A nurse in an emergency department is caring for a client who is unconscious and requires surgery. There is no one available to give consent for the treatment. Which of the following actions should the nurse take?

Prepare the client for surgery.

Obtain consent from the surgeon.

Contact the facility's ethics committee for guidance

Keep the client stable until a family member arrives to give consent.

Answer and Explanation

The Correct Answer is A

A. In an emergency situation where a patient is unconscious and unable to give consent, and there is no available family member or designated surrogate to provide consent, healthcare providers can proceed with life-saving treatment under the principle of implied consent. This principle assumes that a reasonable person would consent to treatment if they were able to do so.

B. The surgeon cannot give consent for the patient. Consent must come from the patient or a legally authorized representative.
C. In situations where consent cannot be obtained from the patient or a legally authorized representative, involving the ethics committee can be a prudent course of action. However, this may delay emergency care.
D. This option may be appropriate if there is a reasonable expectation that a family member or legally authorized representative will arrive within a reasonable timeframe. However, in emergency situations where immediate intervention is necessary to save the patient's life or prevent serious harm, waiting for consent may not be feasible.

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Correct Answer is D

Explanation

D. Demonstrates the nurse's commitment to advocating for the client's wishes and ensuring that their preferences are communicated to the healthcare provider. This response acknowledges the client's desire for ongoing treatment while also facilitating further discussion with the healthcare team about the available options and potential treatment modalities.
A. This may be premature and could be perceived as dismissive of the client's wishes. While hospice care may be appropriate for some clients with terminal illnesses, it should be introduced as an option after thorough discussion and consideration of the client's preferences and goals of care.
B. This may be blunt and insensitive, potentially causing distress or anxiety for the client. It is important to provide information about prognosis in a sensitive and empathetic manner, taking into account the client's emotional state and readiness to discuss such matters.
C. This may overlook the client's desire for continued treatment and may not fully address their concerns or needs. While encouraging the client to focus on quality of life and personal fulfillment is important, it should be done in conjunction with discussions about treatment options and goals of care.

A. Cross the client's ankles when lying supine. B. Use trochanter rolls beside the client's legs. C. Place the client's arms at their side when turning them. D. Logroll the client every 4 hr.

Correct Answer is B

Explanation

B. Trochanter rolls are positioning devices placed alongside the hips and thighs to prevent external rotation of the legs, which can lead to hip dislocation or pressure injuries. Using trochanter rolls helps maintain proper alignment of the lower extremities and reduces the risk of musculoskeletal complications.
A. Crossing the client's ankles when lying supine can increase the risk of pressure injuries, particularly over bony prominences such as the ankles, and impair circulation.
C. Placing the client's arms at their side is not typically recommended as it does not facilitate proper body alignment and can lead to discomfort.
D. Logrolling the client every 4 hours is a technique used for clients with spinal injuries or after certain types of spinal surgery and may not be necessary for all immobile clients.

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A nurse in an emergency department is caring for a client who is unconscious and requires surgery. There is no one available to give consent for the treatment. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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