A nurse is preparing to perform preoperative care for a client who does not speak the same language as the nurse. The client has signed the informed consent form, but is refusing preoperative care. Which of the following actions should the nurse take?

Ask the client's son to explain the preoperative interventions.

Inform the provider about the situation with the client.

Reinforce the benefits of the surgery to the client.

Request another client who speaks the same language to act as an interpreter.

Answer and Explanation

The Correct Answer is B

A. Ask the client's son to explain the preoperative interventions. This is not appropriate as it may lead to miscommunication and is not in line with professional standards for interpretation.
B. Inform the provider about the situation with the client. This is correct. The provider should be informed to address the client's refusal of preoperative care appropriately.
C. Reinforce the benefits of the surgery to the client. Reinforcing the benefits does not address the communication barrier and the client's immediate refusal.
D. Request another client who speaks the same language to act as an interpreter. This is inappropriate and breaches confidentiality. Professional interpreters should be used.

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Correct Answer is C

Explanation

A. Complete an incident report and notify the nursing supervisor. Completing an incident report and notifying the supervisor is not required for routine tasks like faxing a laboratory report.
B. Direct the provider to the admissions department for the information. Directing the provider to another department is not necessary for this task and does not address the specific request to fax the report.
C. Place a cover sheet on top of the document indicating the recipient. This is the correct action. A cover sheet helps protect patient confidentiality by indicating the intended recipient and purpose of the fax, ensuring secure transmission.
D. Fax the complete medical record to the provider's office. Faxing the complete medical record is inappropriate unless specifically requested. Only the relevant laboratory report should be sent to maintain patient confidentiality and comply with privacy regulations.

A. Mask B. Gown C. Gloves D. Goggles

Correct Answer is C

Explanation

The correct sequence for removing personal protective equipment (PPE) to minimize the risk of contamination is:
1. Gloves (C): Gloves are considered the most contaminated and should be removed first. Removing gloves first prevents the risk of contaminating the nurse’s hands when removing other PPE items.
2. Goggles (D): Next, the goggles or face shield should be removed by handling the headband or earpieces. This reduces the risk of touching the face.
3. Gown (B): The gown should be removed by untying or breaking fasteners, and pulling it away from the body without touching the outside of the gown.
4. Mask or Respirator (A): The mask or respirator is removed last, handling only the ties or bands to avoid touching the face.

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A nurse is preparing to perform preoperative care for a client who does not speak the same language as the nurse. The client has signed the informed consent form, but is refusing preoperative care. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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