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Difficulty: HardLegal and Ethical Practice

A practical nurse (PN) is assigned to a busy surgical step-down unit. The charge nurse delegates preoperative preparations for a client scheduled for a partial bowel resection. The provider has documented that the procedure was explained, but the consent form remains unsigned. Which of the following actions by the PN represents legally and ethically sound practice?

  1. Witnessing the client's signature on the consent form and notifying the provider if the client expresses confusion about the surgical outcome.Answer
  2. B
    Explaining the potential complications of the bowel resection to correct the client's minor misunderstandings before obtaining the signature.
  3. C
    Accepting the charge nurse's delegation to independently formulate and document the client's postoperative nursing care plan.
  4. D
    Confirming the client's room number and surgical schedule with a caller who identifies themselves as the client's designated emergency contact.

Answer

The practical nurse should witness the client's signature on the surgical consent form and notify the healthcare provider if the client exhibits any confusion regarding the surgery.
The legally and ethically sound action is for the practical nurse to witness the client's signature on the consent form. If the client expresses any confusion or misunderstanding about the procedure, the nurse's ethical duty is to halt the signing process and advocate for the client by notifying the provider, as only the provider can legally clarify surgical risks and outcomes.

Step-by-Step Solution

1
Evaluate the delegated task regarding informed consent.
Identify that the PN may witness the client's signature but cannot provide the medical explanation of the procedure or its risks.
Obtaining informed consent is a non-delegable duty of the provider. The nurse's role is solely advocacy and witnessing.
2
Evaluate the delegated task regarding the nursing care plan.
Recognize that creating the initial postoperative care plan is outside the PN scope of practice.
The RN is legally responsible for the initial assessment and formulation of the care plan; the PN contributes to and implements it.
3
Evaluate the action regarding telephone communication.
Determine that confirming client location or status to a caller without authorization violates confidentiality laws.
HIPAA requires strict protection of patient information, and an 'emergency contact' status does not automatically grant telephone access to protected health information without verification.

Key Concept

Practical Nurse Scope of Practice, Informed Consent, and Confidentiality
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Topics

Legal and Ethical Practice

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