An emergency department nurse is providing handoff communication using SBAR (situation, background, assessment, recommendations) to the nurse accepting a client in the intensive care unit. The emergency department nurse reports that the client will require a suction set up for gastric tube drainage and will need an endoscopy performed. Which of the following parts of the SBAR report is the nurse communicating?
S-Situation
R-Recommendations
B-Background
A-Assessment
The Correct Answer is B
A. S–Situation: The situation includes immediate information about why the client is being transferred or receiving care, such as current symptoms, diagnosis, or presenting complaint. It does not include upcoming procedures or equipment needs.
B. R–Recommendations: Recommendations include what actions or interventions are needed next, such as upcoming tests, procedures, or equipment setup. Mentioning the need for a suction setup and an endoscopy reflects planning for ongoing care and falls under this category.
C. B–Background: Background refers to the client's medical history, diagnosis, and events leading up to the current situation. It gives context but does not include plans for future care.
D. A–Assessment: Assessment includes clinical findings, vital signs, laboratory results, and how the client is currently presenting. It focuses on objective and subjective data, not future recommendations or equipment planning.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Chronic pulmonary disease: Chronic pulmonary disease, such as COPD, affects the lungs and respiratory system but is not a primary risk factor for peripheral artery disease (PAD), which is caused by atherosclerosis affecting peripheral circulation.
B. Rheumatic fever: Rheumatic fever is associated with inflammatory damage to the heart valves due to a streptococcal infection, but it does not increase the risk of developing PAD, which is vascular in nature and primarily driven by atherosclerotic risk factors.
C. Body mass index of 35: A BMI of 35 indicates obesity, which significantly increases the risk for atherosclerosis and related conditions like PAD. Obesity contributes to poor lipid profiles, hypertension, and insulin resistance, all of which promote arterial narrowing and plaque buildup.
D. History of venous thrombosis: Venous thrombosis affects the venous system and is different from arterial disease. While it may signal vascular issues, it is not considered a direct risk factor for PAD, which involves arterial—not venous—occlusion.
Correct Answer is D
Explanation
A. Malignant brain tumors often originate from another part of the body: While malignant brain tumors can spread from other body parts (metastatic tumors), primary brain tumors, such as gliomas or meningiomas, originate in the brain itself. Malignant brain tumors that metastasize to the brain are relatively less common.
B. Primary CNS tumors commonly spread to other parts of the body: Primary central nervous system (CNS) tumors generally do not spread to other parts of the body. Most CNS tumors are localized, and their spread is usually restricted to the surrounding neural tissue, not to distant organs.
C. Most CNS tumors are spinal tumors: Most central nervous system (CNS) tumors are actually brain tumors, not spinal tumors. Brain tumors are more common in adults, while spinal tumors are rarer in comparison.
D. Ependymomas are primarily brain tumors: Ependymomas are a type of tumor that originates from the ependymal cells in the central nervous system. While they can occur in both the brain and spinal cord, they are more frequently found in the brain, especially in the ventricles. Thus, ependymomas are primarily considered brain tumors.
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