Melva is scheduled for an elective surgery. The surgeon comes to the preoperative area to review the surgical procedure with her. Alternatives are discussed, along with the benefits and risks associated with the surgery. Melva says she understands everything. This is:

Choice A reason: Using the incentive spirometer is important, but it is not specifically related to deep breathing and coughing exercises.

Choice B reason: Breathing deeply and coughing every 4 hours is part of postoperative care, but it does not indicate understanding of the technique to protect the incision.

Choice C reason: Splinting the incision with a pillow while coughing is a recommended technique to support the incision and reduce pain during coughing, indicating an understanding of the instructions.

Choice D reason: Lying flat is not recommended for deep breathing and coughing exercises as it can inhibit lung expansion and is not conducive to effective coughing.

Choice A reason: Informed consent is obtained when a patient agrees to a procedure after understanding its risks and benefits, which is what Melva provided.

Choice B reason: A time out is a final review before surgery to ensure correct patient identity, procedure, and site, which is not described here.

Choice C reason: Patient history refers to the collection of a patient's medical background, which is not the focus in this scenario.

Choice D reason: The pre-op checklist is a list of tasks to be completed before surgery, not a discussion of the procedure itself.