A new graduate nurse asks their manager for guidance on how to respond to a patient who refuses to sign a surgical consent form. The patient says that she won’t sign because she wishes to explore other options. Which of the following responses made by the manager are most appropriate? (Select all that apply)

“The patient must consent because the procedure is necessary for survival.”

“Consent should not be forced.”

“If the surgery is life-saving, we can proceed regardless of what the patient says.”

“Sometimes patients refuse because they are anxious. Give them a sedative, then ask again.”

“The patient has every right to refuse.”

Answer and Explanation

Correct Answer : B,E

Choice A Reason:

“The patient must consent because the procedure is necessary for survival.” This statement is incorrect because it implies that the necessity of the procedure overrides the patient’s autonomy. Informed consent is a fundamental ethical and legal requirement in healthcare. Patients have the right to make their own decisions about their treatment, even if refusing treatment may result in harm or death. Forcing consent undermines patient autonomy and can lead to legal and ethical issues.

Choice B Reason:

“Consent should not be forced.” This statement is correct and aligns with the principles of patient autonomy and informed consent. Forcing a patient to consent to a procedure violates their rights and can lead to ethical and legal complications. Healthcare providers must respect the patient’s decision, provide all necessary information, and support them in making an informed choice.

Choice C Reason:

“If the surgery is life-saving, we can proceed regardless of what the patient says.” This statement is incorrect. Even in life-saving situations, patients have the right to refuse treatment. There are very few exceptions to this rule, such as when a patient is deemed legally incompetent to make decisions. In such cases, a legal guardian or power of attorney may be involved. However, competent patients retain the right to refuse any medical intervention.

Choice D Reason:

“Sometimes patients refuse because they are anxious. Give them a sedative, then ask again.” This statement is inappropriate and unethical. Administering a sedative to obtain consent can be seen as coercive and does not respect the patient’s autonomy. It is important to address the patient’s concerns and anxiety through communication and support, rather than using medication to influence their decision.

Choice E Reason:

“The patient has every right to refuse.” This statement is correct and reflects the ethical principle of respect for patient autonomy. Patients have the right to make their own healthcare decisions, including the right to refuse treatment. Healthcare providers should ensure that patients are fully informed about their options and the potential consequences of their decisions, but ultimately, the decision rests with the patient.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Choice A Reason

Feeling in control of her behavior is an important goal for clients with anorexia nervosa, as it addresses the psychological aspect of the disorder. Anorexia nervosa often involves a significant loss of control over eating behaviors and body image. However, while regaining a sense of control is crucial, it is not the immediate priority when the client is severely underweight and at risk for serious health complications. The primary focus should be on stabilizing the client’s physical health.

Choice B Reason

Making positive statements about improvements in body image is also an important goal, as it can help improve the client’s self-esteem and body perception. However, this goal is more long-term and secondary to addressing the immediate physical health risks associated with severe weight loss. Positive body image can be worked on concurrently with nutritional rehabilitation but should not overshadow the urgent need for weight gain.

Choice C Reason

Identifying changes within the family unit that promote the client’s autonomy is beneficial for long-term recovery. Family dynamics often play a significant role in the development and maintenance of eating disorders. Promoting autonomy and healthy family interactions can support the client’s recovery process. However, similar to the previous goals, this is a secondary priority compared to the immediate need to address the client’s critical nutritional status.

Choice D Reason

Gaining 2 pounds of weight per week is the most immediate and critical goal for a client with anorexia nervosa who is severely underweight. This goal directly addresses the life-threatening physical health risks associated with the disorder, such as malnutrition, electrolyte imbalances, and organ failure. Achieving a safe and steady weight gain is essential for stabilizing the client’s health and providing a foundation for addressing the psychological aspects of the disorder.

A. Please document the admission assessment in the chart. B. Please verify with the client which of the following medications they are taking. C. Please use these client assessment findings to draw a conclusion so that a plan can be developed. D. Please perform a complete assessment of the client.

Correct Answer is B

Explanation

Choice A Reason:

Documenting the admission assessment in the chart is not typically within the scope of practice for an LPN. Admission assessments are comprehensive evaluations that require the clinical judgment and expertise of an RN. LPNs can assist with data collection, but the final assessment and documentation should be completed by an RN.

Choice B Reason:

Verifying with the client which medications they are taking is an appropriate task to delegate to an LPN. This task involves gathering information from the client, which is within the LPN’s scope of practice. The LPN can then report this information back to the RN, who will use it to make clinical decisions and update the care plan.

Choice C Reason:

Using client assessment findings to draw a conclusion and develop a plan is beyond the scope of practice for an LPN. This task requires critical thinking and clinical judgment, which are responsibilities of the RN. The LPN can assist in collecting assessment data, but the interpretation and planning should be done by the RN.

Choice D Reason:

Performing a complete assessment of the client is not typically within the LPN’s scope of practice. While LPNs can perform focused assessments and collect data, comprehensive assessments require the clinical expertise of an RN. The RN is responsible for the overall evaluation and care planning for the client.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who has anorexia nervosa. The nurse should make which of the following client goals the priority?

Correct Answer is D

Explanation

An RN working in a behavioral health unit is evaluating a client. The RN intends to assign some of the nursing responsibilities to a licensed practical nurse (LPN). Which statement made by the RN demonstrates proper delegation to the LPN?

Correct Answer is B

Explanation

A nurse is caring for a client who falls in his room. After the nurse assesses the client, notifies the client’s provider, and completes an incident report, which of the following actions should the nurse take?

A manager plans to address the high turnover rate amongst RNs. Which of the following strategies might motivate the staff and lead to enhanced job satisfaction?

A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?

The clinic nurse has recently opened a client’s chart on the computer. A resident approaches and requests her to remain logged in so he can add a note to the same chart. Her response should be:

According to the Nursing Intellectual Capital (NiC) Theory, which factor increases overall organizational improvement?

A nurse is delivering a presentation on client confidentiality to a group of newly licensed nurses. Which of the following actions demonstrates a breach in patient confidentiality?

A nurse manager seeks to enhance their unit’s use of evidence-based practice. Which of the following is an appropriate strategy for the nurse manager to consider?

A legal consultant recommends that the nurse manager and staff members create a group agreement before addressing conflicts. According to Yoder Wise and Sportsman, agreements about how team members will collaborate are essential because: