aseptic, not clean, environment.
A patient is on call to the OR for an aortobifemoral bypass and the nurse administers the ordered preoperative medication. After administering a preoperative medication to the patient, what should the nurse do?
- A. Encourage light ambulation
- B. Place the bed in a low position with the side rails up
- C. Tell the patient that he will be asleep before he leaves for surgery
- D. Take the patients vital signs every 15 minutes
Correct Answer: B
Rationale: When the preoperative medication is given, the bed should be placed in low position with the side rails raised. The patient should not get up without assistance. The patient may not be asleep, but he may be drowsy. Vital signs should be taken before the preoperative medication is given; vital signs are not normally required every 15 minutes after administration.
You are the nurse caring for an unconscious trauma victim who needs emergency surgery. The patient is a 55 -year-old man with an adult son. He is legally divorced and is planning to be remarried in a few weeks. His parents are at the hospital with the other family members. The physician has explained the need for surgery, the procedure to be done, and the risks to the children, the parents, and the fianc. Who should be asked to sign the surgery consent form?
- A. The fianc
- B. The son
- C. The physician, acting as a surrogate
- D. The patients father
Correct Answer: B
Rationale: The patient personally signs the consent if of legal age and mentally capable. Permission is otherwise obtained from a surrogate, who most often is a responsible family member (preferably next of kin) or legal guardian. In this instance, the child would be the appropriate person to ask to sign the consent form as he is the closest relative at the hospital. The fianc is not legally related to him as the marriage has not yet taken place. The father would only be asked to sign the consent if no children were present to sign. The physician would not sign if family members were available.
The clinic nurse is doing a preoperative assessment of a patient who will be undergoing outpatient cataract surgery with lens implantation in 1 week. While taking the patients medical history, the nurse notes that this patient had a kidney transplant 8 years ago and that the patient is taking immunosuppressive drugs. For what is this patient at increased risk when having surgery?
- A. Rejection of the kidney
- B. Rejection of the implanted lens
- C. Infection
- D. Adrenal storm
Correct Answer: C
Rationale: Because patients who are immunosuppressed are highly susceptible to infection, great care is taken to ensure strict asepsis. The patient is unlikely to experience rejection or adrenal storm.
The nurse is caring for a trauma victim in the ED who will require emergency surgery due to injuries. Before the patient leaves the ED for the OR, the patient goes into cardiac arrest. The nurse assists in the successful resuscitation and proceeds to release the patient to the OR staff. When can the ED nurse perform the preoperative assessment?
- A. When he or she has the opportunity to review the patients electronic health record
- B. When the patient arrives in the OR
- C. When assisting with the resuscitation
- D. Preoperative assessment is not necessary in this case
Correct Answer: C
Rationale: The only opportunity for preoperative assessment may take place at the same time as resuscitation in the ED. Preoperative assessment is necessary, but the nurse could not normally enter the OR to perform this assessment. The health record is an inadequate data source.