A charge nurse is making client assignments in the Intensive Care Department. The healthcare team consists of one nurse with 10 years experience, one nurse with 5 years experience, and a new graduate nurse who just completed a 12-week internship. Which client should the nurse assign to the new graduate nurse?

A client with multisystem failure secondary to a motor vehicle collision.

A client in end-stage liver failure who is experiencing esophageal bleeding.

A client with Adult Respiratory Distress Syndrome who is on a ventilator.

A client with chest tubes secondary to a stab wound to the chest.

Answer and Explanation

The Correct Answer is D

Choice A Reason: A client with multisystem failure secondary to a motor vehicle collision is not an appropriate assignment for the new graduate nurse. This client has complex and unstable needs that require advanced assessment, intervention, and evaluation skills. The nurse should assign this client to a nurse with 10 years experience, who has more expertise and confidence in managing critically ill clients.

Choice B Reason: A client in end-stage liver failure who is experiencing esophageal bleeding is not an appropriate assignment for the new graduate nurse. This client has a high risk of complications such as hemorrhage, infection, hepatic encephalopathy, and hepatic coma. The nurse should assign this client to a nurse with 5 years experience, who has more knowledge and skill in providing palliative care and managing bleeding disorders.

Choice C Reason: A client with Adult Respiratory Distress Syndrome who is on a ventilator is not an appropriate assignment for the new graduate nurse. This client has a life-threatening condition that requires close monitoring of respiratory status, oxygenation, and hemodynamics. The nurse should assign this client to a nurse with 10 years of experience, who has more competence and proficiency in caring for ventilated clients and interpreting data from invasive devices.

Choice D Reason: A client with chest tubes secondary to a stab wound to the chest is an appropriate assignment for the new graduate nurse. This client has a relatively stable condition that requires routine care of chest tubes, pain management, and wound healing. The nurse should assign this client to the new graduate nurse, who has learned the basic principles and techniques of chest tube management during the refresher course and the internship. The charge nurse should also provide supervision and support to the new graduate nurse as needed.

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Correct Answer is D

Explanation

Choice A Reason: This is not the best action because it does not address the conflict between the client and the healthcare provider. The nurse should advocate for the client's wishes and seek a resolution that respects them.

Choice B Reason: This is not an appropriate action because it disregards the client's request and may give false hope. The nurse should respect the client's autonomy and dignity.

Choice C Reason: This is not a sufficient action because it does not ensure that the healthcare provider will comply with the client's request. The nurse should also involve other resources to help resolve the ethical dilemma.

Choice D Reason: This is the best action because it involves an impartial group of experts who can help mediate the situation and protect the client's rights. The nurse should seek ethical consultation when there is a disagreement about end-of-life decisions.

A. Place an isolation cart outside of the room to initiate droplet precautions. B. Schedule bedside play time with the occupational therapist. C. Instruct the child's parents about the need for transmission precautions. D. Assign the child to a room close to the nurse's station.

Correct Answer is A

Explanation

Choice A Reason: This is the best action because it prevents the spread of infection to other clients and staff. Mumps is a viral infection that causes inflammation of the salivary glands and can be transmitted by respiratory droplets. The nurse should place an isolation cart outside of the room and wear a mask, gloves, and gown when entering.

Choice B Reason: This is not the first priority because it does not address the risk of infection. The nurse should schedule bedside play time with the occupational therapist to promote the child's development and coping, but this can be done later.

Choice C Reason: This is not the first priority because it does not ensure that infection control measures are in place. The nurse should instruct the child's parents about the need for transmission precautions and educate them on how to care for their child at home, but this can be done later.

Choice D Reason: This is not the first priority because it does not prevent the spread of infection. The nurse should assign the child to a room close to the nurse's station to monitor his condition and provide comfort, but this is not a critical intervention.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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