The loss of hydrogen ions, or gain of bases, causes the pH of blood to increase and become.

Choice A rationale

This statement is an example of aggressive communication. It uses "you" statements, labels the colleague with insulting terms like lazy and unreliable, and includes threats regarding their job security. Aggressive communication seeks to humiliate or dominate others rather than resolve a conflict. It creates a hostile work environment and destroys the collaborative relationships necessary for patient safety and effective nursing teamwork, failing to meet the standards of professional assertive behavior.

Choice B rationale

This statement represents passive-aggressive communication. The speaker is expressing resentment and frustration indirectly by asking rhetorical questions and making snide remarks about colleagues with children. It avoids addressing the actual issue of overtime directly with the supervisor. This style of communication is manipulative and leads to workplace tension and misunderstandings because the individual's true needs and feelings are not stated clearly or respectfully to the appropriate party.

Choice C rationale

This is an accurate example of assertive communication. It uses "I" statements to express a professional concern and focuses on the objective facts of the patient's condition. The nurse clearly states the problem regarding the lack of pain relief and proposes a specific solution or next step. Assertive communication is direct, honest, and respectful, allowing the nurse to advocate for the patient's needs without attacking or demeaning the other members of the healthcare team.

Choice D rationale

This statement is an example of passive communication. By using phrases like "sorry to be such a pain" and "when you have time," the nurse is minimizing the importance of the task and their own professional role. It lacks the firmness required for effective advocacy. Passive communication often results in the speaker's needs being ignored, which can lead to delays in patient care, such as the discharge process mentioned in this specific scenario.

Choice A rationale

The admission nursing assessment provides a comprehensive baseline of the client's health status at the time they enter the facility. It includes medical history, current symptoms, and a physical exam. While it contains an initial set of vital signs, it does not provide a continuous view of changes over time. To find trends, the nurse needs a document that shows multiple readings over several hours or days, which the admission assessment lacks.

Choice B rationale

Progress notes are used by healthcare providers to document the client's clinical status, interventions, and response to treatment in a narrative or structured format. While a nurse might mention a specific vital sign change in a note, these entries are not the most efficient way to track trends. They are often scattered among other clinical details, making it difficult to quickly visualize patterns or fluctuations in data like blood pressure or temperature.

Choice C rationale

The admissions sheet contains demographic and administrative information, such as the client's name, age, insurance details, and emergency contacts. It may also list the admitting diagnosis and the name of the attending physician. It does not contain clinical data or ongoing monitoring information like vital signs. Using this sheet to look for physiological trends would be impossible because that type of data is simply not recorded on this specific administrative form.

Choice D rationale

The graphic record, often referred to as the flow sheet, is the specific section of the electronic health record where vital signs, weight, and intake/output are documented. It is designed to allow for easy visualization of data over time, often using a table or graph format. This allows the nurse to quickly identify trends, such as a steadily rising temperature or a dropping blood pressure, which is essential for monitoring a postoperative client’s recovery.