護理師照護一位預計進行自選手術的病人。病人表示：「我不太確定我是否還想做這個手術。」護理師應先採取哪項行動？
A nurse is caring for a client who is scheduled for an elective surgery. The client states, 'I am not really sure if I want this surgery anymore.' Which action should the nurse take first?
- AAsk the client to explain their concerns about the surgery✓ 正解請病人說明他們對手術的疑慮
- BDocument that the client is refusing the surgery in the medical record在病歷中記錄病人拒絕手術
- CReassure the client that the surgery is safe and necessary安慰病人手術是安全且必要的
- DNotify the surgeon that the client wishes to cancel the procedure通知外科醫生病人希望取消手術
當病人表達疑慮時，護理師的首要任務是進行評估與溝通。護理程序（Nursing Process）的第一步永遠是評估（Assessment）。透過詢問病人的擔憂，護理師可以釐清病人是因為缺乏資訊、恐懼併發症還是對手術目的有誤解。直接通知醫師（D）或記錄拒絕（B）都跳過了溝通與釐清的步驟。安慰病人手術安全（C）則屬於非治療性溝通，忽視了病人的自主權與情緒感受。只有先了解核心問題，才能決定後續是需要醫師進一步解釋（知情同意的補強），還是病人真的決定行使撤回同意的權利。
When the client expresses doubts, the nurse's first task is to assess and communicate. The first step of the nursing process is always assessment. By asking about the client's concerns, the nurse can clarify whether the issue stems from a lack of information, fear of complications, or misunderstanding of the procedure's purpose. Directly notifying the physician (D) or documenting refusal (B) skips communication and clarification. Reassuring the client that the surgery is safe (C) is non-therapeutic communication that disregards autonomy and emotion. Only after understanding the core issue can the nurse decide whether further explanation by the physician is needed (reinforcing informed consent) or whether the client truly wishes to exercise the right to withdraw consent.
美國護理高度強調病人的「自決權（Self-determination）」與「知情同意（Informed Consent）」的持續性；台灣臨床上護理師有時會迫於排程壓力先進行勸導，但 NCLEX 標準答案一定是以評估病人感受與尊重其撤回權為優先。