The charge nurse of a critical care unit must transfer a client to a general unit to make a bed available for an incoming trauma client. Based on the information provided, which client is best for the nurse to recommend for transfer to the general unit?

Choice A Reason: Managed healthcare plans do not pay for any in-hospital medical evaluations is not the best information for the nurse to provide this family. This statement is false and misleading. Managed healthcare plans may cover in-hospital medical evaluations if they are deemed medically necessary and authorized by the plan. The nurse should not discourage the family from seeking appropriate care for their mother based on inaccurate information.

Choice B Reason: Healthcare costs are escalating because clients want to have diagnostic testing conducted in the hospital is not the best information for the nurse to provide this family. This statement is irrelevant and insensitive. Healthcare costs are influenced by many factors, such as technology, inflation, regulation, and demand. The nurse should not blame the clients for wanting to have diagnostic testing done in the hospital, which may be essential for their health and well-being.

Choice C Reason: The client is grieving normally in response to her husband's death and hospitalization is not necessary is not the best information for the nurse to provide this family. This statement is presumptuous and dismissive. Grief is a complex and individual process that may affect people differently. The nurse should not assume that the client's confusion and disorientation are normal signs of grief, which may mask underlying medical conditions that require evaluation and treatment.

Choice D Reason: Managed care providers have mandatory pre-certification requirements for hospitalization is the best information for the nurse to provide this family. This statement is factual and helpful. Pre-certification is a process by which managed care providers review and approve proposed hospital admissions, procedures, or services before they are performed. The nurse should inform the family that they need to obtain pre-certification from their mother's plan before admitting her to the hospital, or they may face denial of coverage or higher out-of-pocket costs.

Choice A Reason: This is the correct answer because the acuity level of the clients reflects their complexity and intensity of care needs. The higher the acuity level, the more time and resources are required to provide safe and quality care. The charge nurse should consider the acuity level of the clients when determining the appropriate nurse-to-client ratio and staffing needs.

Choice B Reason: The physicians' plans to perform procedures on the unit is not the most important information for the charge nurse to consider because it does not directly affect the nursing workload or staffing requirements. The charge nurse should coordinate with the physicians and other departments to ensure that the procedures are scheduled and performed safely and efficiently.

Choice C Reason: The number of clients leaving the unit for diagnostic tests is not the most important information for the charge nurse to consider because it does not indicate the level of care that the clients need or receive. The charge nurse should ensure that the clients are prepared and accompanied for their tests and that their care is continued and monitored on their return.

Choice D Reason: The skill level of the personnel staffing the unit is not the most important information for the charge nurse to consider because it does not reflect the actual demand or supply of nursing care. The charge nurse should assign and delegate tasks according to the personnel's skill level and scope of practice but also consider other factors such as client acuity, availability, and preference.