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
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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Correct Answer is B
Explanation
Rationale:
A. Asking other staff nurses does not address the immediate concern of the client and could lead to gossip or unnecessary complications.
B. Addressing the concern with the specific staff nurse directly is appropriate to understand any issues and to see if there is a valid reason for the client’s request.
C. Recommending transfer without understanding the issue could be premature and might not address the root of the problem.
D. Notifying human resources is a step that may be needed later but should not be the first action; the manager should first address the issue with the staff nurse.
Correct Answer is A
Explanation
Rationale:
A. Keeping an appointment with a client demonstrates fidelity by honoring commitments and ensuring reliability in care.
B. Allowing a new mother to hold her stillborn infant is compassionate care but relates more to the ethical principle of beneficence.
C. Confirming that a client going for surgery has signed a consent form is related to the principle of autonomy and informed consent.
D. Refusing to disclose information about a client to the media is related to confidentiality, not fidelity.