A nurse is caring for a group of clients on a medical-surgical unit. The nurse should ensure that the client has signed an informed consent form prior to which of the following procedures? (Select all that apply)

Undergoing cardiac catheterization

Receiving moderate sedation

Suctioning a tracheostomy tube

inserting a peripheral IV catheter

inserting an indwelling urinary catheter

Answer and Explanation

Correct Answer : A,B

A) Undergoing cardiac catheterization:

Cardiac catheterization is an invasive procedure that involves threading a thin tube (catheter) through blood vessels to the heart. It carries potential risks, including bleeding, infection, and damage to blood vessels or the heart. Therefore, obtaining informed consent is essential to ensure that the client understands the procedure, its risks, benefits, and alternatives before undergoing it.

B) Receiving moderate sedation:

Moderate sedation (conscious sedation) is a drug-induced state of depressed consciousness during which the client remains responsive to verbal commands. While it is less invasive than general anesthesia, it still carries risks, including respiratory depression, hypotension, and allergic reactions. Informed consent is required to ensure that the client understands the potential side effects and complications associated with sedation.

C) Suctioning a tracheostomy tube:

Suctioning a tracheostomy tube is a routine nursing intervention to remove secretions and maintain airway patency. It does not typically require informed consent unless there are specific circumstances or the client's condition warrants additional explanation or consent, such as if the client is at risk for complications or discomfort during the procedure.

D) Inserting a peripheral IV catheter:

Inserting a peripheral IV catheter is a common nursing procedure that typically does not require informed consent unless there are unusual circumstances or the client's condition warrants additional explanation or consent, such as if the client has specific concerns or medical conditions that may affect the procedure.

E) Inserting an indwelling urinary catheter:

Inserting an indwelling urinary catheter is a routine nursing procedure commonly performed to drain urine from the bladder. Informed consent may be required in certain situations, such as if the client lacks decision-making capacity or if the procedure involves specific risks or considerations that require explanation to the client or their legal representative. However, in most cases, informed consent is obtained as part of the general consent for treatment upon admission to the healthcare facility.

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Correct Answer is B

Explanation

A) Examine personal values:

While examining personal values is important in ethical decision-making, it is not the first step in addressing this particular ethical dilemma. Understanding personal values comes after gathering relevant facts and understanding the situation fully.

B) Collect the relevant facts:

This is the most appropriate initial step when facing an ethical dilemma. Gathering relevant information about the child's condition, the prescribed treatment, and the reasons for the parents' refusal is crucial for making informed decisions and developing a plan of action.

C) Create a plan of action:

Creating a plan of action is an important step in addressing the ethical dilemma, but it should come after collecting all relevant facts. Without a clear understanding of the situation, any plan of action may be incomplete or ineffective.

D) Agree on a desired outcome:

While determining a desired outcome is essential, it should be based on a thorough understanding of the situation, which comes from collecting relevant facts. Agreeing on an outcome before fully assessing the situation may lead to premature or uninformed decisions.

A. Administer liquids to the client using a syringe. B. Elevate the head of the client's bed to 45° during meals. C. Instruct the client to tilt their head back when swallowing. D. Request a speech therapist consult from the provider.

Correct Answer is D

Explanation

A) Administer liquids to the client using a syringe:

Administering liquids using a syringe may not address the underlying issue of food pocketing in the client's cheeks during meals. While syringe feeding may be necessary for clients with severe dysphagia, it does not address the need for comprehensive evaluation and intervention by a speech therapist.

B) Elevate the head of the client's bed to 45° during meals:

Elevating the head of the bed during meals is a standard intervention to help prevent aspiration in clients with dysphagia. While this intervention may be appropriate, it may not directly address the issue of food pocketing in the client's cheeks. Therefore, it is not the most comprehensive intervention for this specific problem.

C) Instruct the client to tilt their head back when swallowing:

Tilting the head back when swallowing is not a recommended intervention for clients with dysphagia. In fact, this maneuver can increase the risk of aspiration, as it can cause food or liquid to enter the airway. Therefore, this intervention would not be appropriate and could potentially exacerbate the client's swallowing difficulties.

D) Request a speech therapist consult from the provider:

This is the most appropriate intervention for addressing the client's dysphagia and food pocketing. Speech therapists are trained to assess and treat swallowing disorders, including pocketing of food in the cheeks. They can conduct a comprehensive evaluation of the client's swallowing function and develop individualized interventions to address the underlying causes of dysphagia. Therefore, requesting a speech therapist consult is the most effective way to manage this issue and improve the client's swallowing safety and efficiency.

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A nurse is caring for a group of clients on a medical-surgical unit. The nurse should ensure that the client has signed an informed consent form prior to which of the following procedures? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

A nurse is assisting with the plan of care for a child whose parents refuse to accept the medical treatment prescribed by the provider. Which of the following actions should the nurse plan to take first to address this ethical dilemma?

Correct Answer is B

Explanation

A nurse is contributing to the plan of care for a client who has dysphagia and is pocketing food in their cheeks during meals. Which of the following interventions should the nurse recommend?

Correct Answer is D

Explanation

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