A nurse is receiving a handoff report from another nurse at shift change. Which information should the nurse prioritize when receiving the report?

Correct answer: C) Document the DNR order in the nursing care plan and communicate it to other health care team members.

Rationale: The nurse should document the DNR order in the nursing care plan and communicate it to other health care team members, as this ensures that the client's wishes are respected and followed in the event of a cardiac or respiratory arrest. Documenting and communicating the DNR order also prevents unnecessary or unwanted interventions that may cause harm or distress to the client.

Incorrect options:

A) Review the DNR order with the client and their family to ensure their understanding and agreement. - This is an unnecessary action, as reviewing the DNR order with the client and their family implies that they may not have made an informed decision or that they may change their mind, which can be disrespectful or coercive. The nurse should assume that the client and their family have already discussed and agreed on the DNR order with the health care provider who wrote it, unless there is evidence of misunderstanding or disagreement.

B) Notify the health care provider of the DNR order and request a written confirmation. - This is an unnecessary action, as notifying

the health care provider of the DNR order and requesting a written confirmation implies that there may be a discrepancy or doubt about

the validity of the order, which can be disrespectful or suspicious. The nurse should assume that the health care provider who wrote

the DNR order has already obtained informed consent from the client and their family and has documented it appropriately, unless there is evidence of error or omission.

D) Initiate a palliative care consultation for the client and their family to discuss end-of-life care options. - This is an inappropriate action, as initiating a palliative care consultation for the client and their family implies that they have a terminal condition or a poor prognosis, which may not be true for clients with pneumonia who have a DNR order. The nurse should not assume that all clients with a DNR order need or want palliative care, unless they express an interest or a need for it.

Correct answer: B) Use gestures and pictures to supplement verbal communication.

Rationale: The nurse should use gestures and pictures to supplement verbal communication, as this helps to convey meaning and clarify messages for clients who have difficulty understanding or producing speech due to aphasia. Gestures and pictures can also help to reduce frustration and anxiety for both parties.

Incorrect options:

A) Speak loudly and slowly to the client. - This is an inappropriate strategy, as speaking loudly and slowly to the client may imply that they are hard of hearing or cognitively impaired, which can be insulting and demeaning. The nurse should speak clearly and at a normal volume and pace, unless there is evidence of hearing loss or cognitive impairment.

C) Ask open-ended questions to elicit more information from the client. - This is an ineffective strategy, as asking open-ended questions may overwhelm or confuse clients who have difficulty expressing themselves due to aphasia. The nurse should ask simple, yes-or-no questions or offer choices that require minimal verbal responses from the client.

D) Finish the client's sentences when they have difficulty expressing themselves. - This is a disrespectful strategy, as finishing

the client's sentences may interrupt their thoughts or impose words that they do not intend to say. The nurse should allow adequate time for the client to communicate and encourage them to use alternative methods, such as writing or pointing, if needed.