The physician has discussed the need for surgery with a client and has obtained informed consent. The nurse determines that the client does not understand the risks and benefits of the procedure. What is the nurse's best action?

Notify the physician

Explain the procedure in simple terms

Cancel the surgery until the problem is solved

Witness the client's signature

Answer and Explanation

The Correct Answer is A

A. This is crucial because informed consent is not just about signing a document; it's about ensuring that the client fully understands the procedure, including the risks, benefits, and alternatives. The physician can then re-evaluate the client's comprehension and provide further clarification if necessary. It is the responsibility of the healthcare team to ensure that the client is making an informed decision.
B. Explaining the procedure in simple terms may be part of the nurse's role, but it is essential that the physician is aware of any gaps in the client's understanding to address them appropriately.
C. Cancelling the surgery is not the immediate best action without first attempting to resolve the misunderstanding.
D. Witnessing the client's signature may be part of the nurse's role, but it is essential that the physician is aware of any gaps in the client's understanding to address them appropriately.

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Correct Answer is B

Explanation

B. This statement aligns with the concept of allostatic load, which refers to the cumulative physiological toll that chronic stress places on the body over time. Initially, the body's stress response system (the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system) is designed to help individuals cope with acute stressors. However, when stress becomes chronic, these physiological responses can become dysregulated and maladaptive, leading to negative health outcomes such as cardiovascular disease, immune dysfunction, and mental health disorders.
A. Chronic stress has been associated with various changes in gene expression and epigenetic modifications. However, these changes typically occur over longer periods and are not the primary mechanism by which chronic stress leads to illness in most cases.
C. Chronic stress can lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system, which are responsible for producing and regulating corticosteroids (such as cortisol) and catecholamines (such as adrenaline and noradrenaline). While acute stress typically results in increased production of these stress hormones, chronic stress can lead to desensitization and dysregulation of these systems, resulting in alterations in hormone levels and potential deficits in the availability of these stress mediators. However, deficits in corticosteroids and catecholamines are not the sole mechanism by which chronic stress leads to illness.
D. While chronic stress can certainly contribute to psychological fatigue and depletion of energy reserves, this is not the primary mechanism by which chronic stress leads to illness. The physiological responses to chronic stress, such as dysregulation of stress hormones, inflammation, and oxidative stress, are more directly linked to the development of various illnesses.

A. "I will not need to take medications to help with my problem." B. "These attacks could last seconds to minutes." C. "These attacks can come on suddenly even when I am alert and active." D. "Sometimes when I get angry It can trigger the attacks."

Correct Answer is A

Explanation

A. Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness and other symptoms such as cataplexy (sudden loss of muscle tone), sleep paralysis, and hallucinations. While lifestyle modifications and behavioral strategies may help manage symptoms, medications are often necessary to control narcolepsy symptoms effectively. Therefore, if a client with narcolepsy states that they will not need medications, further teaching is indeed needed.
B. Narcoleptic attacks, or sleep attacks, can indeed last seconds to minutes. They are characterized by sudden and uncontrollable episodes of sleepiness or sleep onset, which can occur during daytime activities.
C. Narcoleptic attacks can occur suddenly, even when the individual is alert and engaged in activities. These attacks are unpredictable and can significantly disrupt daily life.
D. Emotional triggers, such as stress, excitement, or anger, can sometimes precipitate or exacerbate narcoleptic symptoms, including sleep attacks and cataplexy. However, not all individuals with narcolepsy experience triggers in the same way, and triggers can vary among individuals. Therefore, this statement may or may not be true for the individual in question.

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The physician has discussed the need for surgery with a client and has obtained informed consent. The nurse determines that the client does not understand the risks and benefits of the procedure. What is the nurse's best action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse recognizes that chronic stress can lead to a variety of illnesses in a patient. This is primarily because:

Correct Answer is B

Explanation

The nurse understands that further teaching is needed when a client with narcolepsy states:

Correct Answer is A

Explanation

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