A nurse is caring for a client who is hospitalized and has expressive aphasia. The client's family reports that the nurse failed to obtain written informed consent before inserting an indwelling urinary catheter. Which of the following responses should the nurse make?
"Procedures prescribed by the provider do not require consent.”
"This is a procedure that does not require written informed consent.”
"You are right. I will discuss this issue with the charge nurse.”
"Would you mind signing the informed consent form for the procedure at this time?”
The Correct Answer is B
The correct answer is choice B: "This is a procedure that does not require written informed consent."
Choice B rationale: Informed consent is typically required for invasive procedures, surgery, or treatments that carry significant risks. While inserting an indwelling urinary catheter is considered an invasive procedure, it is generally not a procedure that requires written informed consent. Nurses often have standing orders or standardized procedures in place for catheterization, and consent is usually implied or obtained verbally.
Choice A rationale: Although providers prescribe procedures, consent is still necessary in many cases. However, as mentioned above, written informed consent is not typically required for urinary catheter insertion due to its routine nature in medical care.
Choice C rationale: Discussing the issue with the charge nurse is unnecessary since written informed consent is not generally required for this procedure. The nurse should instead focus on educating the family about standard hospital practices.
Choice D rationale: Asking the family to sign the informed consent form at this point is not appropriate, as it implies that the procedure should not have been performed without written consent. Additionally, urinary catheterization does not typically require written informed consent, so asking them to sign a form could create confusion or unnecessary concern.
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Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Informing the client of the consequences of decreased cerebral circulation is premature without understanding the client's specific reasons for refusing the surgery. Jumping to consequences might not address the underlying fears or concerns the client has, potentially leading to increased resistance or anxiety.
Choice B rationale:
Initiating a mental health consultation is a valuable step if the client's refusal appears to be influenced by psychological or emotional factors. However, before involving mental health professionals, it's important for the nurse to engage in a direct conversation with the client to explore their thoughts, fears, and reservations.
Choice C rationale:
Discussing the client's concerns about having the surgery is the most appropriate action in this scenario. Engaging in an open and nonjudgmental conversation allows the nurse to understand the client's perspective, provide information, clarify misconceptions, and address any fears or uncertainties. This approach respects the client's autonomy and promotes shared decision-making.
Choice D rationale:
Providing the client with information on additional treatment options might be premature if the client's main concern is related to the current recommended surgery. It's crucial to first address the client's specific reservations before exploring other treatment possibilities.
Correct Answer is A
Explanation
Choice A rationale:
Informing the staff of the penalties that can result from medication errors represents an authoritarian approach to managing the issue. This approach relies on authority and fear to enforce compliance. By emphasizing the potential consequences, the nurse manager is attempting to control behavior through fear of punishment. While this might create a short-term change in behavior, it does not address the root causes of the errors or promote a culture of safety.
Choice B rationale:
Encouraging the staff to have two nurses verify medication orders to prevent errors is not an authoritarian approach. It involves collaboration and peer support to enhance medication safety. This approach promotes shared responsibility and accountability, which are not associated with authoritarian leadership.
Choice C rationale:
Providing a suggestion box for the staff to submit ideas for error prevention is not an authoritarian approach. This strategy fosters a participative and democratic leadership style. It encourages staff engagement and input, which contrasts with the top-down nature of authoritarian leadership.
Choice D rationale:
Asking three experienced nurses to help investigate common causes of the errors is not an authoritarian approach. It involves a collaborative and problem-solving approach that seeks input from knowledgeable staff members. This approach aims to identify systemic issues contributing to errors rather than focusing solely on punitive measures.
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