CONSENT, CAPACITY, AND
COMPETENCY ISSUES EXAM GUIDE
WITH COMPLETE SOLUTIONS
a patient presents to the emergency department with a torn left quadriceps muscle. the
pain is so intense that the patient is unable to answer questions during the examination.
a determination is made that the patient needs immediate surgery. what is the first
action the nurse should take? - Answer-a. immediately administer the ordered pain
medicine
the priority nursing action is to administer the ordered pain medication and determine
whether that will remove the temporary barrier to informed consent. impairments of
capacity may be temporary or permanent. examples of temporary impairment include
pain, some forms of mental illness, delirium, extreme anxiety, and the effects of
medications. such temporary barriers may give the false impression of impaired
capacity. the nurse can ask the patient for the surrogate information and keep trying to
reach a family member; however, the ordered pain medications should be administered
first. this circumstance is not a situation in which the patient would suffer imminent harm
(i.e., loss of life or limb) without emergency intervention; thus, emergency privilege or
implied consent is not present. preparing for transfer to the operating room is an
inappropriate first action unless the situation is an emergency.
the preceptor is teaching a new nurse about informed consent. which statement by the
new nurse indicated that further education is needed. - Answer-b. "capacity is a legal
determination made by a court of law."
determining whether a patient has capacity to make medical decisions is a clinical
decision made by the practitioner, not by a court of law. a finding of competence, not
capacity, is a judicial determination that a person is able to manage the person's own
affairs and estate. the patient's capacity to make medical decisions is critical to the
process of informed consent. when a patient is said to have capacity, it means the
patient is recognized as having the ability to make medical decisions. if a person does
not have capacity, a surrogate is needed to make decisions on the patient's behalf.
a patient has been admitted for a surgical procedure and has completed the education
process and signed consent. on the morning of the scheduled procedure, the patient
reports no longer wanting to proceed with the procedure. what is the best response the
nurse can provide? - Answer-c. "I will advise your surgeon that you've changed your
mind and would like to withdraw your consent."
the patient should be told that the practitioner would like to withdraw consent. patients
have a right to change their mind and withdraw consent, and the practitioner must be
notified. telling a patient that it is too late or inconvenient to change the plan is not
COMPETENCY ISSUES EXAM GUIDE
WITH COMPLETE SOLUTIONS
a patient presents to the emergency department with a torn left quadriceps muscle. the
pain is so intense that the patient is unable to answer questions during the examination.
a determination is made that the patient needs immediate surgery. what is the first
action the nurse should take? - Answer-a. immediately administer the ordered pain
medicine
the priority nursing action is to administer the ordered pain medication and determine
whether that will remove the temporary barrier to informed consent. impairments of
capacity may be temporary or permanent. examples of temporary impairment include
pain, some forms of mental illness, delirium, extreme anxiety, and the effects of
medications. such temporary barriers may give the false impression of impaired
capacity. the nurse can ask the patient for the surrogate information and keep trying to
reach a family member; however, the ordered pain medications should be administered
first. this circumstance is not a situation in which the patient would suffer imminent harm
(i.e., loss of life or limb) without emergency intervention; thus, emergency privilege or
implied consent is not present. preparing for transfer to the operating room is an
inappropriate first action unless the situation is an emergency.
the preceptor is teaching a new nurse about informed consent. which statement by the
new nurse indicated that further education is needed. - Answer-b. "capacity is a legal
determination made by a court of law."
determining whether a patient has capacity to make medical decisions is a clinical
decision made by the practitioner, not by a court of law. a finding of competence, not
capacity, is a judicial determination that a person is able to manage the person's own
affairs and estate. the patient's capacity to make medical decisions is critical to the
process of informed consent. when a patient is said to have capacity, it means the
patient is recognized as having the ability to make medical decisions. if a person does
not have capacity, a surrogate is needed to make decisions on the patient's behalf.
a patient has been admitted for a surgical procedure and has completed the education
process and signed consent. on the morning of the scheduled procedure, the patient
reports no longer wanting to proceed with the procedure. what is the best response the
nurse can provide? - Answer-c. "I will advise your surgeon that you've changed your
mind and would like to withdraw your consent."
the patient should be told that the practitioner would like to withdraw consent. patients
have a right to change their mind and withdraw consent, and the practitioner must be
notified. telling a patient that it is too late or inconvenient to change the plan is not
