The nurse is teaching a community group about nerve agents.
The nurse evaluates that the teaching has been effective when the participants state:

Choice A rationale

A ventilator-dependent patient requires complex and specialized respiratory care, including ventilator management, suctioning, and frequent assessments for complications such as pneumonia or acute respiratory distress syndrome. This level of care demands advanced knowledge and experience in critical care, which a nurse with only six months of experience floated from a surgical unit may not possess, potentially compromising patient safety.

Choice B rationale

A patient recently returned from a bronchoscopy and biopsy is at risk for immediate post-procedure complications such as hemorrhage, pneumothorax, or respiratory distress. These potential acute events require prompt and skilled assessment, intervention, and monitoring, which necessitate an experienced nurse with a strong understanding of respiratory physiology and post-procedural care, beyond what a novice nurse might have.

Choice C rationale

A patient on airborne precautions for tuberculosis requires meticulous adherence to infection control protocols to prevent disease transmission. This includes proper use of N95 respirators, negative pressure rooms, and visitor management. While important, managing airborne precautions is a critical skill. However, a nurse with only six months of experience and floated from a surgical unit may not have sufficient experience with medical unit patient acuity or the complexities of managing a communicable disease.

Choice D rationale

Teaching about incentive spirometry is a routine and relatively low-risk intervention, focusing on patient education and demonstrating proper technique. This task aligns well with the skill set of a nurse with six months of experience, even if floated from another unit, as it does not typically involve complex assessments or high-acuity interventions, making it an appropriate assignment for skill reinforcement and patient engagement.

Choice A rationale

Allowing a client at risk for suicide to nap with the door closed poses a significant safety concern. This practice eliminates direct visual observation, which is paramount in suicide prevention. The closed door creates an opportunity for the client to engage in self-harm behaviors unobserved, increasing the risk of a successful suicide attempt by removing immediate intervention capabilities.

Choice B rationale

While distraction can be therapeutic, allowing a client on suicide precautions to engage in crafts in their room unobserved introduces potential risks. Craft materials, if not carefully monitored and selected, could be used as instruments for self-harm. Maintaining constant, direct observation, even during seemingly benign activities, is crucial to prevent access to means for suicide.

Choice C rationale

Providing headphones for relaxing music, while potentially calming, can compromise auditory monitoring of a client on suicide precautions. The headphones can obscure sounds that might indicate distress, agitation, or self-harm attempts. Direct sensory observation, including listening for abnormal sounds, is a critical component of ensuring continuous safety and prompt intervention.

Choice D rationale

Rounding and visualizing the client every 15 minutes is a fundamental suicide precaution intervention. This frequent, direct observation allows for continuous assessment of the client's behavior, mood, and immediate environment. It minimizes opportunities for self-harm by providing consistent monitoring and enables timely intervention if any concerning signs or actions are detected, ensuring client safety.