A nurse from the labor and delivery unit is assigned to float to a medical-surgical unit. Which of the following actions should the nurse take first?
Request orientation to the medical-surgical unit.
Refer to the assigned resource nurse regarding client assignments.
Inform the nursing supervisor of the lack of experience on the medical-surgical unit.
Clarify competencies with the medical-surgical charge nurse.
The Correct Answer is D
Choice A reason: This is not the correct choice because requesting orientation to the medical-surgical unit is not the first action the nurse should take. Orientation is a process that takes time and planning, and it may not be feasible or necessary for a temporary assignment. The nurse should first ensure that they are competent to perform the tasks and procedures required on the medical-surgical unit.
Choice B reason: This is not the correct choice because referring to the assigned resource nurse regarding client assignments is not the first action the nurse should take. The resource nurse is a person who can provide guidance and support to the nurse during the shift, but they are not responsible for determining the nurse's competencies or assigning clients. The nurse should first communicate with the charge nurse, who is the leader of the unit and has the authority to assign clients according to the nurse's skills and experience.
Choice C reason: This is not the correct choice because informing the nursing supervisor of the lack of experience on the medical-surgical unit is not the first action the nurse should take. The nursing supervisor is a person who can oversee the staffing and operations of the nursing units, but they are not directly involved in the clinical care of the clients or the education of the staff. The nurse should first consult with the charge nurse, who can assess the nurse's competencies and provide appropriate resources and education.
Choice D reason: This is the correct choice because clarifying competencies with the medical-surgical charge nurse is the first action the nurse should take. The charge nurse is a person who can evaluate the nurse's skills and knowledge, assign clients according to the nurse's level of expertise, and provide orientation and training as needed. The nurse should be honest and proactive in communicating their competencies and learning needs to the charge nurse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Diminished hand-to-mouth coordination is not a finding that requires a referral to speech-language pathology, as it is related to the motor function of the upper extremities. The nurse should refer the client to physical therapy or occupational therapy for this issue.
Choice B reason: Impaired voluntary cough is a finding that requires a referral to speech-language pathology, as it indicates a possible dysfunction of the swallowing mechanism or the vocal cords. The nurse should refer the client to speech-language pathology for a swallowing evaluation and intervention.
Choice C reason: Altered level of consciousness is not a finding that requires a referral to speech-language pathology, as it is related to the neurological function of the brain. The nurse should monitor the client's Glasgow Coma Scale score and report any changes to the provider.
Choice D reason: Unilateral ptosis is not a finding that requires a referral to speech-language pathology, as it is related to the cranial nerve function of the eye. The nurse should assess the client's pupillary response and eye movements and report any abnormalities to the provider.
Correct Answer is A
Explanation
Choice A reason: The client's current location and status are important information that the nurse should include in the report, as they affect the continuity and quality of care. The nurse should also inform the oncoming nurse of the reason and results of the chest x-ray, if available.
Choice B reason: The client's partner's visit is not relevant information that the nurse should include in the report, as it does not affect the client's care plan or outcomes. The nurse should focus on the client's clinical data and needs, not their personal or social information.
Choice C reason: The client's routine vital signs are not specific information that the nurse should include in the report, as they do not reflect the client's current condition or changes. The nurse should provide the actual vital signs values and trends, as well as any interventions or responses related to them.
Choice D reason: The client's occupation is not pertinent information that the nurse should include in the report, as it does not influence the client's care plan or outcomes. The nurse should respect the client's privacy and confidentiality and avoid disclosing unnecessary or sensitive information.
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