An unresponsive victim of a diving accident is brought to the emergency department where it is determined that immediate surgery is required to save the client's life. The client is accompanied by a close friend, but no family members are available. Which action should the nurse take first?

Ask the client's friend to sign the informed consent since the client is unresponsive.

Notify the unit manager that an emergency court order is needed to allow surgery.

Carry on with surgical preparation of the client without a signed informed consent.

Continue to provide life support until a thorough search for a guardian is completed.

Answer and Explanation

The Correct Answer is C

Rationale

A. The client's friend may not legally be authorized to provide consent unless they hold medical power of attorney or legal guardianship for the client. Without documentation of such authority, the friend cannot sign the informed consent.

B. In emergency situations where a patient lacks decision-making capacity and there is no available legal guardian or next of kin to provide consent, hospitals may seek a court order to proceed with necessary treatment. However, this could delay emergency treatment.

C. This is based on the legal and ethical understanding that saving the patient's life takes precedence when immediate action is required and consent cannot be obtained.

D. Providing life support ensures that the client's immediate medical needs are addressed while efforts are made to locate a legal guardian. However, unavailability of next of kin should not delay definitive intervention

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Correct Answer is C

Explanation

Rationale

A. This is not appropriate because a high HDL level (85 mg/dL) is beneficial and does not typically necessitate medication therapy solely for raising HDL.

B. This is reasonable to assess overall cardiovascular risk factors, including hereditary factors, which can influence the management and prevention of heart disease.

C. It reinforces the positive impact of a high HDL level on reducing cardiovascular risk and provides the client with valuable information about their health status.

D. While dietary advice is important, specifically targeting fatty foods may not be necessary if the client's HDL level is already high. General dietary recommendations for heart health are beneficial but should be tailored to individual needs.

A. Notify the healthcare provider if the client reports any allergies to iodine or shellfish. B. Insert an indwelling urinary catheter prior to going to the x-ray department. C. Encourage the client to drink at least 3 to 4 liters of water prior to the procedure. D. Instruct the client that it will be necessary to keep the legs straight for 6 to 8 hours after the procedure.

Correct Answer is A

Explanation

Rationale

A. Iodinated contrast dye is commonly used in IVP procedures. Clients with a known allergy to iodine or shellfish may be at increased risk of an allergic reaction to the contrast dye. It is crucial to notify the healthcare provider so that appropriate pre-medication or alternative imaging options can be considered to minimize the risk of an allergic reaction.

B. While some procedures may require a urinary catheter, it is not routinely necessary for an IVP. Urinary catheters are generally used when precise urinary output measurement is required or when there are concerns about bladder function during and after the procedure. There is no specific indication for routine urinary catheterization before an IVP.

C. Drinking plenty of fluids before an IVP helps to ensure adequate hydration and can help flush the contrast dye from the body more quickly after the procedure. This can help reduce the risk of contrast dye-related complications such as nephrotoxicity and contrast-induced nephropathy.

D. After an IVP, there is no requirement for the client to keep their legs straight for an extended period. Typically, clients are observed for a brief period after the procedure to monitor for any immediate adverse reactions, but they are not required to keep their legs straight or remain immobile for an extended duration.

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An unresponsive victim of a diving accident is brought to the emergency department where it is determined that immediate surgery is required to save the client's life. The client is accompanied by a close friend, but no family members are available. Which action should the nurse take first?

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Naxlex Comprehensive Predictor Exams

A older adult client tells the nurse that of having a high-density lipoprotein (HDL) level of 85 mg/dL (2.2 mmol/L). Which action should the nurse take? Reference Range: High Density Lipoproteins (HDL) [greater than 45 mg/dL (greater than 0.75 mmol/L)]

Correct Answer is C

Explanation

When preparing a client for an intravenous pyelogram (IVP), it is essential for the nurse to take which action?

Correct Answer is A

Explanation

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