Which client should be transferred from the general pediatric unit to the pediatric intensive care unit?

Choice A reason: A client who is postoperative following a lobectomy and has a chest tube is the most appropriate assignment for a PACU nurse. PACU nurses are highly skilled in caring for immediate postoperative patients, monitoring for complications such as respiratory distress, bleeding, and chest tube management. Their expertise in airway management, pain control, and hemodynamic monitoring makes them well-suited for this client.

Choice B reason: Teaching prior to initiating cardiac rehabilitation requires specialized knowledge in patient education and long-term management of cardiovascular disease. This is best handled by a nurse with experience in cardiac rehabilitation or medical-surgical nursing, not a PACU nurse whose focus is on acute postoperative recovery.

Choice C reason: Discharge planning to a long-term care facility involves coordination of care, patient education, and interdisciplinary communication. These tasks require familiarity with community resources and continuity of care, which are not the primary skills of a PACU nurse.

Choice D reason: Teaching insulin self-administration requires patient education skills and knowledge of diabetes management. This is not within the typical scope of PACU nursing, as PACU nurses focus on immediate postoperative stabilization rather than chronic disease education.

Choice A reason: Telling a new nurse that they will learn to deal with moral distress does not promote a healthy work environment. While moral distress is a reality in nursing, this statement normalizes distress rather than teaching strategies to prevent or address it. It can discourage the new nurse and foster a negative outlook.

Choice B reason: Suggesting that all nurses will experience bullying is harmful and perpetuates a toxic culture. This statement does not encourage proactive measures to prevent bullying or promote respect. Instead, it normalizes unacceptable behavior, which undermines the principles of a healthy workplace.

Choice C reason: Advising a nurse to get another job if they don’t feel supported is dismissive and unhelpful. It does not encourage collaboration, communication, or advocacy for change within the workplace. A healthy environment is built through constructive actions, not avoidance.

Choice D reason: Reporting workplace injuries to the manager is a constructive and appropriate statement. It emphasizes accountability, safety, and communication. This action ensures that hazards are addressed, promotes transparency, and protects both staff and clients. It is a positive behavior that supports a healthy work environment.