Nurses working on a surgical unit are concerned about a physician's treatment of clients during invasive procedures, such as dressing changes and insertion of IV lines. Clients are often crying during the procedures, and the physician is usually unconcerned or annoyed by the client's response. To resolve this problem, the nurses should perform these actions in which order? (Arrange from the first action on top to the last on the bottom.)

Document concerns and report them to the charge nurse.

Talk to the physician as a group in a non-confrontational manner.

Submit a written report to the Director of Nursing.

Contact the hospital's Chief of Medical Services.

File a formal complaint with the state medical board.

Answer and Explanation

The Correct Answer is A,B,C,D,E

Choice A reason: The first step is to document the concerns for an accurate record and report them to the charge nurse to address the issue internally within the unit.

Choice B reason: If the issue is not resolved at the unit level, the next step is to discuss the matter with the physician directly as a group, which can lead to a resolution without escalating the situation.

Choice C reason: Should the problem persist, submitting a written report to the Director of Nursing is appropriate to involve higher management and seek further action.

Choice D reason: If the issue remains unresolved after involving the Director of Nursing, contacting the hospital's Chief of Medical Services is the next step to escalate the matter within the hospital's administrative structure.

Choice E reason: As a last resort, if all internal avenues have been exhausted and the problem persists, filing a formal complaint with the state medical board is necessary to address potential violations of professional conduct.

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Correct Answer is ["A","B","D","E","G"]

Explanation

Choice A reason: Learned coping skills are essential for managing the psychological aspects of obesity and the lifestyle changes required after bariatric surgery. The patient’s engagement with a psychologist and learning coping techniques can help her deal with postoperative stress and maintain the lifestyle modifications necessary for long-term success.
Choice B reason: A psychological assessment helps in understanding the patient’s readiness for surgery and ability to adhere to the postoperative regimen. It can identify any psychological barriers to weight loss and ensure that the patient is mentally prepared for the changes ahead.
Choice C reason: The term “unstained weight loss” seems to be a typographical error, possibly intending to mean “sustained weight loss.” However, sustained weight loss is not applicable in this context as the patient has not yet undergone surgery. Therefore, it does not contribute to the chances of positive outcomes post-surgery.
Choice D reason: Recovery close to the hospital can be beneficial as it allows for easier follow-up visits and quicker access to medical care if complications arise. It also reduces the stress associated with travel for postoperative care.
Choice E reason: Recent weight loss prior to surgery is a positive indicator as it shows the patient’s commitment to lifestyle changes and weight management. It can also reduce surgical risk and improve postoperative recovery1.
Choice F reason: While age can be a factor in surgical risk, there is no direct correlation between the client’s age and the chance for positive outcomes after bariatric surgery. Therefore, it is not a contributing factor in this scenario.
Choice G reason: Family support is crucial for a patient’s recovery and long-term success after bariatric surgery. The patient’s plan to go home with her mother, who lives close to the hospital, indicates a strong support system which can help with adherence to dietary and lifestyle changes.
Choice H reason: A high BMI, such as 41.4 kg/m^2, indicates severe obesity, which is the reason for undergoing bariatric surgery. While it is a factor for considering surgery, it does not inherently increase the chance for positive outcomes post-surgery.

A. Initiate bilateral intermittent sequential pneumatic compression devices. B. Place an indwelling urinary catheter and measure strict intake and output. C. Notify the stroke team to assist with acute assessment and management. D. Administer aspirin to prevent further clot formation and platelet clumping.

Correct Answer is C

Explanation

Choice A reason: While pneumatic compression devices are used for DVT prevention, they are not the immediate intervention for suspected stroke.

Choice B reason: Placing an indwelling urinary catheter is not the first-line intervention for a patient with suspected stroke symptoms.

Choice C reason: Notifying the stroke team is the most appropriate action as the patient's symptoms suggest a possible stroke, requiring urgent evaluation and management.

Choice D reason: Aspirin may be used in the management of stroke, but only after a stroke has been confirmed and not as an immediate intervention.

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Naxlex Comprehensive Predictor Exams

Patient Data Exhibits The nurse reviews the client data. What increases the client's chance for positive outcomes after the completion of the bariatric surgery? Select all that apply.

Correct Answer is ["A","B","D","E","G"]

Explanation

Correct Answer is C

Explanation

Which nursing responsibility is related to health promotion and teaching for the client with rheumatoid arthritis?

Patient Data Exhibits The nurse reviews the assessment findings along with the physician orders. Which immediate interventions would the nurse initiate? Select all that apply.

A new mother on the postpartum unit runs out of the room screaming that her newborn infant's crib is empty and the baby is missing. Which action should the nurse take first?

Patient Data Exhibits Which interventions are indicated to promote positive outcomes for the patient? Select all that apply.

The nurse administers an antibiotic to a client with a respiratory tract infection. To evaluate the medication's effectiveness, what laboratory values should the nurse monitor? Select all that apply.

After receiving a change of shift report for clients on a medical-surgical unit, which activity should the nurse delegate to the practical nurse (PN)?

When caring for a client with full-thickness burns to both lower extremities, which assessment findings warrant immediate intervention by the nurse? Select all that apply.