During the preoperative period, what is the nurse's responsibility regarding informed consent?

Administering preoperative medications to the patient

Witnessing the patient's signature on the consent form

Explaining the surgical procedure to the patient

Monitoring the patient's vital signs during the procedure

Answer and Explanation

The Correct Answer is B

A.   Administering preoperative medications is a nursing responsibility but not directly related to informed consent.
B.   Witnessing the patient's signature is the nurse's primary responsibility regarding informed consent in the preoperative period. This verifies that the patient understands the procedure and voluntarily agrees to it.
C.   Explaining the surgical procedure is the responsibility of the surgeon or physician.
D.   Monitoring vital signs is a postoperative responsibility.

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Correct Answer is D

Explanation

A. Metabolic acidosis is characterized by a primary decrease in bicarbonate (HCO₃⁻) levels, which is not typically a direct result of COPD. However, if a patient with COPD has an additional condition like kidney failure or severe sepsis, they could potentially develop metabolic acidosis. But, this is not the primary concern in COPD.
B. Respiratory alkalosis is caused by hyperventilation, where there is excessive loss of CO₂ leading to an increase in blood pH. This is less common in COPD patients, as they typically have difficulty exhaling CO₂ rather than hyperventilating.
C. Metabolic alkalosis involves an increase in blood pH due to elevated bicarbonate levels or loss of acid. This is not typically associated with COPD, unless there is an unrelated condition causing metabolic alkalosis.
D. COPD is characterized by impaired airflow and reduced ability to expel carbon dioxide (CO₂) effectively. As CO₂ accumulates in the blood, it combines with water to form carbonic acid, which lowers the blood pH, leading to respiratory acidosis.

A. Increase sodium intake. B. Infuse hypotonic IV fluids. C. Administer sodium polystyrene sulfonate. D. Implement a fluid restriction.

Correct Answer is B

Explanation

A. Increasing sodium intake would exacerbate hypernatremia, not correct it. Hypernatremia is characterized by an excess of sodium in the blood, so the goal of treatment is to lower sodium levels, not increase them.
B. Infusing hypotonic IV fluids, such as 0.45% NaCl or D5W (5% dextrose in water), helps to dilute the high sodium concentration in the blood and can assist in correcting hypernatremia. Hypotonic fluids move water into cells and help balance the sodium levels by promoting hydration and lowering the sodium concentration.
C. Sodium polystyrene sulfonate (Kayexalate) is used to treat hyperkalemia (elevated potassium levels), not hypernatremia. It works by exchanging potassium for sodium in the gastrointestinal tract and would not address hypernatremia.
D. Implementing a fluid restriction is generally not the best approach for treating hypernatremia. In fact, fluid restriction could worsen hypernatremia by limiting the client's fluid intake and not addressing the sodium imbalance. The primary goal in hypernatremia is usually to rehydrate the patient with appropriate fluids.

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During the preoperative period, what is the nurse's responsibility regarding informed consent?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has COPD. The nurse should identify the client is at risk for which of the following acid-base imbalances?

Correct Answer is D

Explanation

A nurse is planning care for a client who has hypernatremia. Which of the following actions should the nurse include in the plan of care?

Correct Answer is B

Explanation

A nurse is assessing a client who has right-sided heart failure. Which of the following findings should the nurse expect?

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A nurse is performing tracheostomy care for a client and suctioning to remove copious secretions. Which of the following actions should the nurse take?

A nurse is teaching a class about oxygen transport in the cardiopulmonary system. Which of the following transports oxygen in the blood?

The nurse emphasizes the importance of deep breathing and coughing exercises post-operatively to prevent complications. Which statement by the client indicates understanding of these exercises?

A nurse is observing the closed chest drainage system of a client who is 24 hr post thoracotomy. The nurse notes slow, steady bubbling in the suction control chamber. Which of the following actions should the nurse take?

A post-operative patient is at risk for developing a wound infection. Which of the following nursing assessments is the highest priority to prevent this complication?