A nurse is caring for a group of clients on a medical surgical unit. For which of the following care needs should the nurse initiate a referral for a speech therapist?
A client who has dysphagia
A client who asks about community resources
A client who has terminal cancer and requests hospice at home
A client who wants a priest to visit while they are in the hospital
The Correct Answer is A
A. A client who has dysphagia: Dysphagia, or difficulty swallowing, is within the scope of practice for speech therapists. They are trained to assess and treat swallowing disorders to ensure safe and effective eating and drinking.
B. A client who asks about community resources: A social worker or case manager would be more appropriate for addressing questions about community resources.
C. A client who has terminal cancer and requests hospice at home: This client should be referred to a hospice care coordinator, not a speech therapist.
D. A client who wants a priest to visit while they are in the hospital: This need should be addressed by the hospital's chaplain service or spiritual care department.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Primary prevention: Primary prevention involves measures taken to prevent diseases or injuries before they occur, such as vaccinations or health education to prevent onset of illness. Teaching blood sugar monitoring to someone with diabetes is not primary prevention.
B. Tertiary prevention: Tertiary prevention involves managing disease post-diagnosis to slow or stop disease progression. Teaching a diabetic patient to monitor their blood sugar helps manage their existing condition and prevent complications, making it tertiary prevention.
C. Secondary prevention: Secondary prevention includes screening and early detection of disease to halt or slow its progress. Monitoring blood sugar levels in a diabetic patient is not about early detection but managing an existing condition.
D. Disease surveillance: Disease surveillance involves continuous, systematic collection, analysis, and interpretation of health data. This is not what the nurse is doing when teaching a client to monitor their blood sugar.
Correct Answer is C
Explanation
A. "The vital signs are stable." This statement belongs in the Assessment (A) step, as it provides information about the client’s current clinical condition.
B. "The client has a history of high blood pressure." This statement belongs in the Background (B) step, providing relevant medical history.
C. "The client is disoriented. Pupils are slow to respond to light." The S (Situation) step involves stating the immediate problem or reason for the communication. Describing the client's disorientation and pupil response directly addresses the current issue that prompted the call.
D. "The client should be seen by a neurologist." This statement belongs in the Recommendation (R) step, suggesting the next course of action.
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