A man has been admitted to the hospital unit with a medical diagnosis of chronic obstructive pulmonary disease (COPD). He is receiving supplemental oxygen at 2 L/min via a nasal cannula. Which positioning technique will best assist him with breathing?

Choice A reason: Send the client back to surgery is not the nurse's next action, because it is premature and inappropriate. Sending the client back to surgery requires a medical order and a clear indication of the need for surgical intervention. The nurse cannot make this decision without first assessing the wound and contacting the provider.

Choice B reason: Call the provider immediately is not the nurse's next action, because it is not the most urgent and relevant. Calling the provider immediately is an important action, but it should be done after assessing the wound and gathering the necessary data. The nurse should be able to report the findings of the wound assessment, such as the size, shape, color, amount, and type of drainage, as well as the vital signs, pain level, and mental status of the client.

Choice C reason: Assess the wound for signs of dehiscence is the nurse's next action, because it is the most urgent and relevant. Assessing the wound for signs of dehiscence is a priority action, because it can identify the cause and severity of the problem. Dehiscence is a complication that occurs when the surgical incision splits open or separates, which can cause increased drainage, pain, and infection. Dehiscence can be caused by factors such as infection, poor wound healing, excessive strain, or trauma. Dehiscence can be detected by inspecting the wound for gaps, edges, or protrusions.

Choice D reason: Prepare to culture the wound is not the nurse's next action, because it is not the most urgent and relevant. Preparing to culture the wound is a possible action, but it should be done after assessing the wound and contacting the provider. Culturing the wound is a procedure that involves collecting a sample of the wound drainage and sending it to the laboratory for analysis, which can help identify the type and source of infection. Culturing the wound requires a medical order and a sterile technique.

Choice A reason: This is an incorrect answer because Medicare is a federal health insurance program that covers certain groups of people, such as the elderly, the disabled, and the lowincome. Medicare does not publish the National Patient Safety Goals, but it does have its own quality and safety standards that health care providers must meet to receive reimbursement.

Choice B reason: This is an incorrect answer because the American Nurses Association (ANA) is a professional organization that represents the interests of registered nurses in the United States. The ANA does not publish the National Patient Safety Goals, but it does have its own code of ethics, standards of practice, and policies that guide nursing practice and promote quality and safety.

Choice C reason: This is the correct answer because the Joint Commission is an independent, nonprofit organization that accredits and certifies more than 22,000 health care organizations and programs in the United States. The Joint Commission publishes the National Patient Safety Goals, which are specific and measurable goals that address the most critical patient safety issues in health care. The Joint Commission updates the goals annually based on the latest evidence and expert input.

Choice D reason: This is an incorrect answer because the Institute of Medicine (IOM) is a division of the National Academies of Sciences, Engineering, and Medicine, which is a private, nonprofit organization that provides independent, objective, and authoritative advice to inform policy and practice. The IOM does not publish the National Patient Safety Goals, but it does conduct research and issue reports on various topics related to health and health care, including quality and safety.