A nurse is implementing the chain of command because a provider is not currently available for a client whose condition is rapidly deteriorating. Which of the following actions should the nurse take first?
Call the unit supervisor.
Notify the medical director.
Consult with the charge nurse.
Notify the department head.
The Correct Answer is C
Rationale:
A. Call the unit supervisor: While the unit supervisor plays a role in the chain of command, the nurse should first address the situation at the unit level with immediate leadership before escalating to higher administration.
B. Notify the medical director: The medical director is a high-level administrator typically involved in policy and oversight rather than immediate clinical decisions. This step would occur further along the chain if lower-level leadership fails to respond.
C. Consult with the charge nurse: The charge nurse is the first point of escalation in the nursing chain of command. They are immediately available, familiar with the unit workflow, and can take prompt action or assist in contacting the provider or other necessary personnel.
D. Notify the department head: The department head oversees broader unit operations and would be consulted if the charge nurse and unit supervisor cannot resolve the situation. However, this is not the most immediate first step in an emergency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Bradycardia: While bradycardia can occur in late stages of shock or with certain medications, cardiogenic shock is more commonly associated with tachycardia as the body attempts to compensate for poor cardiac output by increasing heart rate.
B. Hypertension: In cardiogenic shock, blood pressure typically decreases due to the heart’s inability to effectively pump blood. Hypotension, not hypertension, is expected as perfusion to vital organs drops.
C. Increased urine output: A hallmark of cardiogenic shock is reduced perfusion to the kidneys, which results in decreased urine output. Oliguria or anuria may be an early sign of impaired organ perfusion in this condition.
D. Pulmonary congestion: Cardiogenic shock leads to impaired left ventricular function, causing blood to back up into the pulmonary circulation. This results in pulmonary congestion, a key finding that reflects worsening heart failure and reduced cardiac output.
Correct Answer is C
Explanation
Rationale:
A. Pharmacist: Pharmacists specialize in medications and are not typically involved in arranging or obtaining medical supplies like ostomy appliances. Their focus is on drug interactions, dosages, and patient medication education.
B. Occupational therapist: Occupational therapists help clients adapt to daily activities and regain independence, but they do not coordinate the acquisition of medical supplies. They may assist with self-care techniques but not with obtaining equipment.
C. Case manager: Case managers coordinate post-discharge services and ensure clients have access to necessary medical equipment and supplies, including ostomy appliances. They act as liaisons between the healthcare team and vendors or insurance providers.
D. Paramedical technician: This role usually involves assisting with basic clinical tasks under supervision and does not include responsibility for coordinating outpatient resources or durable medical equipment.
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