A nurse is reviewing the plan of care for a group of clients. The nurse should identify that informed consent is required for which of the following procedures?
Irrigation of a wound with antibiotic solution
Insertion of a nasogastric tube
Placement of a central venous catheter
Administration of an iron injection using Z-track technique
The Correct Answer is C
A. Incorrect. Irrigation of a wound with antibiotic solution typically does not require informed consent.
B. Incorrect. Insertion of a nasogastric tube does not usually require informed consent unless it involves specific risks or is part of a research protocol.
C. Correct. Placement of a central venous catheter is an invasive procedure that involves risks, and informed consent is usually required.
D. Incorrect. Administration of an iron injection using the Z-track technique is a routine procedure and does not usually require informed consent.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Correct. Overhearing private client information being discussed by staff members violates the client's right to privacy and confidentiality. The nurse should address the situation immediately and instruct the assistive personnel to stop the conversation.
B. Incorrect. While documenting the event in the client's progress notes may be necessary, addressing the inappropriate behavior of the assistive personnel takes precedence.
C. Incorrect. Informing the client about the conversation is not necessary and may further compromise the client's sense of privacy.
D. Incorrect. Submitting an incident report to the risk manager might be necessary, but the immediate action should be to stop the conversation and address the breach of confidentiality.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"E"}
Explanation
Given the client's symptoms (productive cough, blood-tinged sputum, fatigue, night sweats, low-grade fever, weight loss, and recent travel to South Africa), there is a suspicion of tuberculosis (TB). The Mantoux test (a skin test for TB) and a chest X-ray are appropriate diagnostic tools to evaluate for TB.
A. a nasopharyngeal swab: This test is used to detect respiratory infections, but the client's symptoms and history do not specifically indicate the need for this test.
B. A pulmonary function test: While this test assesses lung function, it may not be the initial choice for evaluating the presented symptoms and history.
C. A chest x-ray
Rationale: Given the client's symptoms of cough, fatigue, night sweats, low-grade fever, and blood-tinged sputum, a chest x-ray is indicated to assess the condition of the lungs and potential underlying respiratory issues.
D. blood cultures
Rationale: The client's symptoms, including fever, could indicate an underlying infection. Blood cultures are used to identify potential bacterial or fungal infections in the bloodstream, but this is not likely for this patient
E. a Mantoux test
Rationale: The client's recent travel history, cough, and weight loss may prompt consideration of a tuberculosis (TB) infection. A Mantoux test is a common initial screening tool for TB exposure.
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