A nurse exchanges information with the oncoming nurse about a patient's care. Which action did the nurse complete?
An electronic record entry
An acuity rating
A referral
A verbal report
The Correct Answer is D
A. An electronic record entry: Documenting in the electronic health record involves recording patient information in a digital system for continuity and legal purposes. While important, this does not involve real-time, interactive communication with the oncoming nurse.
B. An acuity rating: Acuity rating involves assessing the severity of a patient’s condition to determine nursing workload or staffing needs. This is an evaluative process and does not constitute the direct exchange of patient care information between nurses.
C. A referral: A referral is the process of directing a patient to another healthcare professional or service for additional care or evaluation. It does not involve the routine handoff of information between nursing staff.
D. A verbal report: Giving a verbal report, often during a shift change or handoff, is the process of exchanging patient-specific information with the oncoming nurse. This ensures continuity of care by communicating current status, recent changes, interventions, and priority needs in real time.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Sensory overload: Sensory overload occurs when a client is exposed to excessive stimuli, such as noise, light, or activity, which can lead to agitation, anxiety, or confusion. The client’s symptoms of boredom and depression do not reflect an overwhelming sensory environment.
B. Sensory deprivation: Sensory deprivation results from insufficient or monotonous stimuli, leading to psychological and behavioral symptoms such as boredom, restlessness, and depression. In a nursing home setting, limited interaction, lack of environmental stimulation, or isolation can precipitate this condition, matching the client’s observed behaviors.
C. Impaired communication: While impaired communication may contribute to frustration or social withdrawal, it primarily affects the client’s ability to convey or understand information. The behavioral symptoms described are more directly linked to inadequate sensory input rather than the inability to communicate.
D. Sensory perception deficits: Sensory perception deficits involve the loss or alteration of a specific sense (vision, hearing, touch). While this can influence interaction with the environment, the client’s symptoms suggest a broader lack of stimulation rather than a deficit in sensory processing itself.
Correct Answer is ["A","B","C","D"]
Explanation
A. Use clearly marked sharps disposal containers: Properly labeled sharps containers ensure that needles and other sharps are safely disposed of, reducing the risk of accidental injury to the nurse and others. These containers are puncture-resistant, easily accessible, and prevent unsafe handling or environmental contamination, forming a critical component of standard safety protocols.
B. Never force needles into the sharps disposal: Forcing needles into a sharps container can cause the needle to bend, break, or rebound, increasing the risk of needlestick injury. Safe disposal requires gently placing the needle into the container to prevent accidental punctures or exposure to bloodborne pathogens.
C. Inspect needle before giving injection: Checking the needle for defects such as bends, burrs, or contamination prior to use prevents injury during administration and ensures patient safety. It also allows the nurse to identify any compromised equipment before exposure to potentially infectious materials.
D. Remove needle and dispose in sharps box: After an injection, needles must be immediately removed from syringes (if appropriate) and disposed of directly into a sharps container without delay. This reduces the risk of accidental needlesticks, cross-contamination, and occupational exposure to bloodborne pathogens.
E. Recap the needle after giving an injection: This is the most common cause of needlestick injuries. Once a needle has been used on a patient, it must never be recapped. Instead, the safety shield (safety-lock) should be activated immediately using a one-handed technique or a hard surface.
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