一位病人預定進行根除性攝護腺切除術。病人表示：「我改變主意了，我不想做手術了。」護理師應首先採取哪項行動？
A client is scheduled for a radical prostatectomy. The client says, 'I changed my mind. I don't want the surgery anymore.' Which action should the nurse take first?
- ANotify the surgeon immediately about the client's decision.立即通知外科醫師關於病人的決定。
- BInform the client that the operating room is already prepared.告知病人手術室已經準備就緒。
- CExplain the consequences of not having the surgery to the client.向病人說明不接受手術的後果。
- DAssess the client's reasons for wanting to cancel the surgery.✓ 正解評估病人想要取消手術的原因。
當病人表達拒絕治療或改變主意時，護理師的首要行動應是「評估（Assessment）」。護理師需要了解病人的決定是基於恐懼、缺乏資訊、宗教原因還是突發的生理不適。直接通知醫師（A）雖然必要，但在沒弄清楚原因前就回報，無法提供完整的資訊。解釋後果（C）可能被視為強制或說服，違反了自主權。告知手術室已準備好（B）則是在給予心理壓力，完全不專業。透過開放式提問了解病人的擔憂，護理師才能決定後續是需要衛教、心理諮商還是聯繫醫師處理。這是護理程序（nursing process）中評估先於介入的典型應用。
When a client expresses refusal of treatment or change of mind, the nurse's first action is assessment. The nurse needs to understand whether the decision is based on fear, lack of information, religious reasons, or sudden physical discomfort. Notifying the surgeon (A) is necessary but is incomplete without first understanding the reason. Explaining consequences (C) may be perceived as coercive and violates autonomy. Telling them the OR is prepared (B) applies psychological pressure and is unprofessional. Through open-ended questioning, the nurse can decide whether the client needs education, counseling, or physician consultation. This reflects assessment before intervention in the nursing process.
在美國護理中，病人隨時有權撤回同意（Withdraw Consent），護理師需擔任緩和與協調的角色。在台灣，若病人在手術前一刻拒絕，醫護人員往往會動員家屬共同勸說，有時會過度強調醫療後果。NCLEX 則強調護理師應先採取非侵入性的評估與傾聽，確保病人的自主權不被外部壓力削弱。