A nurse is obtaining informed consent for an adolescent who is scheduled for a cardiac catheterization. The adolescent’s guardian states, “I don’t understand why they need to do this procedure.”. Which of the following actions should the nurse take?
Explain the procedure to the adolescent and their guardian.
Witness the adolescent’s signature on the informed consent form.
Request assistance from the anesthesiologist to clarify the misunderstanding.
Notify the provider who is scheduled to perform the procedure.
The Correct Answer is D
Choice A rationale
While explaining the procedure to the adolescent and their guardian is important, it is not the nurse’s primary responsibility to provide detailed explanations of the procedure. This should be done by the provider performing the procedure.
Choice B rationale
Witnessing the adolescent’s signature on the informed consent form is part of the nurse’s role, but it does not address the guardian’s lack of understanding about the procedure.
Choice C rationale
Requesting assistance from the anesthesiologist to clarify the misunderstanding is not appropriate, as the anesthesiologist may not be the best person to explain the procedure. The provider performing the procedure should be the one to provide clarification.
Choice D rationale
Notifying the provider who is scheduled to perform the procedure is the correct action. The provider is responsible for ensuring that the patient and their guardian fully understand the procedure and its risks and benefits before obtaining informed consent.
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Correct Answer is D
Explanation
Choice A rationale
Encouraging flexion and extension of the neck is contraindicated for a client with a halo vest as it can compromise the stability of the cervical spine.
Choice B rationale
Assessing the pin sites for infection once every other day is not sufficient. Pin sites should be assessed at least once per shift to detect and manage any potential infections early.
Choice C rationale
Tightening the screws on the halo device one-quarter turn every 48 hours is not recommended. Adjustments to the halo device should only be made by a healthcare provider to ensure the integrity of the device and the stability of the cervical spine.
Choice D rationale
Repositioning the client using a turning sheet is the correct action. This method helps to reposition the client safely without exerting unnecessary pressure on the cervical spine and aids in preventing pressure ulcers.
Correct Answer is A
Explanation
Choice A rationale
The tumbling E chart is used for visual acuity assessment in children who cannot read letters, such as those who are too young or have language barriers. It involves identifying the direction of the letter “E” in various orientations.
Choice B rationale
Testing the child without glasses before testing with glasses is not the standard procedure for visual acuity assessment. The correct approach is to test with the child’s usual corrective lenses if they have them.
Choice C rationale
The standard distance for visual acuity testing using a chart is 3 meters (10 feet) for children, not 4.6 meters (15 feet).
Choice D rationale
Assessing each eye separately first, then both eyes together, is the correct procedure for visual acuity testing. This ensures accurate measurement of each eye’s visual acuity.