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Difficulty: MediumAdvance Directives and Informed Consent

A practical nurse (PN) at an outpatient surgical center is caring for a client scheduled for an elective inguinal hernia repair. The surgeon has discussed the procedure with the client and left the room. The client is now reviewing the informed consent document. Which of the following actions by the PN are appropriate? (Select all that apply.)

  1. Sign the consent document as a witness to the client's physical signature.Answer
  2. Verify that the client is signing the informed consent document voluntarily.Answer
  3. Contact the surgeon prior to witnessing the signature if the client has lingering questions about the procedure.Answer
  4. D
    Provide a simplified explanation of the surgical risks if the client has difficulty understanding the surgeon's medical terminology.
  5. E
    Accept a delegated task from the registered nurse (RN) to obtain the client's informed consent.

Answer

The appropriate actions for the PN are to sign the document as a witness, verify the client is signing voluntarily, and contact the surgeon if the client has lingering questions.
In the informed consent process, the practical nurse acts strictly as an advocate and witness. The nurse's legal responsibilities are to verify that the client is competent, ensure the consent is given voluntarily without coercion, and witness the client's physical signature. Additionally, if the nurse assesses that the client has lingering questions or does not fully understand the procedure, they must pause the signing process and contact the healthcare provider to return and clarify.

Step-by-Step Solution

1
Identify the legal scope of practice for a practical nurse regarding informed consent.
The nurse's role is limited to advocating for the client, verifying voluntary consent, and witnessing the physical signature.
Understanding legal boundaries prevents the PN from practicing outside their scope.
2
Evaluate the options describing witnessing the signature and verifying voluntary consent.
Both of these actions correctly align with the PN's role as a witness.
A nurse's signature on a consent form legally attests that the correct client voluntarily signed the form.
3
Evaluate the option regarding contacting the surgeon if the client has questions.
This is a correct action because true informed consent has not been achieved if the client remains confused.
The nurse acts as a client advocate to ensure the provider answers all questions before the client signs.
4
Evaluate the options involving explaining surgical risks or accepting a delegation to obtain consent.
These actions are incorrect.
Only the healthcare provider performing the procedure can legally explain risks and obtain the initial consent. The nurse must not accept delegated tasks outside this scope.

Key Concept

The practical nurse's role in informed consent is limited to witnessing the client's signature, verifying the client is signing voluntarily, and assessing client understanding to advocate for further provider explanation if needed.
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Topics

Advance Directives and Informed Consent

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