Mr. M. consents to a procedure on his left ear. After the patient is anesthetized Dr. W. discovers that the right ear is in greater need of surgery. What should the surgeon do?

Correct Answer: B

Rationale: You must obtain informed consent by specific procedure. Consent for another procedure or clear medical necessity cannot infer consent for another procedure. Neither the medical necessity of the procedure, the seriousness of the condition, nor the assumption that any reasonable person would consent is sufficient to assume that consent is given. The patient is not aware of his surroundings and condition because of the sedation. You cannot have an 'informed consent' without waking up and informing the patient. Another example would be a blood transfusion in a Jehovah's Witness. If, during a procedure, a clear but unexpected necessity for blood transfusion arises, you must wake the patient up and ask about the patient's wishes to have or not have blood. The consent or refusal must be informed. You cannot say that because of the necessity or sedation, that you should just give the blood. On the other hand, just because a patient is a Jehovah's Witness, you cannot assume that he will refuse the blood. A refusal must be informed as well. The patient could, after all, be a Jehovah's Witness who does not agree with that religion's teaching on blood. Each procedure must undergo an individual consent process.

Correct Answer: C

Rationale: Only the RN trainer or physician can authorize changes to medication orders, requiring clarification.

Correct Answer: C

Rationale: Systemic medications affect the whole body via the bloodstream, unlike local medications.

Correct Answer: D

Rationale: Quinapril is an ACE inhibitor used for hypertension.

Correct Answer: B

Rationale: Sedatives treat sleeplessness by promoting relaxation and sleep.