# The preoperative nurse reviews the consent process before elective surgery. Which findings require follow-up? Highlight the findings that make the consent incomplete or not voluntary. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=494998&lang=en > language: en > subject: Assignment/Delegation/Supervision > category: MOC ## Question The preoperative nurse reviews the consent process before elective surgery. Which findings require follow-up? Highlight the findings that make the consent incomplete or not voluntary. Nurses' Notes 0745: The client is scheduled for elective colorectal surgery at 0930. During teach-back, the client states that the possible permanent ostomy was not explained. The client correctly states that a blood transfusion may be needed if major bleeding occurs. The nurse confirms that the consent form is written in the client's preferred language. The signed form lists the planned procedure and the responsible surgeon. At 0755, 15 minutes after the medication was administered, the record shows midazolam was given before consent was signed. The client asks the nurse to watch while the client writes the signature. The client points to the marked abdominal site and identifies the planned operation. The record shows that a certified interpreter stayed for the entire consent discussion. The daughter is present because the client requested her support during the discussion. The client then states that the daughter pressured an unwilling client to sign. The client accurately repeats the expected recovery activities. The nurse confirms that the client received a copy of the signed form. The client asks when oral fluids may restart after surgery. The preoperative checklist shows the procedure and client identity were verified together before operating room transport. The client remains alert and oriented during the current assessment. The client states that additional questions can be asked before transport. No emergency condition is documented. ## Explanation Unexplained material information, signing after sedative medication, and pressure from family require follow-up. Valid consent depends on understandable information, decision-making capacity, and a voluntary choice before the procedure. ## In-depth explanation Quick answer Highlight the client not being told about a possible permanent ostomy, signing after receiving midazolam, and agreeing only because a daughter insisted. These findings threaten informed, capable, and voluntary consent. Why this is correct Consent is more than a signature. The practitioner must provide the material information needed for a decision, and the client must be able to understand and choose without coercion. A sedative can impair capacity, while family pressure can make the choice involuntary. The nurse should stop the preoperative progression and obtain the appropriate practitioner follow-up before elective surgery.[2][3] Easy analogy or mental picture Think of consent as a three-legged stool. Its legs are information, capacity, and free choice. If one leg is missing, the stool is not stable. The picture helps organize the assessment, but facility policy and the practitioner still determine how consent is completed. Memory hook Know it, understand it, choose it freely. NCLEX decision rule When a client lacks key information, has received a mind-altering medication, or describes pressure to agree, pause an elective procedure and obtain follow-up. Witnessing a signature does not make the nurse responsible for supplying the practitioner's procedural explanation. Why the other choices are wrong Correctly describing a transfusion possibility, identifying the signed form, requesting a witness, confirming the site, inviting family by choice, repeating the recovery plan, and asking questions all support rather than invalidate the consent process.References - [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing - [2]eCFR: 42 CFR 482.51 Surgical ServicesU.S. Government Publishing Office - [3]eCFR: 42 CFR 482.13 Patient RightsU.S. Government Publishing Office ## Related questions - [A 67-year-old client with chronic obstructive pulmonary disease attends a routine primary …](https://mymerci.kr/pages/nclex_q.php?qn_id=360522&lang=en) - [A registered nurse on a medical-surgical unit is delegating tasks at the start of shift. 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