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.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A. Weigh every morning: Daily weighing helps monitor for fluid retention, which is important in managing heart failure. Sudden weight gain can indicate fluid accumulation and worsening heart failure symptoms, prompting the need for medical attention.
B. Limit fluid intake to 1,500 ml daily: While fluid restriction may be necessary for some
individuals with heart failure, the specific amount varies based on individual circumstances and should be determined by the healthcare provider. A blanket recommendation of 1,500 ml may not be appropriate for all patients.
C. Eat a high protein diet: While a balanced diet is important for overall health, there is no specific evidence to suggest that a high protein diet is essential for heart failure management. Dietary recommendations should be tailored to the individual's needs and comorbidities.
D. Perform range of motion exercises: While exercise is important for overall health, including for individuals with heart failure, range of motion exercises may not be the priority instruction for discharge teaching. Exercise recommendations should be individualized and may include aerobic and resistance training based on the client's condition and functional status.

A. Loss of sensation to the left lower extremity. B. Sloughing tissue around wound edges. C. Weeping serosanguineous fluid from wounds. D. Reporting increased pain and pressure. E. Change in the quality of the peripheral pulses.

Correct Answer is ["A","D","E"]

Explanation

A. Loss of sensation to the left lower extremity warrants immediate intervention as it may indicate nerve damage, impaired circulation, or compartment syndrome. These findings require urgent evaluation to prevent permanent damage.

B. Sloughing tissue around wound edges is a common finding in burn injuries during the healing process. While it requires monitoring and proper wound care, it does not necessitate immediate intervention unless accompanied by signs of infection.

C. Weeping serosanguineous fluid from wounds is expected in burn injuries, especially in the early stages of healing. This finding does not indicate an acute complication.

D. Reporting increased pain and pressure is a critical finding as it may indicate compartment syndrome, a condition where increased pressure within a muscle compartment impairs circulation and tissue viability. Immediate intervention is required to prevent further complications.

E. A change in the quality of peripheral pulses is an alarming finding as it suggests impaired circulation, potentially due to edema, vascular compromise, or compartment syndrome. This requires prompt assessment and action to restore adequate blood flow.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is being discharged home after being treated for heart failure (HF. Which instruction should the nurse include in this client's discharge teaching plan?

Correct Answer is A

Explanation

When caring for a client with full-thickness burns to both lower extremities, what assessment finding(s) warrant immediate intervention by the nurse? Select all that apply.

Correct Answer is ["A","D","E"]

Explanation

Exhibits The nurse reviews the post catheterization orders. Which two orders would the nurse question?

The nurse is completing an admission assessment on an older adult client with dehydration, failure to thrive, and who is immobile. The nurse reports to the healthcare provider that the client's right calf is red and swollen. The nurse should suspect which probable cause of these findings?

The nurse is caring for a client with a history of type 2 diabetes mellitus and hypertension who arrives at the clinic for a scheduled visit. Which finding requires further follow-up by the nurse? Creatinine: Female: [0.5 to 1.1 mg/dL (44 to 97 μmol/L)] Male: [0.6 to 1.2 mg/dL (53 to 106 μmol/L)]

A 22-year-old client is admitted to the hospital in diabetic ketoacidosis (DKA. The client's parent is insisting to know the laboratory test results. Which is the best response for the nurse to provide?

The nurse observes a practical nurse (PN) pouring warm water over the perineal area of a female client who has frequent urinary incontinence while the client is positioned on a bedpan. Which action should the nurse take?