A nurse is caring for an adolescent who has a brain tumor and is receiving hospice care. The nurse is providing counseling regarding the stages of grief, which of the following statements by the adolescent is an example of the bargaining stage?

Rationale:

A. Decide which clients should be transported for a higher level of care: Determining transport priorities is usually the responsibility of the incident command or emergency response team, not individual unit nurses. Unit nurses provide patient assessments and recommendations but do not independently make these critical decisions.

B. Act as a spokesperson to provide information to the media: Communication with the media is handled by designated hospital public relations or administration personnel to ensure consistent and accurate information. Unit nurses are not responsible for media interactions during a disaster.

C. Recommend to the provider a list of clients for early discharge: Unit nurses are familiar with clients’ conditions, stability, and care needs, making them well-suited to recommend which clients can be safely discharged early. This helps prioritize resources and bed availability during a disaster while maintaining patient safety.

D. Determine the need for additional providers: Assessing staffing needs is the responsibility of the nurse manager or disaster coordinator. Unit nurses provide information about patient care demands but do not make staffing deployment decisions during an emergency.

Rationale:

A. Uses the TPN IV tubing to administer the client's next dose of antibiotics: TPN lines should never be used for administering other medications or fluids because this increases the risk of contamination, infection, and incompatibility reactions. TPN requires dedicated IV access to maintain sterility and prevent complications such as sepsis.

B. Plans for a check of the client's fingerstick glucose level every 6 hr: Monitoring blood glucose regularly is essential during TPN administration because high dextrose concentrations can cause hyperglycemia. Checking every 4–6 hours aligns with safe monitoring practices and does not require intervention.

C. Gradually increases the TPN infusion rate each hour until the prescribed rate is achieved: Slowly titrating the TPN rate helps the client adjust to the high glucose content and reduces the risk of hyperglycemia or fluid overload. This demonstrates safe and appropriate administration practice.

D. Schedules a bag and tubing change for 24 hr after the start of the infusion: Changing the TPN solution and tubing every 24 hours is consistent with infection control guidelines. This action maintains sterility and prevents microbial growth, reflecting proper technique.