A nurse is caring for a client who is seeking information about end-of-life decisions. According to the Patient Self-Determination Act, which of the following applies to medical decisions that can be made within organizations that receive Medicare and Medicaid reimbursements?

Choice A reason: Assigning all staff to the emergency department disrupts care for existing inpatients and may overwhelm ED operations. Staff allocation should follow a triage plan, balancing hospital-wide needs. This action is impractical and risks neglecting other patients, making it less effective than preparing resources.
Choice B reason: Preparing to discharge stable clients frees up beds for incoming casualties, optimizing hospital capacity during a mass casualty event. This aligns with disaster protocols, ensuring resources are available for critical patients. It supports efficient triage and care delivery, making it the correct action.
Choice C reason: Canceling all elective surgeries immediately is premature without assessing the event’s scope. Some surgeries may continue if resources allow, per disaster protocols. This action disrupts hospital operations unnecessarily and is less urgent than preparing beds for casualties, making it inappropriate.
Choice D reason: Requesting ventilators assumes specific needs without assessing the casualty event’s nature. Ventilators may not be immediately required, and resource allocation should follow triage protocols. Preparing beds is a more immediate and versatile action, making this choice less prioritized in the initial response.

Choice A reason: Informed consent does not prevent a client from refusing the procedure, as they retain the right to withdraw consent at any time before or during the process. This statement is incorrect, as it misrepresents the client’s autonomy and legal rights under informed consent principles.
Choice B reason: The nurse’s role in witnessing consent is to verify the client’s voluntary agreement, not to explain the procedure in detail. The surgeon or provider is responsible for detailed explanations, making this action outside the nurse’s scope in this context and incorrect.
Choice C reason: Explaining risks and benefits is the surgeon’s responsibility, not the nurse’s when witnessing consent. The nurse ensures the client understands and agrees voluntarily but does not provide the explanation, making this an incorrect description of the nurse’s role in the process.
Choice D reason: The client’s voluntary agreement is a core legal requirement of informed consent, which the nurse verifies as a witness. This ensures the client understands the procedure, risks, and benefits and consents without coercion, aligning with ethical and legal standards, making it correct.