A nurse is preparing to discharge a newborn who has an atrial septal defect. The nurse should expect the provider to refer the client to which of the following interprofessional team members?
Case manager
Physical therapist
Occupational therapist
Nurse manager
The Correct Answer is A
A. Case manager: A case manager coordinates care for clients with chronic conditions or complex health needs. For a newborn with an atrial septal defect, the case manager can arrange follow-up appointments, provide education to the family about monitoring for symptoms, and ensure access to cardiology services. This referral supports continuity of care and helps prevent complications.
B. Physical therapist: Physical therapy focuses on improving mobility, strength, and motor function. While important for certain conditions, a newborn with an atrial septal defect typically does not require routine physical therapy unless there are additional developmental or musculoskeletal concerns. It is not the primary referral for cardiac follow-up.
C. Occupational therapist: Occupational therapy helps clients develop fine motor skills and perform daily activities. For a newborn with a heart defect, OT is usually not indicated unless developmental delays or feeding difficulties are present. Cardiac management and follow-up are more urgent concerns at discharge.
D. Nurse manager: The nurse manager oversees nursing staff and unit operations rather than providing direct patient follow-up or discharge planning. Referral to the nurse manager does not address the newborn’s ongoing care needs after discharge and is not part of standard interprofessional follow-up for an atrial septal defect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. A client who has a burn requiring a sterile dressing change: While burn care is important to prevent infection and promote healing, a dressing change is not immediately life-threatening. This task can be safely addressed after assessing clients with higher-priority acute risks.
B. A client who had an appendectomy 6 hr ago and has diminished bowel sounds: Diminished bowel sounds are common in the immediate postoperative period and do not usually indicate an emergent problem. This client requires ongoing monitoring, but there is no acute threat to life at this time.
C. A client who received a chemotherapy treatment and reports nausea: Nausea following chemotherapy is uncomfortable and should be managed promptly, but it is not immediately life-threatening. Interventions such as antiemetics can be provided after more urgent needs are addressed.
D. A client who has hypothyroidism and is stuporous: Stupor in a client with hypothyroidism may indicate myxedema or severe hypothyroid crisis, which can be life-threatening due to risk of respiratory depression, cardiovascular compromise, or altered mental status. This client requires immediate assessment and intervention, making them the highest priority.
Correct Answer is C
Explanation
A. Keep the head of the client's bed at a 15° angle: Elevating the head of the bed only slightly is insufficient for optimal lung expansion. A higher elevation, usually 30–45°, is recommended to improve ventilation and ease breathing during an exacerbation.
B. Place the client on bedrest for 24 hr: Prolonged bedrest can decrease lung expansion and increase the risk of mucus retention. Encouraging activity as tolerated helps maintain respiratory function and prevents complications.
C. Instruct the client to increase fluid intake to 2.5 L per day: Increased fluid intake helps thin secretions, making them easier to expectorate. This is a key intervention in managing an acute exacerbation of chronic bronchitis to improve airway clearance.
D. Encourage the client to perform deep-breathing exercises every 6 hr: Deep-breathing exercises are beneficial, but they should be performed more frequently than every 6 hours, often hourly or as tolerated, to effectively prevent atelectasis and improve oxygenation.
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