A nurse is speaking with the partner of a client who speaks a different language than the nurse. The partner tells the nurse that the client does not want to sign an informed consent for an urgent cesarean birth. Which of the following actions should the nurse take?
Ask the client's partner to sign as next of kin.
Document the client's refusal in their medical record.
Check to see if the client has an advance directive.
Ask the provider to explain the procedure through an interpreter.
The Correct Answer is D
Rationale:
A. Ask the client's partner to sign as next of kin: The partner cannot legally provide informed consent on behalf of the client unless they have legal power of attorney. Consent must come from the client unless they are incapacitated.
B. Document the client's refusal in their medical record: While documentation is important, it should only occur after ensuring the client fully understands the procedure. Without effective communication, refusal may not be informed.
C. Check to see if the client has an advance directive: Advance directives guide care if the client is incapacitated but may not apply if the client is alert and able to make decisions about the current procedure.
D. Ask the provider to explain the procedure through an interpreter: Using a professional interpreter ensures clear communication so the client can make an informed decision about the cesarean birth, respecting autonomy and reducing misunderstanding.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. "Give the client several choices of foods for meals.": Providing multiple options can overwhelm a client with dementia and increase confusion or frustration. It is better to offer one or two simple choices to support decision-making without causing cognitive overload.
B. "Avoid making eye contact with the client.": Avoiding eye contact can appear dismissive or impersonal. Maintaining gentle eye contact helps establish trust, enhances communication, and can be grounding for clients who are cognitively impaired.
C. "Increase environmental stimuli”: A stimulating environment can lead to agitation or disorientation in clients with dementia. These clients benefit from calm, predictable surroundings with reduced noise, clutter, and distractions to support cognitive clarity.
D. "Label the door to the bathroom with a symbol.": Using clear labels or symbols helps orient clients with dementia and reduces confusion. Visual cues support recognition and promote independence in navigating their environment, especially with essential tasks like toileting.
Correct Answer is B
Explanation
Rationale:
A. "Your child should have surgery in 7 to 10 days to remove the tumor.": Surgical removal of the tumor is a priority and is usually scheduled promptly after diagnosis, not delayed by a week or more. Early intervention reduces the risk of tumor rupture or metastasis.
B. "You should not palpate your child's abdomen prior to surgery.": Avoiding abdominal palpation is crucial because Wilms’ tumors are highly vascular and encapsulated. Palpation could cause rupture, leading to tumor cell spread into the peritoneal cavity and increasing the risk of metastasis.
C. "You should give your child captopril 200 mg PO daily.": Captopril is not a standard medication in the treatment of Wilms’ tumor. It is an antihypertensive that may be used if the child has associated hypertension, but the dosage listed is excessive for pediatric use and should not be prescribed without specific indications.
D. "Your child will not require further treatment after removal of the tumor.": Most children require additional therapy, such as chemotherapy and/or radiation, depending on tumor staging. Surgical removal alone is rarely curative, particularly in advanced or bilateral cases.
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