A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take?
Proceed with treatment without obtaining written consent.
Contact the client's next of kin to obtain consent for treatment.
Notify risk management before initiating treatment.
Have the client sign a consent for treatment.
The Correct Answer is A
Rationale:
A. In emergency situations where the client is unable to provide informed consent (disoriented) and there is a life-threatening condition (cardiac arrhythmia), treatment should proceed under the principle of implied consent to save life or prevent serious harm.
B. Contacting next of kin may cause a delay in critical treatment and is not required in emergencies.
C. Notifying risk management is unnecessary and would delay care.
D. The client is disoriented and unable to legally sign consent, so this option is not appropriate.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. Personal beliefs about family relationships are subjective and not necessary for a change-of-shift or transfer report.
B. Detailed wound care procedures belong in the medical record or care plan, not in the transfer report.
C. A client’s bathing preference is relevant to daily care but not essential for continuity of care during transfer.
D. The time of the last pain medication is critical information for continuity of care and client safety, ensuring the next care team can manage pain effectively and avoid overdosing.
Correct Answer is A
Explanation
Rationale:
A. Nonmaleficence refers to the ethical principle of avoiding harm or preventing injury. By removing a fall hazard, the nurse is actively working to prevent harm to the client.
B. Veracity means telling the truth and being honest with clients, which is not demonstrated in this scenario.
C. Utility focuses on the greatest good for the greatest number, not on preventing individual harm in a direct care setting.
D. Autonomy is respecting the client’s right to make their own decisions about care, but it does not apply to removing environmental hazards.
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