Identify the correct sequence of ISBAR-R.
Information, Standard, Background, Advice and Recommendation
Introduction, Statistics, Background, Actions and Recommendation
Introduction, Situation, Background, Assessment and Recommendation/ Read back
Information, Situation, Background, Alertness, Response to treatment
The Correct Answer is C
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Maintaining skin integrity:
Maintaining skin integrity is crucial for preventing pressure ulcers and other skin-related issues, especially for patients who are bedridden or have limited mobility. Preventive measures, like turning the patient regularly and keeping the skin clean and dry, are essential. While important, it is not always the highest priority and can be managed alongside other nursing interventions.
B. Adequate nutrition:
Providing adequate nutrition is vital for the patient's overall health and recovery. Malnutrition can impair the healing process and weaken the immune system. However, in immediate critical situations, addressing the airway, breathing, and circulation (ABCs) takes precedence over nutritional concerns. Once the patient is stable, addressing nutrition becomes a priority in the nursing care plan.
C. Pain control:
Managing pain is crucial for a patient's comfort and well-being. Uncontrolled pain can cause anxiety, impair healing, and decrease the overall quality of life. Pain control is a high priority, but in certain emergencies where the patient's airway or circulation is compromised, managing pain might be temporarily secondary until the primary issues are addressed.
D. Airway management:
Ensuring a clear airway is often the highest priority in emergency situations. Without a patent airway, the patient cannot breathe effectively, leading to oxygen deprivation and potential cardiac arrest. Nurses and healthcare providers focus on maintaining or establishing a clear airway to ensure the patient can breathe adequately. Once the airway is secured, attention can be directed to other aspects of care.
Correct Answer is B
Explanation
A. Developed by an RN:
This option suggests that an RN (Registered Nurse) is solely responsible for creating the initial care plan. While nurses significantly contribute to the care plan, it is often a collaborative effort involving various healthcare professionals, including doctors, nurses, and other specialists.
B. Completed on the day of admission:
This choice means that the initial care plan, outlining the patient's immediate healthcare needs and interventions, is developed and documented on the day the patient is admitted to the healthcare facility. It's essential to establish a plan promptly to ensure the patient receives appropriate and timely care.
C. Used as the basis of care throughout a hospital stay without alteration:
This option suggests that the initial care plan remains unchanged throughout the patient's hospital stay. However, healthcare plans need to be dynamic, adapting to the patient's evolving condition. Care plans are continuously assessed and modified based on the patient's response to treatments and interventions.
D. Developed by the primary care provider and incorporated into the nursing care:
This choice implies that the initial care plan is created by the primary care provider (which could be a doctor) and then integrated into the nursing care. While doctors provide medical diagnoses and orders, nurses play a crucial role in implementing and coordinating the care plan, ensuring the patient's needs are met.
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