RN Nursing · Legal Responsibilities in Nursing · Practice question
A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take?
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Notify risk management before initiating treatment.
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Have the client sign a consent for treatment.
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Contact the client's next of kin to obtain consent for treatment.
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✓
Proceed with treatment without obtaining written consent.
Answer & explanation
Correct: Proceed with treatment without obtaining written consent.
In emergency situations where a client is unable to provide informed consent due to incapacity — such as disorientation and a life-threatening cardiac arrhythmia — the doctrine of implied consent applies. This legal principle holds that a reasonable person in the same situation would consent to emergency treatment to prevent death or serious harm. Therefore, the nurse should proceed with treatment without obtaining written consent. Notifying risk management before initiating treatment would cause a dangerous delay and is not appropriate in a true emergency. Having the client sign a consent form is not possible because the client is disoriented and lacks decision-making capacity at this time. While contacting next of kin may be appropriate for ongoing care decisions, waiting to reach them before beginning emergency treatment would be inappropriate when the client faces an immediate threat to life. The priority is stabilizing the client, and the law recognizes implied consent in these circumstances to protect both the client and the healthcare team. Documentation of the emergency circumstances should follow treatment initiation.
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