The nurse is caring for a patient who will be having surgery shortly. The patient requests that a religious bracelet be worn in the operating room to help ensure a good surgical outcome. Which is the most appropriate action of the nurse?
Insist that the patient remove the bracelet and give it to a family member during surgery.
Notify the patient’s surgeon of the patient’s refusal to remove the bracelet before having surgery.
Call the operating room staff to determine if the bracelet can stay on during surgery.
Remove the bracelet from the patient's wrist after sedating medication has been administered.
The Correct Answer is C
Choice A reason: This is an incorrect choice because insisting that the patient remove the bracelet and give it to a family member during surgery is not the most appropriate action of the nurse. This action may violate the patient's right to autonomy, religious freedom, and cultural sensitivity. The nurse should respect the patient's beliefs and preferences and try to accommodate them as much as possible, unless they pose a significant risk to the patient's safety or the surgical procedure.
Choice B reason: This is an incorrect choice because notifying the patient’s surgeon of the patient’s refusal to remove the bracelet before having surgery is not the most appropriate action of the nurse. This action may imply that the patient is non-compliant or difficult, and may create a conflict between the patient and the surgeon. The nurse should communicate with the patient and the surgeon in a respectful and collaborative manner, and seek a mutually agreeable solution.
Choice C reason: This is the correct choice because calling the operating room staff to determine if the bracelet can stay on during surgery is the most appropriate action of the nurse. This action shows that the nurse is willing to advocate for the patient and to consult with the relevant authorities to find out the best option. The nurse should follow the policies and protocols of the operating room and the infection control guidelines, and ensure that the bracelet does not interfere with the surgical site, the equipment, or the sterile field.
Choice D reason: This is an incorrect choice because removing the bracelet from the patient's wrist after sedating medication has been administered is not the most appropriate action of the nurse. This action may be considered unethical, dishonest, or disrespectful, as the nurse is taking advantage of the patient's altered mental status and going against the patient's wishes. The nurse should obtain the patient's informed consent before performing any intervention, and should not deceive or coerce the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This is incorrect. Presbyopia is not a term for age-related hearing loss. Presbyopia is a term for age-related vision loss. Presbyopia is a condition where the lens of the eye becomes less flexible and less able to focus on near objects. It can cause difficulty in reading, writing, or doing other close-up tasks.
Choice B reason: This is correct. Presbycusis is a term for age-related hearing loss. Presbycusis is a condition where the inner ear or the auditory nerve degenerates over time. It can cause difficulty in hearing high-pitched sounds, speech, or background noise. It can also affect the balance and the quality of life.
Choice C reason: This is incorrect. Meniere’s disease is not a term for age-related hearing loss. Meniere’s disease is a term for a disorder of the inner ear that causes episodes of vertigo, hearing loss, tinnitus, and ear fullness. It can affect people of any age, but it is more common in middle-aged adults. It can be triggered by stress, infection, or allergy.
Choice D reason: This is incorrect. Tinnitus is not a term for age-related hearing loss. Tinnitus is a term for a ringing, buzzing, or other sound in the ears or head that is not caused by an external source. It can affect people of any age, but it is more common in older adults. It can be caused by various factors, such as noise exposure, ear infection, medication, or hearing loss.
Correct Answer is A
Explanation
Choice A reason: This is the correct choice because the apical pulse is the most accurate measurement of the heart rate and rhythm. Digoxin is a cardiac medication that affects the heart rate and can cause arrhythmias. Therefore, the nurse should use the apical pulse to monitor the patient's response to the medication.
Choice B reason: This is an incorrect choice because the carotid pulse is not the best site to measure the heart rate before administering digoxin. The carotid pulse is located in the neck and can be affected by external factors such as pressure or movement. The carotid pulse is also not recommended for routine use because it can stimulate the vagus nerve and lower the heart rate.
Choice C reason: This is an incorrect choice because the radial pulse is not the best site to measure the heart rate before administering digoxin. The radial pulse is located in the wrist and can be affected by peripheral factors such as circulation or temperature. The radial pulse can also be inaccurate or irregular if the patient has an arrhythmia.
Choice D reason: This is an incorrect choice because the brachial pulse is not the best site to measure the heart rate before administering digoxin. The brachial pulse is located in the upper arm and can be affected by arm position or blood pressure. The brachial pulse is also not as reliable as the apical pulse for detecting changes in the heart rate and rhythm.
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