The nurse is having difficulty hearing his patient’s apical pulse with his stethoscope. Which action will help the nurse hear the heartbeat more clearly?

Choice A reason: This is an incorrect choice because the hospice RN works closely with the patient’s daughter to ensure that the patient’s dying requests are met is not a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Working closely with the patient’s daughter is an example of family-centered care, not team nursing.

Choice B reason: This is an incorrect choice because the RN cares for the same five patients every day during their stay following joint replacement surgery is not a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Caring for the same five patients every day is an example of primary nursing, not team nursing.

Choice C reason: This is the correct choice because the RN, the LPN, and the nursing assistant work together to provide all the care needed by eight patients for the shift is a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Each member of the team performs specific duties appropriate to their role to provide total patient care. Teams may include licensed practical nurses (LPNs) and unlicensed assistive personnel (UAP) that are supervised by a registered nurse (RN). Less experienced, or non-critical care RNs, may be assigned to a team in a critical care unit led by an experienced critical care RN. Each team member plays a vital role.

Choice D reason: This is an incorrect choice because the RN coordinates care of the patient with the physician assistant to ensure that the clinical pathway is followed is not a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Coordinating care of the patient with the physician assistant is an example of interprofessional collaboration, not team nursing.

Choice A reason: This is incorrect. The antipyretic medication will not inhibit bacterial growth within the culture tubes. Antipyretics are medications that reduce fever by affecting the hypothalamus, the part of the brain that regulates body temperature. They do not have any antibacterial effect.

Choice B reason: This is incorrect. Venous distension is not greater because of fluid retention from hyperthermia. Venous distension is the swelling of the veins due to increased pressure or volume of blood. Hyperthermia is the condition of having a body temperature above the normal range. It can cause dehydration, not fluid retention.

Choice C reason: This is incorrect. Elevated temperatures do not slow metabolic rate and improve blood oxygenation. Elevated temperatures increase metabolic rate and demand more oxygen. This can lead to tissue hypoxia, acidosis, and organ damage.

Choice D reason: This is correct. The causative organism is most prevalent during a spike in temperature. A spike in temperature is a sudden rise in body temperature that indicates an infection. Drawing a blood culture before giving an antipyretic medication can help identify the type and number of bacteria in the blood. This can guide the appropriate antibiotic therapy and monitor the response to treatment.