A nurse is preparing to notify the provider about a change in a client's status. Which of the following information should the nurse plan to include in the "background" portion of the Situation, Background, Assessment, Recommendation (SBAR) Communication tool?
Client's present condition.
Suggestions for the provider regarding client care.
Physical findings.
Previous treatments.
The Correct Answer is D
Choice A rationale: The client's present condition is the "Situation" component of SBAR. It identifies the immediate reason for the call and the current problem that requires the provider's attention or intervention.
Choice B rationale: Suggestions for the provider regarding client care constitute the "Recommendation" phase. This part involves the nurse proposing specific actions, tests, or treatments to address the identified clinical issue.
Choice C rationale: Physical findings are categorized under the "Assessment" portion of SBAR. This includes vital signs and clinical observations made by the nurse to evaluate the client's current physiological state.
Choice D rationale: Previous treatments belong in the "Background" section. This component provides historical context, including admitting diagnosis, medical history, allergies, and relevant interventions already performed to inform the provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
To calculate how many milliliters (mL) of diazepam oral solution should be administered, you can use the following formula:
Dose (mL) = Desired dose (mg) / Concentration (mg/mL)
In this case, the desired dose is 2 mg, and the concentration of the diazepam oral solution is 5 mg/1 mL.
Dose (mL) = 2 mg / 5 mg/mL = 0.4 mL
So, the nurse should administer 0.4 mL of diazepam oral solution with each dose. The correct answer is:
A) 0.4 mL.
Correct Answer is D
Explanation
Choice A rationale:
Apply the skin sealant on damp skin. Rationale: Applying skin sealant on damp skin is not the recommended approach for securing an ostomy appliance. It's important to ensure that the skin is clean and dry before applying the sealant or the skin barrier. Moisture can compromise adhesion and lead to skin irritation or appliance detachment.
Choice B rationale:
Remove the appliance before emptying the pouch. Rationale: Removing the appliance before emptying the pouch is not a necessary step when changing an ostomy appliance. Typically, the pouch can be emptied without removing the entire appliance, which helps maintain the seal and reduces unnecessary skin exposure.
Choice C rationale:
Ensure that the skin is slightly damp for better adhesion of the pouch. Rationale: Ensuring that the skin is slightly damp is not advisable for better adhesion of the pouch. The skin should be completely dry before applying the pouch to ensure proper adhesion. Moisture on the skin can lead to leakage or detachment of the appliance.
Choice D rationale:
Trace the size of stoma onto the skin barrier. Rationale: This choice is the correct answer because tracing the size of the stoma onto the skin barrier ensures a precise fit, which is crucial for preventing leaks and maintaining the integrity of the ostomy. A proper fit also helps in preventing skin irritation and discomfort. Choosing the correct barrier size based on the stoma's dimensions is a key aspect of effective ostomy care.
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