The charge nurse is making assignments for a 15-bed skilled nursing unit with the staff of one nurse, two practical nurses (PN), and two unlicensed assistive personnel (UAP). Which client should be assigned to the PN?

Choice A reason: Discussing why visitors should not lie in the bed with the client is not the best action for the nurse to implement. The nurse should not waste time explaining the rationale to the visitor, as this may cause conflict or resentment. The nurse should focus on the immediate safety and comfort of the client and the visitor.

Choice B reason: Notifying the charge nurse that the visitor is lying on the client's bed is not the best action for the nurse to implement. The nurse should not escalate the situation to the charge nurse, as this may imply that the nurse is unable to handle the problem. The nurse should use his or her own authority and judgment to resolve the issue.

Choice C reason: Explaining that the client has the right to have a visitor lie on the bed is not the best action for the nurse to implement. The nurse should not condone or encourage the visitor's behavior, as this may compromise the client's health and hygiene. The nurse should respect the client's wishes, but also uphold the standards of care and infection control.

Choice D reason: Instructing the UAP to ask the visitor to get off the client's bed is the best action for the nurse to implement. The nurse should delegate the task to the UAP, who has already established rapport with the visitor and the client. The nurse should also monitor the situation and ensure that the UAP is polite and respectful to the visitor and the client.

Choice A reason: Calling the client's next of kin and having them provide verbal consent is not the appropriate action for the nurse to take. The client is an adult and has the right to make his own decisions about his health care. The nurse should respect the client's autonomy and not involve his family without his permission.

Choice B reason: The nurse can reinforce information but cannot provide the primary explanation of the procedure. The HCP must clarify any confusion before consent is valid.

Choice C reason: Informed consent requires that the client fully understands the procedure, risks, benefits, and alternatives before signing. The healthcare provider (HCP) is responsible for explaining the procedure, not the nurse. Since the client’s question indicates misunderstanding, the nurse must notify the provider so they can clarify the information before consent is obtained.

Choice D reason: Postponing the procedure until the client understands the risks/benefits is not the best action for the nurse to take. The cardiac catheterization may be a time-sensitive and necessary procedure for the client's condition. The nurse should not delay the procedure without a valid reason. The nurse should try to enhance the client's understanding and confidence before postponing the procedure.