During transport to the operating room for mitral valve replacement, a patient with a signed consent form says that she does not want to go through with the surgery and asks to be returned to her room. What is the best response from the nurse?

“The operating room is prepared; let’s not keep the surgeon waiting.”

“You have the right to cancel surgery, but it could be weeks before you are rescheduled.”

“You sound frightened; tell me what you are thinking.”

“Your preoperative medications will have you feeling more relaxed in a minute, it will be fine.”

Answer and Explanation

The Correct Answer is C

Choice A reason: Pressuring the patient to proceed disregards her autonomy and right to revoke consent. Exploring her concerns respects her decision, making this incorrect, as it dismisses the patient’s expressed wish to cancel the mitral valve replacement surgery during transport.

Choice B reason: Highlighting rescheduling delays may coerce the patient, undermining her right to refuse. Addressing her fears validates her feelings, making this incorrect, as it prioritizes logistics over the patient’s autonomy and emotional state during the surgical consent process.

Choice C reason: Asking about the patient’s thoughts acknowledges her fear and respects her right to revoke consent, facilitating open communication. This aligns with ethical nursing practice, making it the correct response to support the patient’s decision regarding mitral valve replacement surgery.

Choice D reason: Dismissing the patient’s refusal with reassurance about medications ignores her autonomy and consent rights. Exploring her concerns is more appropriate, making this incorrect, as it fails to address the patient’s explicit wish to cancel the surgery during transport.

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Correct Answer is ["A","C","E"]

Explanation

Choice A reason: Fever is common in acute cholecystitis due to gallbladder inflammation or infection. This aligns with clinical assessment findings, making it a correct manifestation the nurse would expect in a client experiencing an acute episode of cholecystitis during evaluation.

Choice B reason: Positive Cullen’s sign indicates intra-abdominal bleeding, not cholecystitis, which causes right quadrant pain. Indigestion is typical, making this incorrect, as it’s unrelated to the nurse’s expected findings in a client with acute gallbladder inflammation.

Choice C reason: Indigestion, often with bloating or nausea, supports cholecystitis, as gallstones impair bile flow. This aligns with gastrointestinal assessment, making it a correct manifestation the nurse would identify in a client with an acute cholecystitis episode.

Choice D reason: A palpable mass in the left upper quadrant suggests spleen or gastric issues, not cholecystitis, which affects the right side. Right quadrant pain is correct, making this incorrect, as it doesn’t support the nurse’s diagnosis of acute cholecystitis.

Choice E reason: Pain in the upper right quadrant, especially after fatty meals, is classic in cholecystitis due to gallbladder contraction against obstruction. This aligns with clinical findings, making it a correct manifestation the nurse would expect in acute cholecystitis assessment.

Choice F reason: Vague lower right quadrant discomfort is more typical of appendicitis, not cholecystitis, which causes upper right pain. Fatty meal-related pain is correct, making this incorrect, as it doesn’t align with the nurse’s expected findings in cholecystitis.

Choice G reason: Left upper quadrant pain suggests pancreatic or gastric issues, not cholecystitis, which is right-sided. Right quadrant pain is typical, making this incorrect, as it doesn’t support the nurse’s assessment of acute cholecystitis in the client’s presentation.

A. Administer furosemide (Lasix) 40 mg IV. B. Decrease the rate of the IV fluids and notify the health care provider. C. Document the CVP reading in the chart. D. Check the client’s urine specific gravity.

Correct Answer is B

Explanation

Choice A reason: Administering furosemide without a provider’s order is outside nursing scope and risks harm. Decreasing IV fluids addresses elevated CVP, making this incorrect, as it bypasses protocol compared to the nurse’s priority of adjusting fluids and consulting the provider.

Choice B reason: A CVP of 16 cm H2O suggests fluid overload; decreasing IV fluids and notifying the provider prevents worsening heart failure. This aligns with hemodynamic monitoring protocols, making it the correct action for the nurse to take to address the client’s elevated CVP.

Choice C reason: Documenting the CVP is necessary but doesn’t address the urgent fluid overload indicated by 16 cm H2O. Decreasing fluids is proactive, making this incorrect, as it delays intervention compared to the nurse’s priority of managing the client’s high CVP.

Choice D reason: Checking urine specific gravity assesses hydration but is less urgent than addressing elevated CVP with fluid adjustment. Notifying the provider takes precedence, making this incorrect, as it’s secondary to the nurse’s action to manage fluid overload immediately.

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During transport to the operating room for mitral valve replacement, a patient with a signed consent form says that she does not want to go through with the surgery and asks to be returned to her room. What is the best response from the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client who is experiencing an acute episode of cholecystitis. Which of these clinical manifestations supports this diagnosis? (Select all that apply)

Correct Answer is ["A","C","E"]

Explanation

The nurse cares for a client with 0.9% sodium chloride infusing at 125 mL/h. 2 hours after the infusion was started, the client’s central venous pressure (CVP) reading is 16 cm H2O. It is MOST important for the nurse to take which action?

Correct Answer is B

Explanation

Which ethical principle is most important when soliciting informed consent from a patient?

After teaching a client with irritable bowel syndrome (IBS), a nurse assesses the client’s understanding. Which menu selection indicates that the client correctly understands the dietary teaching?

The nurse is providing dietary education to a client with gastroesophageal reflux disease (GERD). The nurse indicates that the client understands the teaching if the client states a plan to avoid which foods to prevent symptom exacerbation? (Select all that apply)

A nurse is caring for a client who is being treated for heart failure and has a prescription for furosemide. The nurse should plan to monitor for which of the following adverse effects of the medication?

A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is being assessed by the nurse. Which assessment findings would be consistent with acute pancreatitis? (Select all that apply)

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