46. Nurses working on a surgical unit are concerned about a physician's treatment of clients during invasive procedures, such as dressing changes and insertion of IV lines. Clients are often crying during the procedures, and the physician is usually unconcerned or annoyed by the client's response. To resolve this problem, the nurses should perform these actions in which order? (Arrange from the first action on top to last on the bottom.)

Document concerns and report them to the charge nurse.

Contact the hospital's Chief of Medical Services.

Submit a written report to the Director of Nursing.

File a formal complaint with the state medical board.

Talk to the physician as a group in a non-confrontational manner.

Answer and Explanation

The Correct Answer is E, A, C, B, D

E. Talk to the physician as a group in a non-confrontational manner.

This is the first and most direct approach to address any interpersonal or professional issues. It allows for open communication and the possibility to resolve the issue without escalating it further.

A. Document concerns and report them to the charge nurse.

If the initial conversation does not lead to a change in behavior, documentation provides a record of the incidents and concerns, which is essential for any further action.

C. Submit a written report to the Director of Nursing.

Reporting the issue to higher management is a step up from reporting to the charge nurse. It brings the concern to the level of administration that can take more significant actions.

B. Contact the hospital's Chief of Medical Services.

If the issue persists despite the steps taken, involving the Chief of Medical Services is appropriate as they have the authority over medical staff and can address the physician's behavior from a position of leadership.

D. File a formal complaint with the state medical board.

This is the last resort when all other internal avenues have been exhausted. It involves external authorities that can impose sanctions or take other actions to ensure professional standards are maintained.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Monitoring skin elasticity is important for assessing hydration status but is not directly related to the risk of bleeding after a bone marrow biopsy in a client with thrombocytopenia.
B. Assessing body temperature is important for detecting signs of infection but is not the most immediate concern following a bone marrow biopsy in a client with thrombocytopenia.
C. Measuring urinary output is important for assessing renal function but is not the most immediate concern following a bone marrow biopsy in a client with thrombocytopenia.
D. Observing the aspiration site is the most important assessment following a bone marrow biopsy in a client with thrombocytopenia because thrombocytopenia increases the risk of
bleeding at the site. It is crucial to monitor for signs of bleeding, such as hematoma formation or continued bleeding, and to apply pressure as needed to prevent or control bleeding.

A. Depression. B. Right lower abdominal pain. C. Peripheral neuropathy. D. Confusion.

Correct Answer is D

Explanation

A. Depression: While depression may occur in some individuals with Wernicke's syndrome, confusion is the primary assessment finding associated with this condition.
B. Right lower abdominal pain: Abdominal pain is not a characteristic symptom of Wernicke's syndrome. Confusion, ophthalmoplegia, and ataxia are more common.
C. Peripheral neuropathy: While peripheral neuropathy may occur in some neurological conditions, it is not specific to Wernicke's syndrome, which primarily presents with confusion, ophthalmoplegia, and ataxia.
D. Confusion: Confusion is a hallmark symptom of Wernicke's syndrome and should be a primary focus of assessment and care planning for this condition.

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Naxlex Comprehensive Predictor Exams

A client with leukemia undergoes a bone marrow biopsy. The client's laboratory values indicate the client has thrombocytopenia. Based on this data, which nursing assessment is most important following the procedure?

Correct Answer is D

Explanation

A client is admitted with the diagnosis of Wernicke's syndrome. Which assessment finding should the nurse use in planning the client's care?

Correct Answer is D

Explanation

The nurse notes that a client is receiving a heparin infusion labeled, Heparin Sodium 25,000 Units in 5% Dextrose Injection, 500 mL at a rate of 50 mL/hour. What dose of heparin is the client receiving per hour? (Enter the numerical value only.)

The nurse is caring for a client with a binge eating disorder. Which goal should the nurse first establish with the client?

The nurse places an opioid patch on the chest of a client with intractable pain who also has obstructive sleep apnea (OSA). Which intervention is most important for the nurse to implement before leaving the client?

Exhibits The nurse reviews the assessment findings along with the physician orders. Which immediate interventions would the nurse initiate? Select all that apply

After receiving a change of shift report for clients on a medical surgical unit, which activity should the nurse delegate to the practical nurse (PN)?

A client receives a prescription for itraconazole. Which statement made by the client requires additional instruction by the nurse?

A client who is one day postpartum tells the nurse that her baby cannot latch onto the breast. The nurse determines that the client's nipples are inverted. Which action should the nurse implement?

The nurse is developing a plan of care for a client who reports chest pain on exertion and who is newly diagnosed with cardiovascular disease. Which outcome should the nurse include in the plan of care for this client?