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What is the responsibility of the nurse in obtaining an informed consent for surgery?
- A. Describing in a clear and simply stated manner what the surgery will involve
- B. Explaining the benefits, alternatives, and possible risks and complications of surgery
- C. Using the nurse/client relationship to persuade the client to sign the operative permit
- D. Providing the informed consent for surgery and witnessing the client's signature
Correct Answer: D
Rationale: The nurse's role is to witness the client's signature and ensure the consent form is completed, not to explain the procedure.
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The nurse caring for a client in the neonatal intensive care unit administers adult-strength Digitalis to the 3-pound infant. As a result of her actions, the baby suffers permanent heart and brain damage. The nurse can be charged with:
- A. Negligence
- B. Tort
- C. Assault
- D. Malpractice
Correct Answer: D
Rationale: Malpractice involves professional negligence causing harm, as in administering an incorrect dose of medication.
The physician has prescribed Gantrisin (sulfasoxazole) 1 g in divided doses for a client with a urinary tract infection. The nurse should administer the medication:
- A. With meals or a snack
- B. 30 minutes before meals
- C. 30 minutes after meals
- D. At bedtime
Correct Answer: A
Rationale: Gantrisin should be taken with food to reduce gastrointestinal upset, and adequate fluid intake is needed to prevent crystalluria.
The nurse is caring for a client who is having surgery the next morning. The client says, 'I'm really scared about surgery. I've never been put to sleep before and I'm afraid I might not wake up.' Which response by the nurse is the most therapeutic?
- A. Why are you worried about such a minor procedure?
- B. We can call the doctor and cancel the surgery if you would prefer.
- C. It's normal to be afraid of something new like surgery. Tell me how you feel.
- D. Don't worry, you have a really good doctor and he will see to it that nothing goes wrong.
Correct Answer: C
Rationale: Acknowledging fear as normal and inviting the client to express feelings is therapeutic, fostering trust and emotional support.
The nurse is supervising the staff providing care for an 18-month-old hospitalized with hepatitis A. The nurse determines that the staff’s care is appropriate if which of the following is observed?
- A. The child is placed in a private room.
- B. The staff removes a toy from the child’s bed and takes it to the nurse’s station.
- C. The staff offers the child french fries and a vanilla milkshake for a midafternoon snack.
- D. The staff uses standard precautions.
Correct Answer: A
Rationale: contact precautions required for diapered or incontinent clients
Which action is contraindicated in the client with epiglottis?
- A. Ambulation
- B. Oral airway assessment using a tongue blade
- C. Placing a blood pressure cuff on the arm
- D. Checking the deep tendon reflexes.
Correct Answer: B
Rationale: Using a tongue blade can trigger airway obstruction in epiglottitis, making it contraindicated.