# Immediately before a bedside lumbar puncture, the nurse leads the team through the Universal Protocol "time-out." Which best describes the required components of the time-out?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=373883&lang=en  
> language: en  
> subject: NCLEX-RN  
> category: MOC

## Question

Immediately before a bedside lumbar puncture, the nurse leads the team through the Universal Protocol "time-out." Which best describes the required components of the time-out?

## Option

1. The nurse alone reviews the chart to confirm the patient and procedure before bringing the equipment to the bedside.
2. The entire team pauses immediately before the procedure and verbally confirms the correct PATIENT (two identifiers), the correct PROCEDURE, the correct SITE, and that all needed equipment, imaging, and consent are present and correct. **✔ Correct answer**
3. The provider alone announces the patient name and procedure as they put on sterile gloves; the team is not required to participate.
4. The time-out is performed in the morning during the team huddle for all procedures planned that day, eliminating the need for individual time-outs.

**Correct answer: 2**

## Explanation

Universal Protocol requires the ENTIRE team to pause and verbally verify correct patient, correct procedure, correct site, correct position, and that equipment, imaging, and consent are present immediately before the procedure starts. The time-out must include all team members (active engagement), not just the nurse alone (1) or the provider alone (3). A single morning huddle (4) does NOT replace a procedure-specific time-out — each procedure requires its own time-out at the start.

## In-depth explanation

Wrong-site, wrong-procedure, wrong-patient surgery is a sentinel event. The time-out is the final stop. The classic NCLEX trap is "the nurse already confirmed the patient earlier, so we can skip" — wrong; the time-out happens immediately before the procedure with the entire team actively participating.

## Clinical scenario

The nurse is preparing for a **bedside lumbar puncture**. Per Joint Commission Universal Protocol, a **pre-procedure time-out** is performed by the entire team immediately before the procedure starts.

## Key concepts

- **Universal Protocol** — Joint Commission protocol to prevent wrong-site, wrong-procedure, wrong-patient surgery and procedures.
- **Pre-procedure time-out** — Team pause immediately before procedure to verbally confirm patient, procedure, site, position, equipment, and consent.
- **Site marking** — Surgeon marks the surgical site with their initials before the procedure; an additional verification layer.

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