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 steps to follow when providing wound care
The client's preferred time for bathing
The belief that the client has a difficult relationship with his son
The Correct Answer is B
Choice A reason: This is not the information that the nurse should include in the change-of-shift report. The time the client received his last dose of pain medication is not relevant to the transfer to the rehabilitation facility. The nurse should document the pain medication administration in the medication record and communicate it to the receiving nurse.
Choice B reason: This is the information that the nurse should include in the change-of-shift report. The steps to follow when providing wound care are important to ensure the continuity and quality of care for the client. The nurse should explain the type, location, and condition of the wound, the dressing materials and frequency, and any signs of infection or complications.
Choice C reason: This is not the information that the nurse should include in the change-of-shift report. The client's preferred time for bathing is not essential to the transfer to the rehabilitation facility. The nurse should respect the client's preferences and routines, but they are not a priority for the report.
Choice D reason: This is not the information that the nurse should include in the change-of-shift report. The belief that the client has a difficult relationship with his son is not based on facts and may be biased or inaccurate. The nurse should avoid making assumptions or judgments about the client's family dynamics and focus on the objective data and the client's needs.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Asking the client's daughter to interpret the conversation is not a correct action, as it may compromise the accuracy and confidentiality of the information. The nurse should not use family members or friends as interpreters, as they may have biases, emotions, or personal agendas that could interfere with the communication.
Choice B reason: Talking loudly while facing the client is not a correct action, as it may be perceived as rude or aggressive by the client. The nurse should not assume that the client can understand them better by increasing the volume or using gestures, as these may have different meanings in different cultures.
Choice C reason: Accessing a language line to interpret what is being said is the correct action, as it ensures that the communication is clear, accurate, and respectful. The nurse should use a qualified interpreter who is familiar with the medical terminology and the cultural context of the client.
Choice D reason: Using a bilingual dictionary to translate is not a correct action, as it may be time-consuming and ineffective. The nurse should not rely on a dictionary or a translation app, as they may not capture the nuances or expressions of the language. The nurse should also avoid using medical jargon or slang that may not be understood by the client.
Correct Answer is C
Explanation
Choice A reason: Using condoms during treatment for chlamydia is important for preventing transmission, but this is not the priority nursing action. The most critical step for the nurse is fulfilling the legal and public health obligation to report the infection to the health department, as chlamydia is a reportable sexually transmitted infection.
Choice B reason: This is not the correct choice because this action is not appropriate for clients who have chlamydia. Chlamydia is caused by bacteria, not viruses, so antiviral creams are ineffective and unnecessary. The nurse should administer the prescribed antibiotics and monitor the client for any adverse reactions or complications.
Choice C reason:Reporting the infection to the local health department is correct. Chlamydia is a reportable disease in all states, and this step ensures proper public health tracking, partner notification, and prevention of further spread. This is a nurse’s responsibility in accordance with infection control and community health regulations.
Choice D reason: This is not the correct choice because this action is not indicated for clients who have chlamydia. Contact precautions are used to prevent the transmission of infections that are spread by direct or indirect contact with the client or their environment. Chlamydia is not spread by contact, but by sexual intercourse. The nurse should use standard precautions, which include hand hygiene and wearing gloves, when caring for the client.
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