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?
Subtotal thyroidectomy performed one hour ago, receiving a unit of packed red blood cells.
Combined partial and full-thickness burns on the anterior chest three days ago. O2 saturation is 92%.
Renal transplant yesterday, complaining of flank pain and who states, "it's hot in here."
Nephrotic syndrome diagnosed 2 days ago, decreased serum protein level and mild edema.
The Correct Answer is D
Choice A Reason: A subtotal thyroidectomy is a major surgery that involves the removal of part of the thyroid gland. The client may have complications such as bleeding, infection, hypocalcemia, or vocal cord damage. The client also needs close monitoring of vital signs, blood transfusion, and airway patency. This client is not stable enough to be transferred to a general unit.
Choice B Reason: A combined partial and full-thickness burn is a serious injury that involves damage to the epidermis, dermis, and underlying tissues. The client may have complications such as infection, fluid loss, hypovolemia, shock, or respiratory distress. The client also needs wound care, pain management, fluid replacement, and oxygen therapy. This client is not stable enough to be transferred to a general unit.
Choice C Reason: A renal transplant is a major surgery that involves the replacement of a diseased kidney with a healthy one from a donor. The client may have complications such as rejection, infection, bleeding, thrombosis, or urinary obstruction. The client also needs immunosuppressive therapy, anti-infective therapy, fluid and electrolyte balance, and pain management. This client is not stable enough to be transferred to a general unit.
Choice D Reason: Nephrotic syndrome is a kidney disorder that causes excessive protein loss in the urine, leading to low serum protein levels and edema. The client may have complications such as infection, thromboembolism, or malnutrition. The client needs diuretic therapy, protein replacement, dietary modification, and infection prevention. This client is relatively stable and can be transferred to a general unit.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason: The ability to update the equipment each year may be desirable, but not the most important question to consider. Updating the equipment may incur additional costs and may not be necessary or feasible depending on the type and function of the equipment.
Choice B Reason: The number of departments that can use the equipment is the most important question to
consider, as it reflects the potential impact and benefit of the equipment for the organization. The more departments that can use the equipment, the more efficient and cost-effective it will be.
Choice C Reason: The cost of equipment is an important question to consider, but not the most important one. The cost of equipment should be compared with the expected benefits and outcomes of using the equipment, not just in terms of monetary value, but also in terms of quality of care and patient satisfaction.
Choice D Reason: The need for annual repair is an important question to consider, but not the most important one. The need for annual repair may indicate the reliability and durability of the equipment, but it may also depend on the frequency and intensity of use, and the availability and accessibility of maintenance services.
Correct Answer is D
Explanation
Choice A Reason: This is not the best action because it does not address the conflict between the client and the healthcare provider. The nurse should advocate for the client's wishes and seek a resolution that respects them.
Choice B Reason: This is not an appropriate action because it disregards the client's request and may give false hope. The nurse should respect the client's autonomy and dignity.
Choice C Reason: This is not a sufficient action because it does not ensure that the healthcare provider will comply with the client's request. The nurse should also involve other resources to help resolve the ethical dilemma.
Choice D Reason: This is the best action because it involves an impartial group of experts who can help mediate the situation and protect the client's rights. The nurse should seek ethical consultation when there is a disagreement about end-of-life decisions.
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