46. Nurses working on a surgical unit are concerned about a physician's treatment of clients during invasive procedures, such as dressing changes and insertion of IV lines. Clients are often crying during the procedures, and the physician is usually unconcerned or annoyed by the client's response. To resolve this problem, the nurses should perform these actions in which order? (Arrange from the first action on top to last on the bottom.)

Document concerns and report them to the charge nurse.

Contact the hospital's Chief of Medical Services.

Submit a written report to the Director of Nursing.

File a formal complaint with the state medical board.

Talk to the physician as a group in a non-confrontational manner.

Answer and Explanation

The Correct Answer is E, A, C, B, D

E. Talk to the physician as a group in a non-confrontational manner.

This is the first and most direct approach to address any interpersonal or professional issues. It allows for open communication and the possibility to resolve the issue without escalating it further.

A. Document concerns and report them to the charge nurse.

If the initial conversation does not lead to a change in behavior, documentation provides a record of the incidents and concerns, which is essential for any further action.

C. Submit a written report to the Director of Nursing.

Reporting the issue to higher management is a step up from reporting to the charge nurse. It brings the concern to the level of administration that can take more significant actions.

B. Contact the hospital's Chief of Medical Services.

If the issue persists despite the steps taken, involving the Chief of Medical Services is appropriate as they have the authority over medical staff and can address the physician's behavior from a position of leadership.

D. File a formal complaint with the state medical board.

This is the last resort when all other internal avenues have been exhausted. It involves external authorities that can impose sanctions or take other actions to ensure professional standards are maintained.

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Correct Answer is A

Explanation

A. Promoting full diaphragmatic excursion by massaging the back helps to facilitate deep breathing and lung expansion, which is essential for preventing respiratory complications such as atelectasis and pneumonia after surgery.
B. Noting areas of atelectasis on daily chest x-rays is important for assessing respiratory status, but it is a monitoring intervention rather than a preventive intervention.
C. Assisting the client to a chair the day after surgery when the condition is stable promotes early mobility and prevents complications such as deep vein thrombosis, but it may not directly
address respiratory complications.
D. Providing ice or oral liquids when the client passes flatus may be part of the postoperative care plan, but it does not directly address respiratory complications. It's more related to bowel function and hydration status.

A. Encourage the use of ice on the areola. B. Recommend using a breast shield. C. Teach about the use of a breast pump. D. Offer supplemental formula feedings.

Correct Answer is B

Explanation

A. Encouraging the use of ice on the areola is not appropriate for addressing inverted nipples. Ice may cause discomfort and vasoconstriction, making latching more difficult.
B. Recommending the use of a breast shield can help draw out inverted nipples, making it easier for the baby to latch onto the breast. Breast shields can be used temporarily until the nipples
become more erect or until breastfeeding techniques are established.
C. Teaching about the use of a breast pump may be appropriate for establishing milk supply or relieving engorgement, but it does not directly address the issue of inverted nipples or difficulty with latching.
D. Offering supplemental formula feedings should be a last resort and should only be considered if other methods of addressing latch difficulties, such as using a breast shield or seeking
assistance from a lactation consultant, have been unsuccessful.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for an older adult client who is admitted to the surgical unit following a partial gastrectomy. In addition to frequent position changes, which postoperative intervention is most beneficial for the nurse to perform in preventing respiratory complications?

Correct Answer is A

Explanation

A client who is one day postpartum tells the nurse that her baby cannot latch onto the breast. The nurse determines that the client's nipples are inverted. Which action should the nurse implement?

Correct Answer is B

Explanation

After receiving a change of shift report for clients on a medical surgical unit, which activity should the nurse delegate to the practical nurse (PN)?

Exhibits Based on the results of the echocardiogram, the physician has decided to repair the ventricular septal via cardiac catheterization. What should the nurse's focused assessment include before the cardiac catheterization? Select all that apply.

The home care nurse provided self-care instructions for a client with chronic venous insufficiency caused by deep vein thrombosis. What instruction(s) should the nurse include in the client's discharge teaching plan? Select all that apply.

The nurse implements a primary prevention program for sexually transmitted diseases in a nurse managed health center. Which outcome indicates that the program was effective?

An older adult client is being admitted to a short-term rehabilitation facility after a long hospitalization. The nurse is performing a functional assessment with the client. Which action should the nurse implement?

The nurse places an opioid patch on the chest of a client with intractable pain who also has obstructive sleep apnea (OSA). Which intervention is most important for the nurse to implement before leaving the client?

A client with chronic obstructive lung disease who is receiving oxygen at 1.5 L/minute by nasal cannula, is currently short of breath. Which action should the nurse take?

A client with a history of unstable angina presents to the emergency department with constant chest pressure that is unrelieved with rest. The client appears anxious, pale, and diaphoretic. After obtaining the client's vital signs, which action should the nurse take next?