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A nurse is caring for a client who has a history of dementia. The client is alert and oriented to person, place, and time, and has advance directives. The client is scheduled for a procedure that requires informed consent. Which of the following persons should sign the informed consent?

The client

The client's son, who has a durable power of attorney

The client's partner

The client's daughter, who is the primary caregiver

Answer and Explanation

The Correct Answer is A

Rationale:

A. The client should sign the informed consent if they are alert, oriented, and capable of making decisions. The client's ability to understand the procedure and its implications is key to valid informed consent.

B. The client's son, who has a durable power of attorney would only sign the consent if the client were not competent or unable to understand the procedure, which is not the case here.

C. The client's partner may be involved in the decision-making process but does not have the legal authority to sign the consent unless designated as a legal representative.

D. The client's daughter, who is the primary caregiver would also not have the legal authority to sign the consent unless she holds a durable power of attorney or the client is deemed incapable of giving consent.

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A. The nurse opens the top flap of a sterile tray toward the body when assisting the provider with a thoracentesis. B. The nurse uses clean gloves when discontinuing a client's intravenous infusion. C. The nurse uses the client's telephone number as one form of identification when administering medications to a client. D. The nurse empties a client's drainable colostomy pouch when it is one-third full.

Correct Answer is C

Explanation

Rationale:

A. Opening a sterile tray flap toward the body can be incorrect practice, but it is a minor procedural issue that does not necessarily pose an immediate risk.

B. Using clean gloves is appropriate for non-sterile tasks like discontinuing an IV infusion.

C. Using a telephone number as identification is not acceptable; proper identification should include at least two identifiers like name and date of birth.

D. Emptying a colostomy pouch when it is one-third full is appropriate practice to prevent overflow and maintain hygiene.

A. A client requesting a referral for home health services B. A client asking about his PCA pump that contains morphine C. A client who needs assistance with a bath D. A client who has questions about his new prescription

Correct Answer is B

Explanation

Rationale:

A. Requesting a referral is important but not immediately critical compared to other needs.

B. Asking about a PCA pump with morphine indicates a potential issue with pain management or medication delivery that needs immediate attention.

C. Assisting with a bath is important for comfort and hygiene but is less urgent compared to immediate pain management.

D. Questions about a new prescription should be addressed but are generally less urgent than issues related to pain management.

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Correct Answer is C

Explanation

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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