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 C
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 Situation component, which is the "S" in SBAR. This first step establishes the identity of the patient and the reason for the communication. Background, conversely, focuses on the clinical history and factors that led up to the current situation, rather than basic identifiers used to open the conversation.
Choice C reason: Background information includes the clinical context and history pertinent to the client's care, such as medical history, allergies, and code status. Knowing the code status provides the receiving nurse with essential historical legal and clinical context regarding the client’s wishes and limitations of care, which is a foundational element of the "B" in SBAR.
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 B
Explanation
Choice A reason: Nurses who have advanced training may provide direct care for clients, but this is not specific to case management. Case management is a collaborative process that involves assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and human service needs.
Choice B reason: Nurses use critical pathways when caring for clients as part of case management. Critical pathways are standardized plans of care that outline the expected outcomes, interventions, and time frames for a specific diagnosis or procedure. They help to ensure quality, continuity, and cost-effectiveness of care.
Choice C reason: Nurses delegate and supervise assigned tasks, but this is a general nursing responsibility and not specific to case management. Case management requires more than just task delegation and supervision. It also involves communication, coordination, and evaluation of care.
Choice D reason: The nurse completes one specific task for a group of clients is not an accurate description of case management. Case management is not task-oriented, but client-centered and outcome-focused. The nurse is responsible for the overall care of the client, not just one aspect of it.
Correct Answer is D
Explanation
Choice A reason: Diminished hand-to-mouth coordination is a finding that indicates a motor deficit, not a speech or language problem. The nurse should refer the client to a physical therapist or an occupational therapist for this issue.
Choice B reason: Altered level of consciousness is a finding that indicates a cognitive impairment, not a speech or language problem. The nurse should monitor the client's mental status and report any changes to the provider.
Choice C reason: Unilateral ptosis is a finding that indicates a cranial nerve deficit, not a speech or language problem. The nurse should assess the client's eye movements and facial symmetry and report any abnormalities to the provider.
Choice D reason: Impaired voluntary cough is a finding that indicates a swallowing disorder, which is a speech or language problem. The nurse should refer the client to a speech-language pathologist for further evaluation and intervention. The client may have dysphagia, which can increase the risk of aspiration and pneumonia.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.