A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a medical-surgical unit?

A primigravida client who is 1 day postoperative following a cesarean birth and has a PCA pump.

A client who is at 32 weeks of gestation and has premature rupture of membranes.

A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor.

A client who has gestational diabetes and is receiving biweekly nonstress tests.

Answer and Explanation

The Correct Answer is A

Rationale:
A. A post-cesarean client with a PCA pump requires routine postoperative monitoring and pain management, which are familiar tasks for a medical-surgical RN. This makes the assignment appropriate.
B. A client with premature rupture of membranes at 32 weeks requires specialized obstetrical knowledge and monitoring for complications such as infection and preterm labor.
C. A client with preeclampsia on misoprostol induction requires close fetal and maternal monitoring, which demands specialized obstetric expertise.
D. A client with gestational diabetes undergoing nonstress tests needs interpretation of fetal monitoring results, which is outside the scope of practice for a floated med-surg RN.

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Correct Answer is C

Explanation

Rationale:
A. The SBAR communication tool is used for structured communication among health care providers, not for measuring outcomes.
B. Flowcharts are used to map processes and identify where problems may occur, but they do not measure outcomes.
C. Clinical indicators are measurable items that reflect the quality of care provided (e.g., infection rates, fall rates, readmission rates). They are the appropriate tool for evaluating outcomes in quality improvement.
D. Cause-and-effect diagrams (Ishikawa or fishbone diagrams) are used to identify potential causes of a problem, not to measure outcomes.

A. Tell the client to mark the right side of his head with indelible ink. B. Contact the surgery department to validate the operative site. C. Ask the surgeon to clarify the operative site with the client. D. Continue with the surgery because the client already gave informed consent.

Correct Answer is C

Explanation

Rationale:
A. It is not appropriate for the client to independently mark the operative site; this could lead to errors. Site marking must be done by the surgical team per protocol.
B. Contacting the surgery department does not directly resolve the client’s confusion or ensure proper informed consent.
C. The surgeon is responsible for confirming and clarifying the surgical site with the client. The nurse should advocate for the client’s safety by notifying the surgeon of the discrepancy.
D. Proceeding with surgery despite the client’s expressed concern would be unsafe and violates the principles of informed consent and patient safety.

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A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a medical-surgical unit?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse manager is developing a quality improvement project. The nurse manager should recognize that which of the following tools should be used to measure outcomes?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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