A nurse on a surgical unit is caring for a client who is scheduled for surgery. The client states. "I cannot do this. I do not want this surgery." Which of the following actions should the nurse take?
Tell the client about the benefits of the surgery.
Inform the client that it is too late to stop the surgery.
Let the client know that their surgeon will be notified of their decision.
Reassure the client that it is expected to be nervous before surgery.
The Correct Answer is C
A. While educating the client about the benefits of surgery is important, it is not appropriate to dismiss the client's concerns in this situation.
B. It is important to respect the client's autonomy and decision-making process. If the client expresses a desire to reconsider the surgery, their wishes should be respected.
C. The nurse should respect the client's decision and communicate their wishes to the surgical team for further discussion and decision-making.
D. While reassurance is important, it should be provided in a way that acknowledges and respects the client's concerns and decisions.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. With the Z-track method, the skin is pulled laterally or to the side before the needle is inserted and released after the injection is administered to ensure the medication remains within the muscle and does not leak into the subcutaneous tissue.
B. The angle of insertion for intramuscular injections can vary depending on factors such as the client's body habitus and the length of the needle but is typically 90 degrees.
C. The needle should be withdrawn slowly and steadily to minimize tissue trauma and prevent medication leakage.
D. The Z-track method involves pulling the skin laterally or to the side before inserting the needle to create a zigzag pathway for the medication. This helps seal the needle track after the injection, reducing the risk of medication leakage into subcutaneous tissues.
Correct Answer is D
Explanation
A. This action may increase the risk of injury to both the nurse and the client.
B. This action does not effectively prevent the fall or minimize injury.
C. Moving quickly to a position in front of the client can cause imbalance and increase the risk for falling.
D. Allowing the client to slide down their outstretched leg can help prevent injury to both the client and the nurse.
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