A nurse on a surgical unit is preparing to transfer a client to a rehabilitation facility. Which of the following information should the nurse include in the change-of-shift report?
The time the client received his last dose of pain medication
The steps to follow when providing wound care
The client's preferred time for bathing
The belief that the client has a difficult relationship with his son
The Correct Answer is B
Choice A reason: This is not the information that the nurse should include in the change-of-shift report. The time the client received his last dose of pain medication is not relevant to the transfer to the rehabilitation facility. The nurse should document the pain medication administration in the medication record and communicate it to the receiving nurse.
Choice B reason: This is the information that the nurse should include in the change-of-shift report. The steps to follow when providing wound care are important to ensure the continuity and quality of care for the client. The nurse should explain the type, location, and condition of the wound, the dressing materials and frequency, and any signs of infection or complications.
Choice C reason: This is not the information that the nurse should include in the change-of-shift report. The client's preferred time for bathing is not essential to the transfer to the rehabilitation facility. The nurse should respect the client's preferences and routines, but they are not a priority for the report.
Choice D reason: This is not the information that the nurse should include in the change-of-shift report. The belief that the client has a difficult relationship with his son is not based on facts and may be biased or inaccurate. The nurse should avoid making assumptions or judgments about the client's family dynamics and focus on the objective data and the client's needs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is the first action the nurse preceptor should take to demonstrate appropriate time management. By determining the client care goals, the nurse preceptor can prioritize the most important and urgent tasks for each client and delegate appropriately.
Choice B reason: This is not the first action the nurse preceptor should take to demonstrate appropriate time management. Reviewing the client's new laboratory values is an important task, but it should be done after determining the client care goals and before completing the required tasks.
Choice C reason: This is not the first action the nurse preceptor should take to demonstrate appropriate time management. Completing the required tasks is an essential part of nursing care, but it should be done after determining the client care goals and reviewing the client's new laboratory values.
Choice D reason: This is not the first action the nurse preceptor should take to demonstrate appropriate time management. Documenting the assessment data is a vital part of nursing care, but it should be done after completing the required tasks and before the end of the shift.
Correct Answer is C
Explanation
Choice A reason: A provider's prescription is not a resource for developing a standard for removal of indwelling urinary catheters. A prescription is a specific order for a particular client, not a general guideline for a group of clients.
Choice B reason: Maslow's hierarchy of needs is not a resource for developing a standard for removal of indwelling urinary catheters. Maslow's hierarchy of needs is a theory of human motivation that ranks the basic needs of individuals from physiological to self-actualization. It does not provide specific information on how to perform nursing interventions.
Choice C reason: Evidence-based practice is a resource for developing a standard for removal of indwelling urinary catheters. Evidence-based practice is the integration of the best available research evidence, clinical expertise, and client preferences and values into clinical decision making. It helps to ensure that the nursing care is effective, safe, and consistent.
Choice D reason: A critical pathway is not a resource for developing a standard for removal of indwelling urinary catheters. A critical pathway is a tool that outlines the expected course of treatment and outcomes for a specific diagnosis or procedure. It does not provide detailed instructions on how to perform nursing interventions.
Choice E reason: A surgical record is not a resource for developing a standard for removal of indwelling urinary catheters. A surgical record is a document that records the details of a surgical procedure, such as the type of surgery, the anesthesia used, the operative findings, and the complications. It does not provide information on the postoperative care of the client.
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