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Difficulty: HardLegal and Ethical Practice

An adult client is in a preoperative holding area preparing for an elective cholecystectomy. The surgeon has previously discussed the procedure, and a licensed practical nurse (PN) is present to witness the client's signature on the informed consent document. As the client picks up the pen, they pause and state, "I know the surgeon mentioned some risks, but I don't really understand what happens if my bile duct gets injured. Is that life-threatening?" Which action should the PN take first to ensure the client's legal rights are protected?

  1. Stop the consent process and notify the surgeon that the client requires further clarification about the procedural risks.Answer
  2. B
    Answer the client's specific questions regarding the bile duct injury based on the facility's surgical educational materials.
  3. C
    Reassure the client that the surgeon performs this procedure frequently and that severe complications are extremely unlikely.
  4. D
    Instruct the client to sign the document to maintain the surgical schedule and assure them the surgeon will answer questions in the operating room.

Answer

The correct action is to stop the consent process and notify the surgeon that the client requires further clarification about the procedural risks.
Informed consent is a legal right requiring the client to have a clear understanding of the risks, benefits, and alternatives of a procedure. The nurse's role is to witness the voluntary signature and verify understanding. If the client expresses confusion or asks specific questions about risks, the nurse must advocate for the client by halting the signing process and requiring the provider to return and provide further explanation.

Step-by-Step Solution

1
Analyze the client's statement regarding the surgical risks.
The client explicitly indicates a lack of understanding regarding the potential complications of the procedure.
Informed consent requires the client to fully comprehend the procedure, its risks, benefits, and alternatives before voluntarily signing.
2
Identify the PN's scope of practice in the informed consent process.
The PN acts only as a witness to the signature and an advocate who verifies client understanding.
Explaining medical risks and surgical complications is strictly the responsibility of the healthcare provider performing the procedure.
3
Determine the legally and ethically correct intervention based on the assessment.
The PN must halt the signing process and contact the surgeon.
This ensures the client's legal right to fully informed consent is protected and prevents the PN from practicing outside their authorized scope.

Key Concept

Role of the Practical Nurse in Informed Consent
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Topics

Legal and Ethical Practice

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