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.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. "I am happy that you are getting better and will be able to go home."
This response focuses on the client’s progress and avoids engaging with their polarized views. It provides positive reinforcement and shifts the focus toward recovery.

B. "Tomorrow I will talk to that nurse about how you were treated last night."
This could escalate the situation and may inadvertently validate the client's idealization or devaluation of others, without fully understanding the dynamics.

C. "I am glad you like me. Which nurse was acting aloof to you?"
This response reinforces the client’s idealization of the current nurse, which could perpetuate dichotomous thinking.

D. "What did the night nurse do that makes you think the nurse is aloof?"
This invites the client to focus on negative perceptions of the night nurse, potentially escalating their emotional instability.

A. Swollen feet and ankles. B. Blood tinged sputum. C. Rapid, regular heart rate. D. Elevated blood pressure.

Correct Answer is B

Explanation

A. Swollen feet and ankles: While swelling can indicate fluid retention, it may not necessarily warrant immediate intervention unless it is severe or accompanied by other concerning symptoms.

B. Blood-tinged sputum is the most concerning finding because it suggests pulmonary congestion or pulmonary edema, which can occur due to increased pressure in the pulmonary circulation secondary to mitral valve stenosis. This could indicate acute decompensation of the client’s condition, requiring immediate intervention to prevent respiratory compromise or worsening heart failure.

C. Rapid, regular heart rate (e.g., sinus tachycardia) is a compensatory response to reduced cardiac output and increased demand. While it warrants monitoring and potential treatment, it is not as critical as the presence of blood-tinged sputum, which signals acute pulmonary involvement

D. Elevated blood pressure: While elevated blood pressure may indicate increased cardiac workload, rapid, irregular heart rate is a more immediate concern in this context due to its potential to cause complications such as thromboembolism

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A client with a history of rheumatic fever is diagnosed with mitral valve stenosis. The client has shortness of breath with exertion and fatigue. Which assessment finding warrants immediate intervention by the nurse?

Correct Answer is B

Explanation

Exhibits Review H and P and laboratory results. What item(s) should be included in the treatment regimen for this client? Select all that apply.

The nurse administers an antibiotic to a client with a respiratory tract infection. To evaluate the medication's effectiveness, what laboratory value(s) should the nurse monitor? Select all that apply.

A 22-year-old client is admitted to the hospital in diabetic ketoacidosis (DKA. The client's parent is insisting to know the laboratory test results. Which is the best response for the nurse to provide?

The healthcare provider prescribes ear drops to an adult client with an ear infection. Which teaching should the nurse provide?

Which is the primary goal when planning nursing care for a client with degenerative joint disease (DJD?

The nurse is completing an admission assessment on an older adult client with dehydration, failure to thrive, and who is immobile. The nurse reports to the healthcare provider that the client's right calf is red and swollen. The nurse should suspect which probable cause of these findings?

An older adult client arrives at the clinic describing a new onset of urinary incontinence. Which intervention should the nurse implement?

When caring for a client with full-thickness burns to both lower extremities, what assessment finding(s) warrant immediate intervention by the nurse? Select all that apply.