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. What is a primary intervention for managing hyperphosphatemia?

A. Increasing calcium intake
B. Increasing phosphorus intake
C. Decreasing calcium intake
D. Administering phosphate binders

Correct answer: D

Rationale: Administering phosphate binders is a primary intervention for managing hyperphosphatemia. Phosphate binders work by binding phosphorus in the gut, preventing its absorption. Increasing calcium intake (Choice A) is not a primary intervention for hyperphosphatemia and can actually exacerbate the condition by potentially raising calcium levels. Increasing phosphorus intake (Choice B) is contraindicated in hyperphosphatemia. Decreasing calcium intake (Choice C) may help manage hypercalcemia but is not the primary intervention for hyperphosphatemia.

3. Which endocrine disorder would the nurse assess for in the client who has a closed head injury with increased intracranial pressure?

A. Pheochromocytoma
B. Diabetes insipidus
C. Hashimoto's disease
D. Gynecomastia

Correct answer: B

Rationale: The correct answer is B, Diabetes insipidus. Diabetes insipidus can develop after a head injury due to damage to the hypothalamus or pituitary gland, leading to a deficiency in antidiuretic hormone (ADH). Pheochromocytoma (Choice A) is a tumor of the adrenal gland that causes excessive release of catecholamines, leading to hypertension. Hashimoto's disease (Choice C) is an autoimmune condition affecting the thyroid gland. Gynecomastia (Choice D) refers to the enlargement of breast tissue in males and is not directly related to a closed head injury with increased intracranial pressure.

4. The client diagnosed with acute vein thrombosis is receiving a continuous heparin drip, an intravenous anticoagulant. The health care provider orders warfarin (Coumadin), an oral anticoagulant. Which action should the nurse take?

A. Discontinue the heparin drip before initiating the Coumadin
B. Check the client’s INR before beginning Coumadin
C. Clarify the order with the healthcare provider as soon as possible
D. Administer the Coumadin along with the heparin drip as ordered

Correct answer: D

Rationale: The correct answer is to administer the Coumadin along with the heparin drip as ordered. Heparin and warfarin are often given together initially because warfarin takes a few days to become effective. Discontinuing the heparin drip before initiating Coumadin can increase the risk of clot formation. Checking the client's INR before starting Coumadin is important but not the immediate action required. Clarifying the order with the healthcare provider is not necessary as both medications are commonly used together.

5. Which electrolyte imbalance is a potential side effect of diuretics?

A. Hyperkalemia
B. Hypercalcemia
C. Hypomagnesemia
D. Hypokalemia

Correct answer: D

Rationale: The correct answer is D, Hypokalemia. Diuretics commonly cause hypokalemia due to increased urinary excretion of potassium. Hyperkalemia (Choice A) is the opposite, characterized by high potassium levels and is not typically associated with diuretics. Hypercalcemia (Choice B) is an elevated calcium level, which is not a common side effect of diuretics. Hypomagnesemia (Choice C) is low magnesium levels, which can be a side effect of diuretics, but the most common electrolyte imbalance associated with diuretics is hypokalemia.