a client scheduled for surgery cannot sign the operative consent form because he has been sedated with opioid analgesics the nurse should take which

ATI RN

ATI RN Custom Exams Set 2

1. A client scheduled for surgery cannot sign the operative consent form because he has been sedated with opioid analgesics. The nurse should take which best action regarding the informed consent?

A. Obtain a court order for the surgery
B. Sign the informed consent on behalf of the client
C. Send the client to surgery without the consent form being signed
D. Obtain a telephone consent from a family member, with the consent being witnessed by two healthcare providers

Correct answer: D

Rationale: In situations where a client is unable to sign the consent form, obtaining a telephone consent from a family member, with the consent being witnessed by two healthcare providers, is the best course of action. This ensures that the client's best interests are considered and that proper authorization is obtained. Option A, obtaining a court order, is not necessary in this scenario and could delay the surgery. Option B, signing the consent on behalf of the client, is not appropriate as it may raise ethical and legal concerns. Option C, sending the client to surgery without a signed consent form, is not advisable as it violates the principles of informed consent and places the client at risk.

2. The nurse is caring for a client in a sickle cell crisis. Which is the pain regimen of choice to relieve the pain?

A. Frequent aspirin (acetylsalicylic acid) and a non-narcotic analgesic
B. Motrin (ibuprofen), an NSAID, PRN
C. Demerol (meperidine), a narcotic analgesic, every four (4) hours
D. Morphine, a narcotic analgesic, every two (2) to three (3) hours PRN

Correct answer: D

Rationale: In a sickle cell crisis, morphine is the preferred analgesic due to its potency and effectiveness in managing severe pain. Choice A is incorrect because aspirin is contraindicated in sickle cell disease due to its potential to cause a further decrease in blood flow. Choice B, Motrin (ibuprofen), is also not the ideal choice as NSAIDs can exacerbate renal complications in sickle cell patients. Choice C, Demerol (meperidine), is not recommended for sickle cell pain management due to its toxic metabolite accumulation which can cause seizures and other complications.

3. When does short-bowel syndrome usually occur?

A. The longitudinal muscles of the intestine contract
B. More than 50% of the small intestine is surgically removed
C. More than 50% of the large intestine is surgically removed
D. Transit time is decreased due to infection or drugs

Correct answer: B

Rationale: Short-bowel syndrome typically occurs when more than 50% of the small intestine is surgically removed. This condition leads to malabsorption issues due to the reduced length of the intestine for absorption. Choices A, C, and D are incorrect because short-bowel syndrome specifically relates to the insufficient length of the small intestine, not the contraction of longitudinal muscles, surgical removal of the large intestine, or decreased transit time due to infection or drugs.

4. The client with peripheral venous disease is scheduled to go to the whirlpool for a dressing change. What is the nurse’s priority intervention?

A. Escort the client to the physical therapy department
B. Medicate the client 30 minutes before going to the whirlpool
C. Obtain the sterile dressing supplies for the client
D. Assist the client to the bathroom prior to the treatment

Correct answer: B

Rationale: The correct answer is B. Pain management is essential before the procedure to ensure the client’s comfort and cooperation during the dressing change. Escorting the client to the physical therapy department (Choice A) is not the priority at this point. Obtaining sterile dressing supplies (Choice C) is important but not the priority before addressing pain management. Assisting the client to the bathroom (Choice D) is not the priority intervention for a dressing change in the whirlpool.

5. What causes hepatic encephalopathy?

A. Buildup of ammonia in the body
B. Buildup of urea in the body
C. Fatty infiltration of the liver
D. Jaundice

Correct answer: A

Rationale: Hepatic encephalopathy is caused by the buildup of ammonia in the body, not urea. Ammonia accumulates due to liver dysfunction, leading to neurological symptoms. Fatty infiltration of the liver may lead to conditions like non-alcoholic fatty liver disease, but it is not the direct cause of hepatic encephalopathy. Jaundice is a symptom of liver dysfunction but is not the primary cause of hepatic encephalopathy.