Following a wildfire, a nurse is determining which clients can be discharged to free up beds for injured clients. Which clients should the nurse recommend for discharge? Select All That Apply.
Adolescent client admitted last shift for spontaneous pneumothorax
Older adult client admitted for diabetic ketoacidosis: most recent ABGs show pH is acidic
Young adult client who is 1 day preoperative for elective ileostomy
Older adult client who is intubated for acute respiratory failure
Adult client who is 3 days postoperative for appendectomy, with stable vital signs
Correct Answer : C,E
Disaster triage prioritizes surge capacity through the discharge of hemodynamically stable patients or those with deferred procedures. Discharge criteria include minimal nursing care needs and absence of life-threatening physiological imbalances or pending emergent interventions.
Rationale:
A. Spontaneous pneumothorax requires continuous chest tube monitoring for air leaks or lung re-expansion. Discharging an adolescent within 24 hours of admission is unsafe due to the high risk of recurrence. This client remains physiologically unstable.
B. Diabetic ketoacidosis presenting with an acidic pH indicates ongoing metabolic derangement requiring intravenous insulin. These patients are at risk for cerebral edema and fatal electrolyte shifts. Discharge is contraindicated until the anion gap closes.
C. This client is medically stable and awaiting an elective procedure that is not immediately life-saving. Surgery can be rescheduled to accommodate victims of the wildfire disaster. Preoperative status allows for safe discharge to home.
D. Intubated clients require mechanical ventilation and intensive nursing care for survival. Acute respiratory failure carries a high mortality rate without continuous hemodynamic and airway support. This client is ineligible for transfer or discharge.
E. A patient 3 days following an appendectomy with stable vitals has likely transitioned to oral intake. This client meets criteria for routine discharge as the postoperative risk for immediate hemorrhage or sepsis has significantly decreased.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["100"]
Explanation
Step 1: Identify the formula
gtt/min = (Total volume × Drop factor) ÷ Time (in minutes)
Step 2: Convert time to minutes
2 hours × 60 = 120 minutes
Step 3: Insert values
= (200 × 60) ÷ 120
Step 4: Calculate
= 12000 ÷ 120
= 100 gtt/min
Correct Answer is C
Explanation
Transactional leadership is predicated on a reciprocal exchange system where followers are motivated by a structure of rewards and punishments. This style emphasizes operational efficiency and adherence to established rules through formal authority and contractual obligations. The leader focuses on monitoring performance and utilizing extrinsic motivators to ensure that specific organizational goals or compliance benchmarks are met.
Rationale:
A. This statement reflects a laissez-faire leadership style, characterized by a hands-off approach and minimal direction from the manager. By abdicating authority to the staff, the leader promotes total autonomy, which can lead to lack of coordination. It lacks the structured exchange or performance monitoring inherent in a transactional model.
B. This approach is indicative of autocratic leadership, where the manager maintains strict control and makes decisions without seeking staff input. It prioritizes immediate compliance and task completion through direct orders rather than an exchange of benefits. This style is often necessary in crisis management but does not utilize the reward-based transactional framework.
C. This is a classic example of transactional leadership, as it uses a tangible reward to motivate staff toward a specific goal. The manager establishes a clear contingent contract where compliance with a deadline results in a gift card. This focus on performance-linked incentives is the defining characteristic of transaction-based management.
D. This statement illustrates transformational leadership, which focuses on shared vision, collaboration, and inspiring staff toward higher organizational purposes. It emphasizes intrinsic motivation and collective brainstorming to achieve excellence rather than simple task-reward exchanges. Transformational leaders seek to empower staff through visionary engagement and professional growth.
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