A newly hired unlicensed assistive personnel (UAP) expresses fear to the charge nurse about collecting a sputum specimen from a client who is HIV positive. Which action should the charge nurse take first?

Choice A Reason: This is not the first action because it does not address the safety risk of smoking in the hospital. The nurse should document the occurrence after taking appropriate measures to prevent fire and injury.

Choice B Reason: This is not the first action because it does not stop the client from smoking in the bathroom. The nurse should obtain a prescription for a nicotine patch if the client agrees to quit smoking, but this is not a priority at this time.

Choice C Reason: This is not the first action because it does not ensure that the client will comply with the hospital smoking policy. The nurse should educate the client about the health hazards of smoking and the hospital rules, but this can be done later.

Choice D Reason: This is the best action because it alerts the authority figure who can intervene and enforce the hospital smoking policy. The nurse should notify the charge nurse as soon as possible to prevent fire and injury.

Choice A Reason: This is the correct answer because the acuity level of the clients reflects their complexity and intensity of care needs. The higher the acuity level, the more time and resources are required to provide safe and quality care. The charge nurse should consider the acuity level of the clients when determining the appropriate nurse-to-client ratio and staffing needs.

Choice B Reason: The physicians' plans to perform procedures on the unit is not the most important information for the charge nurse to consider because it does not directly affect the nursing workload or staffing requirements. The charge nurse should coordinate with the physicians and other departments to ensure that the procedures are scheduled and performed safely and efficiently.

Choice C Reason: The number of clients leaving the unit for diagnostic tests is not the most important information for the charge nurse to consider because it does not indicate the level of care that the clients need or receive. The charge nurse should ensure that the clients are prepared and accompanied for their tests and that their care is continued and monitored on their return.

Choice D Reason: The skill level of the personnel staffing the unit is not the most important information for the charge nurse to consider because it does not reflect the actual demand or supply of nursing care. The charge nurse should assign and delegate tasks according to the personnel's skill level and scope of practice but also consider other factors such as client acuity, availability, and preference.