A nurse is preparing to witness a client who is scheduled for a bilateral mastectomy sign the informed consent form. The client states, "I am glad they are not taking both breasts." Which of the following actions should the nurse take?

Check with the surgery department that the procedure is correct.

Notify the provider after the client signs the form.

Explain to the client that both breasts are to be removed.

Ask the provider to clarify the procedure with the client before she signs the form.

Answer and Explanation

The Correct Answer is D

A. Check with the surgery department that the procedure is correct. While important, it does not address the client's misunderstanding.
B. Notify the provider after the client signs the form. The client should not sign the form until they understand the procedure.
C. Explain to the client that both breasts are to be removed. The nurse should not provide surgical explanations beyond their scope.
D. Ask the provider to clarify the procedure with the client before she signs the form. The provider must ensure the client understands the procedure before consent is signed.

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Correct Answer is ["A","D"]

Explanation

A. Place the client in contact isolation. Contact isolation helps prevent the spread of C. difficile to other patients and staff by requiring the use of gowns and gloves when entering the patient's room.
B. Prepare the client for a colonoscopy. This is not typically part of the standard care plan for C. difficile infection. Colonoscopies are not indicated for diagnosing or managing C. difficile.
C. Administer docusate sodium 500 mg daily. Docusate sodium is a stool softener and is not appropriate for treating C. difficile, which causes diarrhea.
D. Use a bleach solution to clean the client's bedside table. Bleach is effective at killing C. difficile spores, which are resistant to many other cleaning agents.
E. Use hand sanitizer immediately after caring for the client. Hand sanitizers are not effective against C. difficile spores. Handwashing with soap and water is necessary.

A. Spaghetti with meat sauce, Cantaloupe, green bean and a glass of milk B. Chicken with cream sauce and milk C. Chicken, mashed potatoes D. Chicken with cream sauce, asparagus, and a glass of milk E. Chicken, mashed potatoes, coleslaw, brown rice, tomato slices and a glass of milk

Correct Answer is A

Explanation

A. Spaghetti with meat sauce, cantaloupe, green beans, and a glass of milk This meal represents a balanced MyPlate meal by including grains (spaghetti), protein (meat sauce), fruits (cantaloupe), vegetables (green beans), and dairy (milk).
B. Chicken with cream sauce, and milk This meal lacks variety and does not include fruits, vegetables, or grains, making it less balanced.
C. Chicken, mashed potatoes This meal lacks fruits and vegetables, and does not include a dairy component.
D. Chicken with cream sauce, asparagus, and a glass of milk This meal lacks a grain component.
E. Chicken, mashed potatoes, coleslaw, brown rice, tomato slices, and a glass of milk While balanced, this meal is more complex and not typical of the simpler MyPlate guideline.
F. Shrimp curry, white rice, and a glass of milk This meal is missing fruits and vegetables.

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A nurse is preparing to witness a client who is scheduled for a bilateral mastectomy sign the informed consent form. The client states, "I am glad they are not taking both breasts." Which of the following actions should the nurse take?

Nursing Test Bank

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