A nurse is caring for a client who has breast cancer and is postoperative following a bilateral mastectomy. Which of the following statements indicates the client has an altered body image?

Choice A reason: Thinking about wanting the procedure shows indecision, not consent understanding. Informed consent requires comprehension of the procedure, risks, and benefits, ensuring voluntary agreement. Contemplation alone is incomplete, failing to confirm the client’s grasp of the consent form’s legal purpose.
Choice B reason: Stating that signing indicates permission reflects understanding of informed consent, which documents voluntary agreement after receiving procedure details, risks, and benefits. This aligns with ethical and legal standards, confirming the client’s comprehension of the consent form’s role in authorizing surgery.
Choice C reason: Asking about risks indicates engagement but not consent understanding. It suggests a need for more information, not confirmation of the form’s purpose. While important, it does not reflect comprehension of the consent process as clearly as acknowledging the act of signing.
Choice D reason: Wanting to discuss concerns with the doctor shows the client seeks clarification, not that they understand the consent form’s purpose. It indicates an ongoing process, not confirmation of the form’s role in granting permission, unlike acknowledging the signing’s significance.

Choice A reason: Explaining the implications of a Do Not Resuscitate (DNR) status ensures the client understands that no CPR or intubation will occur if their condition deteriorates. This supports informed consent and autonomy, clarifying the scope of DNR to prevent misunderstandings. It respects the client’s decision-making capacity, ensuring their wishes align with end-of-life care preferences.
Choice B reason: Placing a “Do Not Resuscitate” sign outside the room breaches confidentiality under HIPAA, risking unauthorized disclosure of sensitive information. DNR status is communicated via medical records or wristbands. This action is inappropriate, as it does not contribute to implementing the client’s wishes and violates privacy standards, making it an incorrect response.
Choice C reason: Obtaining family consent is unnecessary for a competent client’s DNR request, as autonomy rests with the client. If decisionally capable, their wishes override family input. The nurse’s role is to support the client’s decision, not seek family approval, unless the client is incapacitated, which is not indicated, making this action inappropriate.
Choice D reason: Documenting the DNR request in the medical record ensures the care team follows the client’s wishes, preventing unwanted interventions. Accurate documentation communicates code status, supports legal and ethical standards, and ensures continuity of care. This is critical for aligning treatment with the client’s end-of-life preferences, making it a necessary action.