A nurse on a medical-surgical unit is assisting with the review of the electronic medical record for a group of clients during a mass casualty event.
Exhibits
Select the 2 clients the nurse should recommend for discharge to make room for clients injured in the disaster.
Client 4
Client 5
Client 3
Client 1
Client 2
Correct Answer : C,E
A. Client 4:
This client has COPD with a fever of 39.5° C and blood-tinged sputum, likely due to an acute infection such as pneumonia. The client is unstable and requires inpatient treatment - not a discharge candidate.
B. Client 5:
This client has diarrhea, dehydration, hypotension (BP 84/50 mm Hg), and tachycardia. These are unstable vital signs and require continued inpatient care - not a discharge candidate.
C. Client 3:
This client is 4 days post–hip arthroplasty, is ambulating well with assistance, and is stable. The client can be discharged with home health or outpatient follow-up to free up a bed during a mass casualty.
D. Client 1:
This client was admitted for chest pain and recently required nitroglycerin for relief. Cardiac instability risk remains, so the client should not be discharged at this time.
E. Client 2:
This client is stable, awaiting elective bariatric surgery the next day. Elective procedures can be postponed, and the client can be discharged during a disaster to make room for critical cases.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Admission paperwork:
Admission paperwork is not essential for emergency transfer; it contains historical data that is less urgent for immediate care decisions.
B. Care plan:
While the care plan outlines ongoing interventions, it is less critical for emergency management during an acute event.
C. Medication administration record:
The MAR provides essential, up-to-date information about the client’s current medications, dosages, and administration times, which is critical for safe and accurate care in the receiving facility.
D. Discharge summary:
A discharge summary is completed at the end of a stay, not during an emergency transfer.
Correct Answer is D
Explanation
A. Reposition the client for pain relief:
This is independent nursing care, not interdisciplinary.
B. Develop a client-specific nursing diagnosis:
This is part of the nursing process performed independently by nurses.
C. Change the client's dressing every shift:
This is a nursing intervention, not necessarily interdisciplinary unless specialized input is needed.
D. Collaborate with the respiratory therapist on pulmonary care:
Interdisciplinary care involves collaboration between different healthcare professionals; working with a respiratory therapist is an example.
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