A nurse is preparing to transfer a client from the emergency department to a medical-surgical unit using the SBAR communication tool. Which of the following information should the nurse include in the background portion of the report?
The client's vital signs
The client's name
The client's code status
A prescribed consultation
The Correct Answer is B
Choice A reason: The client's vital signs are not part of the background information, but rather the assessment information. The background information should include relevant and concise data about the client's history, diagnosis, and treatment.
Choice B reason: The client's name is part of the background information, as it identifies the client and establishes rapport. The name should be the first thing the nurse says when initiating the SBAR communication.
Choice C reason: The client's code status is not part of the background information, but rather the recommendation information. The code status should be communicated at the end of the SBAR communication, along with any other suggestions or requests for the receiving nurse.
Choice D reason: A prescribed consultation is not part of the background information, but rather the situation information. The situation information should describe the current problem or reason for the transfer.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Providing the client with written information in their spoken language is the appropriate action for the nurse to take. This would ensure that the client understands the information and can refer to it later. It would also respect the client's culture and preferences.
Choice B reason: Speaking very slowly during the teaching session is not an appropriate action for the nurse to take. This would not improve the communication or comprehension of the client. It might also be perceived as patronizing or disrespectful by the client.
Choice C reason: Using medical terminology while explaining the medications is not an appropriate action for the nurse to take. This would confuse the client and hinder the learning process. The nurse should use simple and clear language that the client can understand.
Choice D reason: Having the client's family member who is present interpret is not an appropriate action for the nurse to take. This would compromise the accuracy and confidentiality of the information. It might also create a conflict of interest or a bias for the family member. The nurse should use a professional interpreter or a translation device if available.
Correct Answer is B
Explanation
Choice A reason: Placing a surgical mask on the client during transfer to the unit is not an appropriate action for the nurse to take. Cutaneous anthrax is not transmitted through respiratory droplets, but through direct contact with the spores that enter the skin. A surgical mask does not protect the client or others from the infection.
Choice B reason: Preparing to administer antibiotics to the client is an appropriate action for the nurse to take. Cutaneous anthrax is caused by a bacterium called Bacillus anthracis, which can be treated with antibiotics, such as ciprofloxacin or doxycycline. Antibiotics can prevent the infection from spreading to other parts of the body and causing serious complications.
Choice C reason: Planning to administer an antiviral medication to the client is not an appropriate action for the nurse to take. Cutaneous anthrax is not caused by a virus, but by a bacterium. Antiviral medications are ineffective against bacterial infections and may cause adverse effects or interactions.
Choice D reason: Wearing an N95 respirator mask while caring for the client is not an appropriate action for the nurse to take. An N95 respirator mask is used to protect the nurse from airborne pathogens, such as tuberculosis or measles. Cutaneous anthrax is not airborne, but contact-based. The nurse should wear standard precautions, such as gloves and gown, and wash their hands thoroughly after caring for the client.
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