A nurse on a medical-surgical unit is caring for a client who asks about advance directives and states that he wants to appoint a health care proxy. Which of the following responses should the nurse make?

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

This option suggests an urgent response, prioritizing the immediate need for surgery over the formal process of obtaining informed consent. In certain emergency situations, such as when a patient's life or health is in imminent danger and obtaining consent is not feasible, healthcare providers may proceed with treatment or surgery to prevent further harm or loss of life. However, this approach should be guided by established protocols, legal considerations, and the principle of providing the best possible care for the patient.

b. Delay the surgery until the nurse can obtain informed consent:

This option advocates for ensuring that the patient's autonomy and rights are respected by obtaining informed consent before proceeding with surgery. While obtaining consent is essential, delaying surgery may not always be feasible or advisable in emergency situations where prompt intervention is necessary to prevent deterioration of the patient's condition. However, if circumstances allow, making efforts to obtain informed consent is ethically and legally preferable.

c. Obtain telephone consent from the facility administrator before the surgery:

This option proposes seeking consent from a designated authority within the healthcare facility, such as a facility administrator, via telephone. While this approach may be practical in some cases, it may not always be sufficient to ensure that the patient's rights are fully respected, particularly if the administrator does not have the legal authority to provide consent on behalf of the patient. In emergency situations, obtaining consent from a legally authorized representative of the patient, if available, is generally preferred.

d. Ask the anesthesiologist to sign the consent:

This option involves delegating the responsibility of signing the consent form to another member of the healthcare team, in this case, the anesthesiologist. However, consent for surgery should ideally be obtained directly from the patient or their legally authorized representative, as they are the ones who have the right to make decisions about their medical care. Relying on another healthcare provider to sign the consent form may not adequately protect the patient's autonomy and legal rights.

a. "You can ask an AP to teach a simple task to a client."

While assistive personnel may assist with client education under the supervision of a licensed nurse, the primary responsibility for teaching tasks to clients usually rests with licensed healthcare providers.

b. "You should assign tasks you are unfamiliar with to an experienced AP."

Delegating tasks to assistive personnel should be based on their competency and the complexity of the task, not necessarily on the nurse's familiarity with it. It is essential to delegate tasks that the AP is trained and competent to perform.

c. "If you are unsure about an AP’s ability, observe them performing the task."

This is the correct statement. It emphasizes the importance of assessing an assistive personnel's competence by observing their performance before delegating tasks, especially if there is uncertainty about their abilities.

d. "The person who delegates a task is not held accountable for the outcome."

This statement is incorrect. The person delegating a task is ultimately accountable for ensuring that the task is performed correctly and safely. Delegation does not relieve the delegator of accountability.