A nurse on a medical-surgical unit is caring for a client transferred from another department. The nurse should verify that the client has given informed consent prior to which of the following procedures?

Removal of staples from a surgical wound.

Providing a sputum specimen.

Receiving moderate sedation.

Collection of a blood specimen for ABGS.

Answer and Explanation

The Correct Answer is C

Answer is c. Receiving moderate sedation.

a. Removal of staples from a surgical wound: This procedure is typically considered routine and minimally invasive, involving the removal of staples used for wound closure. While it involves physical manipulation of the wound site, it does not carry significant risks or require the alteration of the patient's consciousness. Therefore, obtaining informed consent for this procedure is not typically necessary as it falls within the standard of care for post-operative wound management.

b. Providing a sputum specimen: Collecting a sputum specimen is a non-invasive procedure commonly performed to aid in the diagnosis of respiratory conditions such as infections or chronic lung diseases. It involves expectorating mucus from the respiratory tract, which does not pose significant risks to the patient. As such, informed consent is usually not required for this procedure since it is relatively simple and does not involve any invasive interventions or alteration of consciousness.

c. Receiving moderate sedation: Correct. Moderate sedation involves the administration of drugs, typically benzodiazepines or opioids, to induce a state of decreased consciousness and relaxation while maintaining the patient's ability to respond to verbal commands and physical stimulation. This procedure carries inherent risks, including respiratory depression, cardiovascular complications, and potential allergic reactions to the medications used. Due to the potential for adverse effects and the altered state of consciousness induced by moderate sedation, informed consent is necessary to ensure that patients understand the risks and benefits of the procedure before it is performed.

d. Collection of a blood specimen for ABGs: Arterial blood gas (ABG) analysis involves the collection of a blood sample from an artery, typically the radial artery in the wrist, to assess the patient's acid-base balance, oxygenation status, and ventilation. While this procedure does involve puncturing the skin and accessing the arterial blood supply, it is considered a standard diagnostic test in many clinical settings. However, the invasiveness of the procedure and potential risks such as bleeding, hematoma formation, and arterial injury may necessitate informed consent in certain situations, especially if the patient has underlying coagulopathies or other risk factors that could increase the likelihood of complications.

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Correct Answer is A

Explanation

Choice A rationale:

Ethics committees are tasked with providing guidance and recommendations in ethical dilemmas. They don't make the final decisions, but rather facilitate discussions and help individuals involved in the situation to weigh the options and make informed choices. This is consistent with the committee's role in addressing complex ethical decisions.

Choice B rationale:

Providing a legal representative for the family is not the primary role of an ethics committee. Legal representation is a separate matter and might be considered in situations where there are legal implications, but the committee's primary function is to address ethical concerns and conflicts.

Choice C rationale:

While ethics committees can offer recommendations, their focus is not necessarily on determining the best course of action for the client. Instead, they help individuals explore ethical principles and values to make decisions that align with the client's best interests.

Choice D rationale:

The ethics committee does not make decisions on behalf of the nursing team. Its role is to provide guidance and promote ethical discussions. Deciding how the nursing team should resolve the dilemma is beyond the committee's scope.

A. Role model a positive approach to the changes. B. Redirect the conversation when staff members make negative comments about the changes. C. Encourage staff members who support the changes to discuss the issue with resistant staff. D. Suggest that resistant staff members transfer to a different unit. E. Reprimand staff members who are resistant to the changes.

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

Explanation

The correct answers are Choices A and C.

Choice A rationale: Modeling positivity leverages social learning and transformational leadership, sets constructive norms, reduces uncertainty, and promotes psychological safety, facilitating Lewin’s change movement and sustained adoption of bariatric workflows and equipment safely.

Choice B rationale: Redirecting negativity suppresses concerns, undermines just culture, and blocks feedback necessary for Lewin’s unfreezing, reducing trust, psychological safety, and data to address barriers, thereby entrenching covert resistance to change process.

Choice C rationale: Engaging supportive peers utilizes diffusion of innovations and social proof; peer dialogue surfaces practical barriers, shares tacit knowledge, normalizes change behaviors, and increases motivation and adherence to bariatric care practices.

Choice D rationale: Suggesting transfers is coercive and punitive, contradicting transformational leadership and just culture, damages morale and retention, bypasses root-cause analysis, and fails to address legitimate change barriers or build sustainable engagement.

Choice E rationale: Reprimanding resistance pathologizes normal adaptation, undermines psychological safety and voice, increases turnover intentions, entrenches oppositional behavior, and conflicts with evidence-based change management; reserve discipline for misconduct, not expressed skepticism alone.

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