A newly licensed nurse is giving a change-of-shift report using Introductions, Situation, Background, Assessment, Recommendation (ISBAR) to an oncoming nurse. Which of the following statements by the newly licensed nurse should be included in the "Background" portion of the report?
"The client has a new prescription for incentive spirometry."
"The client's partner plans to return later today."
"The client has no living family members."
"I initiated a consultation by a nutritionist."
The Correct Answer is C
A. "The client has a new prescription for incentive spirometry.": This statement is more appropriate for the "Assessment" or "Recommendation" section, as it pertains to current treatment plans and interventions rather than the background context of the client's history.
B. "The client's partner plans to return later today.": This information is relevant to the client's social support and engagement but is not critical background information. It may be included in the "Situation" or "Recommendation" sections instead.
C. "The client has no living family members.": This statement is pertinent to the "Background" portion, as it provides important context regarding the client's social situation and support system. Understanding the client's background helps the receiving nurse assess potential psychosocial needs and planning for care.
D. "I initiated a consultation by a nutritionist.": This action relates to ongoing care and assessment of the client's nutritional needs, making it more appropriate for the "Assessment" or "Recommendation" section. It is not part of the historical background needed for effective handoff.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
A. Log out of the computer terminal before leaving: Logging out of the computer terminal is a crucial step in maintaining client confidentiality. It prevents unauthorized individuals from accessing sensitive client information when the nurse is away from the terminal.
B. Share passwords for computer access with colleagues: Sharing passwords compromises the security of client information and violates confidentiality protocols. Each nurse should use their unique login credentials to ensure accountability and protect client data.
C. Change computer access passwords on a regular basis: Regularly changing passwords enhances security and helps protect client confidentiality. This practice reduces the risk of unauthorized access to electronic medical records.
D. Avoid accessing information about clients admitted to other units: Avoiding access to information about clients in other units is an essential practice for maintaining confidentiality. Nurses should only access information relevant to their assigned clients to ensure compliance with privacy regulations.
E. Shred computer-generated client worksheets after use: Shredding printed materials containing client information is vital for protecting confidentiality. Proper disposal of sensitive documents prevents unauthorized access to client data and ensures compliance with privacy policies.
Correct Answer is D
Explanation
A. "Children are more resilient to the effects of poverty than adults": Children are particularly vulnerable to the effects of poverty due to inadequate nutrition, limited access to healthcare, and increased exposure to adverse childhood experiences, which can have long-term physical and mental health consequences.
B. "Minority groups living in poverty experience lower rates of chronic disease": Minority populations in poverty often experience higher rates of chronic illnesses such as diabetes, hypertension, and cardiovascular disease due to disparities in healthcare access, increased stress, and socioeconomic barriers to preventive care.
C. "Older adults are less likely to experience poverty due to receiving Social Security benefits": While Social Security provides financial assistance, many older adults still live in poverty due to high medical costs, inadequate retirement savings, and the rising cost of living, leading to food insecurity and difficulty affording medications.
D. "Adolescents living in poverty are more likely to be diagnosed with a conduct disorder": Poverty is associated with increased exposure to environmental stressors, family instability, and limited access to mental health resources, which can contribute to higher rates of behavioral disorders, including conduct disorder, in adolescents.
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