A nurse on a surgical unit is preparing to transfer a client to a rehabilitation facility. Which of the following information should the nurse include in the change-of-shift report?

The time the client received his last dose of pain medication

The belief that the client has a difficult relationship with his son

The steps to follow when providing wound care

The client's preferred time for bathing

Answer and Explanation

The Correct Answer is A

- A) Knowing the time the client received his last dose of pain medication is crucial for continuity of care, ensuring that the client receives their next dose on time and pain management is consistent.
- B) Personal beliefs about the client's relationships are not relevant to the medical care and should remain confidential unless it directly impacts the care plan.
- C) While important, the detailed steps for wound care will be included in the client's care plan and are not typically communicated during a change-of-shift report unless there is a change or an issue.
- D) The client's preferred time for bathing is a part of personal care preferences and, while important for client comfort, is not critical information for a change-of-shift report unless it affects immediate care needs.

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Correct Answer is A

Explanation

a. Decreased level of consciousness is a critical finding in a client with meningitis and may indicate worsening intracranial pressure or neurological deterioration, requiring immediate intervention.
b. While an increased temperature may indicate infection, it is not as immediately concerning as a decreased level of consciousness in a client with meningitis.
c. A generalized rash over the trunk may be present in some types of meningitis, but it is not as immediately urgent as a decreased level of consciousness.
d. Photophobia (sensitivity to light) is a common symptom of meningitis but may not require immediate intervention unless accompanied by other concerning neurological findings such as a decreased level of consciousness.

A. Help the AP assist the client with the transfer B. Demonstrate the proper client transfer technique to the AP C. Instruct the AP to request assistance when unsure about a task D. Refer the AP to the facility procedure manual

Correct Answer is B

Explanation

a. While helping the AP assist the client with the transfer is a hands-on approach, it might not address the root cause of the incorrect technique. Demonstrating the proper technique ensures that the AP understands the correct method for future transfers.
b. This option directly addresses the observed issue by providing immediate education and correction to the AP, helping to prevent future errors.
c. Instructing the AP to request assistance when unsure about a task is a good general practice, but in this specific scenario, addressing the incorrect technique is more pressing.
d. Referring the AP to the facility procedure manual might provide guidance, but it doesn't offer immediate correction or education on the observed error.

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A nurse on a surgical unit is preparing to transfer a client to a rehabilitation facility. Which of the following information should the nurse include in the change-of-shift report?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has meningitis. Which of the following findings should the nurse report to the provider immediately?

Correct Answer is A

Explanation

A nurse manager observes assistive personnel (AP) incorrectly transferring a client to the bedside commode. Which of the following actions should the nurse take first?

Correct Answer is B

Explanation

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