A nurse in the emergency department is assessing a client who is unconscious following a motor-vehicle crash. The client requires immediate surgery. Which of the following actions should the nurse take?

Delay the surgery until the nurse can obtain informed consent.

Transport the client to the operating room without verifying informed consent.

Ask the anesthesiologist to sign the consent.

Obtain telephone consent from the facility administrator before the surgery.

Answer and Explanation

The Correct Answer is B

Rationale:
A. Delaying surgery to obtain informed consent is unsafe in an emergency situation where immediate intervention is required to save life or prevent serious harm. Waiting could result in worsening of the client’s condition or death.

B. Transporting the client to the operating room without verifying informed consent is appropriate under the principle of implied consent in emergencies. When a client is unconscious and life-threatening conditions exist, healthcare providers are ethically and legally permitted to provide necessary care to preserve life or prevent serious harm, even without signed consent.

C. Asking the anesthesiologist to sign the consent is incorrect. Consent must come from the client or their legally authorized representative. The anesthesiologist cannot provide consent on behalf of the patient in an emergency.

D. Obtaining telephone consent from the facility administrator is unnecessary in life-threatening emergencies. Administrative consent does not override the ethical principle of emergency implied consent.

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Correct Answer is C

Explanation

Rationale:
A. Limiting catheter usage to 4 days is too rigid and not evidence-based. Catheters should be removed as soon as medically indicated, not automatically on a set day. Unnecessary catheterization is a risk factor for infection, so the focus is on minimizing use, not adhering to a fixed timeline.

B. Routine catheter irrigation is not recommended for infection prevention in clients with indwelling catheters. Irrigation can introduce pathogens and disrupt the closed system, increasing UTI risk.

C. Maintaining a closed urinary drainage system with securely sealed connections is a key evidence-based intervention to prevent catheter-associated urinary tract infections (CAUTIs). A closed system reduces the risk of contamination and prevents bacteria from entering the bladder.

D. Cleansing the periurethral area with antiseptic solutions is unnecessary for routine care. Routine hygiene with soap and water is sufficient; antiseptic cleaning has not been shown to reduce CAUTI rates and may cause irritation.

A. "If you have any concerns about the procedure, the surgery can be canceled. B. "Let me provide you with resources you can read about the surgery." C. "You should not have signed the consent form if you have reservations about the surgery." D. "I will contact the provider and request medication to help you relax."

Correct Answer is A

Explanation

Rationale:
A. The nurse should recognize that informed consent must be voluntary and based on understanding. If the client expresses doubt or uncertainty, the nurse should ensure the client knows they have the right to withdraw consent at any time, even after signing the form. This response supports the client’s autonomy and is consistent with ethical and legal standards in healthcare.

B. Providing resources can help inform the client but does not address the immediate concern that the client is unsure. The priority is to acknowledge their uncertainty and involve the provider in re-discussing options if needed.

C. Telling the client they should not have signed the consent form is judgmental and dismissive, which may increase anxiety and undermine trust. It does not support client autonomy or informed decision-making.

D. Requesting medication to help the client relax addresses anxiety but does not resolve the underlying issue of informed consent. Sedation cannot substitute for informed, voluntary consent and may be ethically and legally inappropriate.

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A nurse in the emergency department is assessing a client who is unconscious following a motor-vehicle crash. The client requires immediate surgery. Which of the following actions should the nurse take?

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