A nurse is teaching a client at risk for melanoma about what to look out for when checking the skin. The nurse determines that the teaching was successful based on which client statement(s)? (Select all that apply)

Choice A reason: Ensuring the patient receives all necessary information is the physician’s responsibility, not the nurse’s. Informed consent involves explaining risks, benefits, and alternatives, impacting patient autonomy. The nurse’s role is to witness the consent, verifying the patient’s understanding and voluntary agreement, ensuring ethical and legal standards are met without delivering medical details.

Choice B reason: Assessing competence is typically the physician’s role, as it requires evaluating cognitive capacity, influenced by neurological or psychological factors. Nurses may observe mental status but do not formally determine competence. Witnessing consent ensures the patient’s voluntary agreement, aligning with ethical principles of autonomy, making this a secondary nursing responsibility.

Choice C reason: Giving a complete procedure description is the surgeon’s duty, as it requires detailed medical knowledge of risks and outcomes. Nurses reinforce education but focus on witnessing consent to confirm voluntary agreement. Providing medical details exceeds the nurse’s scope, potentially causing confusion or miscommunication, impacting the patient’s informed decision-making process.

Choice D reason: Witnessing informed consent is the nurse’s primary role, verifying the patient received and understood information from the physician and consents voluntarily. This upholds autonomy, ensuring the patient’s decision aligns with their values. The nurse’s signature confirms the process, protecting legal and ethical standards without requiring them to provide medical explanations.

Choice E reason: Researching non-surgical alternatives is outside the nurse’s scope during preoperative teaching. Physicians discuss treatment options, considering cancer stage and biology. Nurses focus on witnessing consent, ensuring the patient’s understanding and voluntary agreement, supporting autonomy without delving into medical research, which could delay or confuse the consent process.

Choice A reason: Stating that talking to the client makes the nurse feel better is inappropriate as it centers on the nurse's emotions rather than the patient’s needs. Communication with dying patients supports dignity, assuming they may retain awareness, which aligns with patient-centered end-of-life care principles.

Choice B reason: Suggesting that talking reduces the nurse’s fear of death is unprofessional and irrelevant. The focus should be on the patient’s potential awareness and dignity. This response dismisses the therapeutic value of communication, which may comfort the patient, per palliative care and psychosocial support guidelines.

Choice C reason: Believing the patient can hear while alive is accurate, as studies suggest hearing persists in dying patients, supporting communication to provide comfort and dignity. This response reflects evidence-based practice, respecting the patient’s potential awareness and aligns with compassionate end-of-life care, per palliative care principles.

Choice D reason: Claiming the family requested talking is inaccurate and deflects responsibility. The rationale should be based on the patient’s potential to hear, supporting dignity. This response lacks a clinical basis and undermines the nurse’s professional judgment in providing meaningful end-of-life communication, per nursing ethics.