一位病人安排了手術，但告訴護理師：「我其實不太清楚為什麼我需要開這個刀。」護理師的最佳行動是什麼？
A client is scheduled for a surgical procedure but tells the nurse, 'I'm not really sure why I need this operation.' What is the nurse's best action?
- ADocument the client's statement in the medical record and proceed with prep.將病人的陳述記錄在病歷中並繼續準備
- BNotify the surgeon that the client needs further explanation.✓ 正解通知外科醫師該病人需要進一步解釋
- CReassure the client that the surgeon is very experienced.安撫病人說外科醫師非常有經驗
- DExplain the surgical procedure and its benefits to the client.向病人解釋手術程序及其益處
這是關於知情同意與病人擁護的核心考題。護理師的專業職責之一是確認病人對即將進行的處置有充分理解。當病人明確表達不解（Lacks understanding）時，原有的知情同意文件即便已簽署也視為無效。護理師不應自行解釋（這超出權限），也不應敷衍安撫。最安全且正確的做法是「暫停流程並召回醫師」。臨床決策中，病人的「理解程度」優於「文件簽署與否」。這體現了 Autonomy 與安全照護的結合。
Informed consent is the surgeon's legal and ethical responsibility, not the nurse's. When a client expresses lack of understanding about the procedure, the existing consent is no longer truly informed even if signed. The nurse acts as the client's advocate by notifying the surgeon to return and provide adequate explanation before proceeding. Reassurance, nurse-led explanation, or proceeding with prep would violate informed-consent standards.
在美國，病人若在術前表示不解，護理師必須立刻暫停術前給藥（Pre-op meds），否則會被視為強迫。台灣臨床上護理師有時會試圖緩解病人焦慮而做過多解釋，NCLEX 則強調「退回給醫師」是唯一合法的專業反應。