A nurse in an emergency department is caring for a client who is unconscious and requires surgery. There is no one available to give consent for the treatment. Which of the following actions should the nurse take?

Prepare the client for surgery.

Contact the facility's ethics committee for guidance.

Keep the client stable until a family member arrives to give consent.

Obtain consent from the surgeon.

Answer and Explanation

The Correct Answer is A

A. Prepare the client for surgery: In emergency situations, if immediate intervention is required to save the client’s life or prevent significant harm, the principle of implied consent may apply. This means that if the client is unconscious and immediate treatment is necessary, healthcare providers may proceed with treatment under the assumption that the client would consent if able. However, this should be done in accordance with facility policies and legal guidelines.

B. Contact the facility's ethics committee for guidance: Contacting the ethics committee can be helpful for guidance on how to handle consent issues in complex situations, but it might not provide a timely solution for immediate emergency situations.

C. Keep the client stable until a family member arrives to give consent: While stabilizing the client's condition is important, waiting for a family member to arrive to give consent may not be feasible in emergency situations where immediate treatment is necessary. The nurse should seek guidance from appropriate channels to determine the best course of action.

D. Obtain consent from the surgeon: Surgeons do not have the authority to provide consent for treatment on behalf of a client who is unconscious. Consent must come from a legally authorized decision-maker, such as the client themselves if they have previously provided informed consent, or a designated healthcare proxy.

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Correct Answer is D

Explanation

A. Apply the pouch while the skin barrier is still damp.

Applying the pouch while the skin barrier is damp can lead to poor adhesion and potential leaks. It’s essential to ensure the skin is completely dry before attaching the pouch.

B. Change the pouch once every 24 hr.: The frequency of pouch changes depends on individual client needs, stoma output, and the type of pouching system used. Changing the pouch every 24 hours may be unnecessary for some clients and could potentially cause skin irritation or damage.

C. Rub the peristomal skin dry after cleaning: Rubbing the peristomal skin dry after cleaning can cause irritation and damage to the skin. Instead, the nurse should gently pat the skin dry using a soft cloth or towel to avoid causing friction or trauma to the delicate skin surrounding the stoma.

D. Ensure the pouch is 0.32 cm (1/8 in) larger than the stoma:a allows for a better fit and helps prevent the edges of the stoma from coming into contact with stool, which can cause irritation and breakdown of the skin. A proper fit also helps ensure a secure seal and prevents leakage.

A. Client care provider B. Client educator C. Client advocate D. Case manager

Correct Answer is A

Explanation

A. Client care provider

In this scenario, the nurse manager is planning to observe a newly licensed nurse perform a straight catheterization on a client to ensure client safety. By directly overseeing the procedure and providing guidance, feedback, and support, the nurse manager is assuming the role of a client care provider. This role involves ensuring that nursing care is delivered effectively and safely, especially when orienting or supervising new staff members.

B. Client educator:

While client education is important in nursing practice, the nurse manager's primary role in this scenario is not to educate the client but rather to observe and supervise the newly licensed nurse performing a procedure.

C. Client advocate:

Although advocating for client safety is a fundamental aspect of nursing practice, in this specific scenario, the nurse manager is more directly involved in overseeing the procedural skill of the newly licensed nurse rather than advocating for the client's rights or needs.

D. Case manager:

A case manager typically coordinates and manages the overall care of clients, including planning and arranging services. However, in this scenario, the nurse manager's role is focused on directly observing and supervising a specific nursing procedure rather than coordinating broader aspects of the client's care.

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A nurse in an emergency department is caring for a client who is unconscious and requires surgery. There is no one available to give consent for the treatment. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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