A nurse asks the assistive personnel (AP) to take a specimen to the laboratory and the AP refuses. Which of the following actions should the nurse take?

Complete an incident report.

Take the specimen to the laboratory.

Report the AP to the charge nurse.

Ask the AP about her concerns with the assignment.

Answer and Explanation

The Correct Answer is D

A.   Completing an incident report may be necessary if the refusal could potentially impact patient care or if there are policies or procedures in place that require documenting such incidents. It helps to document the details of the refusal and any subsequent actions taken.
B.   If the AP refuses to take the specimen, the nurse may need to take responsibility for ensuring the specimen is delivered to the laboratory promptly. This ensures that patient care activities are not delayed and that necessary diagnostic tests are performed in a timely manner.
C.   Reporting the refusal to the charge nurse or supervisor is appropriate, especially if there are concerns about the AP's behavior or if it is part of the facility's policy to escalate such incidents. The charge nurse can then address the situation and determine the appropriate course of action.

D.   Communicating with the AP to understand their concerns is essential. It allows the nurse to clarify any misunderstandings, address any issues or barriers the AP may have, and potentially resolve the situation collaboratively. It's important to listen to the AP's perspective and provide clarification or reassurance if needed.

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Correct Answer is D

Explanation

A. PaCO2 (partial pressure of carbon dioxide) reflects the respiratory component of acid-base balance. In metabolic acidosis, the respiratory system compensates by increasing ventilation to decrease PaCO2 (hyperventilation). Therefore, PaCO2 is typically below normal (less than 35-45 mm Hg) in metabolic acidosis, not above 45 mm Hg.
B. HCO3 (bicarbonate) is a buffer that helps regulate pH in the body. In metabolic acidosis, there is a primary decrease in HCO3 due to either increased acid production (e.g., lactic acidosis, ketoacidosis) or decreased acid elimination (e.g., renal failure). Therefore, HCO3 is typically below normal (< 22-26 mEq/L) in metabolic acidosis, not above 26 mEq/L.
C. PaO2 (partial pressure of oxygen) measures the oxygen level in the blood. It is not directly related to the diagnosis of metabolic acidosis. Low PaO2 levels may indicate respiratory dysfunction or impaired gas exchange but are not specific to metabolic acidosis.
D. pH below 7.35 indicates acidosis. In metabolic acidosis, the primary defect is a decrease in blood pH due to an excess of acids or a loss of bases. The pH typically decreases below the normal range of 7.35-7.45 in metabolic acidosis.

A. The client has a fever. B. The client has possible hemorrhage or bleeding. C. The client has chronic obstructive pulmonary disease (COPD). D. The client has calcium channel blocker medicate prescribed.

Correct Answer is D

Explanation

A. Fever can cause tachycardia (increased heart rate) rather than bradycardia. It is not typically associated with slowing of the heart rate unless there are other complicating factors such as severe infection or medication side effects.
B. Significant blood loss can lead to hypovolemia (low blood volume), which can result in bradycardia as a compensatory mechanism to maintain blood pressure. However, the blood pressure in this scenario is

normal (120/80), which makes severe hemorrhage less likely unless compensated by fluid resuscitation or other factors.
C. COPD can cause chronic hypoxia and respiratory acidosis, which can lead to chronic respiratory compensation and potentially bradycardia. However, COPD alone is less likely to cause bradycardia in the absence of severe exacerbation or other complicating factors.
D. Calcium channel blockers (CCBs) are medications commonly prescribed for conditions such as hypertension, angina, and arrhythmias. They work by blocking calcium channels in cardiac and smooth muscle cells, resulting in decreased heart rate and vasodilation. Bradycardia is a known side effect of CCBs, especially when taken in excess or in combination with other medications that affect heart rate.

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A nurse asks the assistive personnel (AP) to take a specimen to the laboratory and the AP refuses. Which of the following actions should the nurse take?

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