Before the administration of preoperative medications, the nurse is preparing to witness the patient signing the operative consent form when the patient says, I do not really understand what the doctor said. Which action is best for the nurse to take?

• A. Provide an explanation of the planned surgical procedure.
• B. Notify the surgeon that the informed consent process is not complete.
• C. Administer the prescribed preoperative antibiotics and withhold any ordered sedative medications.
• D. Notify the operating room staff that the surgeon needs to give a more complete explanation of the procedure.

Answer: (B)

The key idea is that informed consent must reflect true understanding by the patient. The nurse’s role is to witness the signature, not to explain the procedure. When the patient says they don’t really understand what the doctor said, the appropriate action is to pause the signing and involve the surgeon to clarify and answer questions, ensuring the patient fully understands the procedure, risks, benefits, and alternatives. This may also involve arranging a translator or using a teach-back method to confirm comprehension. No preoperative medications should be given until the consent is complete and the patient demonstrates understanding, so nothing assumes consent before it’s truly informed.

Providing an explanation yourself would go beyond the nurse’s scope and could inadvertently bias or unduly influence the patient. Notifying the operating room staff that the surgeon needs to give a more complete explanation bypasses the direct patient–physician clarification that’s needed, whereas informing the surgeon directly ensures the right person addresses the patient’s questions and completes the consent appropriately.