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Exam (elaborations)

Consent, Capacity, And Competency Issues Exam Guide With Complete Solutions

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CONSENT, CAPACITY, AND COMPETENCY ISSUES EXAM GUIDE WITH COMPLETE SOLUTIONS

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CONSENT, CAPACITY, AND
COMPETENCY ISSUES EXAM GUIDE
WITH COMPLETE SOLUTIONS
a patient is brought via ambulance to the local emergency department. the patient is
found to be unresponsive and in need of emergency surgery to stop bleeding. what
should the nurse be aware of? - Answer-b. the surgery can proceed without informed
consent from the patient

in this situation, the surgery can proceed without informed consent from the patient. the
standard for emergency treatment without informed consent is whether the patient
would suffer imminent harm in the amount of time required to find or appoint a
surrogate. in this scenario, time is the essence, and irreparable harm will occur before a
surrogate is appointed or a family member is contacted. the nurse cannot act as a
surrogate decision maker for a patient.

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

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