A nurse is caring for a group of clients. Which of the following actions by the nurse demonstrates client advocacy?

Submitting an incident report to risk management following a client fall

Documenting the effectiveness of pain medication in the client's health record

Asking another nurse to check a medication calculation for a client

Informing the family of a deceased client of the client's wish to be an organ donor

Answer and Explanation

The Correct Answer is D

A. "Submitting an incident report to risk management following a client fall." While this is important for safety and quality improvement, it is not a direct act of client advocacy.
B. "Documenting the effectiveness of pain medication in the client's health record." This is a critical part of nursing documentation but does not actively advocate for the client.
C. "Asking another nurse to check a medication calculation for a client." This promotes medication safety, but it is not an example of client advocacy.
D. "Informing the family of a deceased client of the client's wish to be an organ donor." Advocacy means ensuring the client’s wishes are honored, especially in sensitive situations like organ donation.

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Correct Answer is C

Explanation

A. Laboratory results Lab results are diagnostic data, not part of the health history. They are obtained separately through testing.
B. Physical examination findings The physical exam is a separate component of the assessment and is not included in the health history, which focuses on subjective data.
C. Health habits The health history includes subjective data provided by the client, such as dietary habits, exercise routine, smoking, alcohol use, sleep patterns, and medication use. This information helps the nurse understand the client’s lifestyle and risk factors.
D. Observed client behaviors While a nurse may take note of behaviors, the health history is based on the client’s self-reported information, not observations.

A. Instruct the client to take small sips of water. B. Ask the client to hyperextend their neck during palpation. C. Inspect the isthmus as the client holds their breath for 5 seconds. D. Assist the client to a supine position prior to the assessment.

Correct Answer is A

Explanation

A. "Instruct the client to take small sips of water."
Having the client take small sips of water helps the nurse observe the thyroid gland as it moves up and down with swallowing, making abnormalities more noticeable.
B. "Ask the client to hyperextend their neck during palpation."
The client should slightly extend (not hyperextend) their neck to relax the muscles and allow for better palpation of the thyroid gland.
C. "Inspect the isthmus as the client holds their breath for 5 seconds."
The thyroid gland is best observed during swallowing, not by holding the breath.
D. "Assist the client to a supine position prior to the assessment."
Thyroid assessment is performed with the client in a sitting or standing position, not lying down.

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A nurse is caring for a group of clients. Which of the following actions by the nurse demonstrates client advocacy?

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