A nurse is planning to use the SBAR communication tool when giving on coming shift report. Which of the following statements should the nurse include in the R step?

"There are no provider's prescriptions available."

"The client should be seen by a neurologist."

"The client is disoriented. Pupils are slow to respond to light."

"The client was found unconscious on the floor in her home."

Answer and Explanation

The Correct Answer is B

A. "There are no provider's prescriptions available." This statement is about the current situation or background, not a recommendation.
B. "The client should be seen by a neurologist." The Recommendation (R) step involves suggesting actions or solutions, such as recommending that the client be seen by a neurologist.

C. "The client is disoriented. Pupils are slow to respond to light." This statement belongs in the Assessment (A) step as it describes the nurse’s clinical findings.
D. "The client was found unconscious on the floor in her home." This statement provides background information (B) about the client’s situation.

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Correct Answer is D

Explanation

A. Tell the client they are wrong: Telling the client they are wrong is dismissive and does not foster a therapeutic relationship.
B. Ask the client why they think that way: Asking the client why they think that way may provide insight, but it does not clarify the difference between an allergy and an intolerance.
C. Ignore the comment and proceed with the teaching plan: Ignoring the comment is not appropriate as it fails to address the client’s concern and provide necessary education.
D. Explain to the client the difference between medication intolerance and allergy: This response provides education and clarifies the difference, helping the client understand their reaction to the medication.

A. Principles of nursing practice B. Nursing Scope and standards of practice C. American Nurses Association posting statements. D. Code of Ethics for Nurses from the ANA

Correct Answer is D

Explanation

A. Principles of nursing practice: While important, the principles of nursing practice are more general and do not specifically address confidentiality as comprehensively as the Code of Ethics.
B. Nursing Scope and standards of practice: These outline the expectations for professional practice but are not as focused on confidentiality as the Code of Ethics.
C. American Nurses Association posting statements: This is not a recognized document for guiding professional standards related to confidentiality.
D. Code of Ethics for Nurses from the ANA: The Code of Ethics for Nurses from the American Nurses Association (ANA) provides guidelines on maintaining patient confidentiality and professional conduct.

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A nurse is planning to use the SBAR communication tool when giving on coming shift report. Which of the following statements should the nurse include in the R step?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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