A client diagnosed with a brain tumor is considering whether or not to have surgery after the physician explains that possible responses might include stroke, facial paralysis, and other mobility-limiting events

Question

A few hours after signing the consent form, the client anxiously calls the nurse to withdraw consent, and then reverses the decision again a few moments later. This behavior continues over the next several hours. How should the nurse understand what is going on with this client? 1. The client is vacillating regarding the decision for surgery.
2. The client does not have adequate information to make a decision.
3. The client is refusing surgery.
4. The client is undergoing stress.

Answer 1

1
Rationale: The client's frequent change of mind regarding the surgery suggests that the client is in the third stage of conflict and is vacillating, first moving towards one goal and then another. The client has not made a clear choice to refuse surgery (that would be an approach-avoidance conflict). While it is important to recognize that the client is stressed, that in itself does not help explain what the client is experiencing and does not provide direction for a nursing intervention. There is nothing in the scenario to indicate the client does not have adequate information; the consent process would have provided information and the client would have had opportunity to ask for clarification.