An incapacitated older adult with dementia is brought to the emergency department by a rescue squad after falling and breaking an arm. When the patients children arrive, they are adamantly against the patient having any medical care and insist that prayer will heal the broken arm. What action by the nurse is most appropriate?

Check facility policies and contact the hospital social worker

Allow the family to pray with the patient then escort them to the waiting room

Call the police who can force the family to accept medical care

Call security to keep the family from interfering with medical care

Answer and Explanation

The Correct Answer is A

A.   When faced with a situation where a patient's family refuses medical care, it is important to follow the facility's policies and procedures. In many cases, the hospital social worker can be a valuable resource in helping to resolve such situations. The social worker can provide support to the family, help them understand the importance of medical care, and advocate for the patient's best interests.
B.   While it is important to respect the family's cultural and religious beliefs, it is also important to ensure that the patient receives the necessary medical care. Allowing the family to pray with the patient is appropriate, but the patient should still receive medical attention for their broken arm.
C.   This is not a appropriate course of action. While the patient has a right to receive medical care, it is important to approach the situation with respect and compassion, and to try to work with the family to find a solution that is in the best interests of the patient.
D.   This could escalate the situation and make it more difficult to resolve. It is important to approach the situation with empathy and understanding, and to try to work with the family to find a solution that is acceptable to all parties.

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Correct Answer is ["A","B","D"]

Explanation

A. The patient's mental status is crucial for understanding their current cognitive and emotional condition. This information helps the incoming nurse assess whether there have been any changes or concerns regarding the patient's orientation, mood, or cognitive function.
B. Documenting all pertinent nursing care provides a comprehensive overview of what has been done for the patient during the shift, including any treatments, medications administered, and changes in the patient's condition.
C. While knowing who visited the patient might be relevant in some contexts, it is generally not a core component of clinical shift reports unless the visitors' presence impacted patient care or the patient’s condition. This information is usually not necessary for the shift report unless it directly affects the
patient’s care or treatment, such as if a visitor brought important information or had a significant impact on the patient.

D. The status of lung sounds is a specific aspect of the patient's physical assessment and can indicate respiratory issues or improvements. This data is necessary if the patient has a respiratory condition or if there have been recent changes in their respiratory status. It helps the incoming nurse evaluate the effectiveness of treatments and ongoing respiratory care.
E. Information about the patient's favorite TV shows is not relevant to clinical care and does not impact
the patient’s health status or the nursing interventions required. This information is not necessary for
the shift report as it does not contribute to the patient’s medical or care needs.

A. Reporting muscle aches and frequent stumbling B. Dozing off in chair and not recognizing staff C. Pulse. 118 beats/min; and BP 160/90 D. Pulse, 58 beats/min; and BP 100/60

Correct Answer is C

Explanation

A. While these symptoms can be associated with alcohol withdrawal, they are not as indicative of an immediate medical emergency as tachycardia and hypertension.
B. While these symptoms may suggest cognitive impairment, they are not as indicative of impending alcohol withdrawal syndrome as tachycardia and hypertension.
C. Alcohol withdrawal can lead to various physiological changes, including increased heart rate and blood pressure. A pulse of 118 beats/min and a blood pressure of 160/90 indicate a significant increase in both vital signs, which could be a sign of impending alcohol withdrawal syndrome.
D. These vital signs are within normal limits and do not indicate a significant risk of alcohol withdrawal syndrome.

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Naxlex Comprehensive Predictor Exams

What data are necessary to compile an effective end-of-shift report? (Select all that apply.)

Correct Answer is ["A","B","D"]

Explanation

The nurse is assessing patients for impending alcohol withdrawal. The nurse assesses the patient with which of the following conditions as a priority?

Correct Answer is C

Explanation

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