The nurse plans to use the Situation, Background, Assessment, and Recommendation (SBAR) format of communication during which interaction?

Obtaining clarification from a client's healthcare power-of-attorney.

Completing discharge teaching to a client and family members.

Reporting a change in a client's condition to the healthcare provider.

Offering therapeutic support and comfort to a grieving family.

Answer and Explanation

The Correct Answer is C

A. Obtaining clarification from a client's healthcare power-of-attorney:

While clear communication is important in this scenario, SBAR may not be necessary as the nurse is seeking information rather than providing a detailed report or recommendation.

B. Completing discharge teaching to a client and family members:

SBAR may not be the most suitable format for discharge teaching, as it is primarily used for communication between healthcare providers regarding a patient's condition and care plan. Discharge teaching typically involves providing comprehensive instructions and information in a manner tailored to the needs of the client and family members.

C. Reporting a change in a client's condition to the healthcare provider:

This is the most appropriate scenario for using the SBAR format. When communicating a change in a client's condition to the healthcare provider, the SBAR framework allows the nurse to provide a concise summary of the situation, relevant background information, assessment findings, and recommendations for further action.

D. Offering therapeutic support and comfort to a grieving family:

SBAR communication is not suitable for offering therapeutic support and comfort to a grieving family. This interaction requires empathy, active listening, and emotional support rather than a structured communication format like SBAR.

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Correct Answer is B

Explanation

A. Switch to a non-rebreather mask:

A non-rebreather mask delivers a higher concentration of oxygen (typically 10-15 L/min) compared to a nasal cannula. However, switching to a non-rebreather mask is a more drastic step that might not be necessary immediately. Other, simpler interventions should be considered first.

B. Verify placement of pulse oximeter:

Before making any changes, it's crucial to verify the accuracy of the oxygen saturation reading. The pulse oximeter might be misplaced or malfunctioning, leading to an inaccurate reading. This is an appropriate first action to ensure the reading is correct before deciding on further interventions.

C. Remove nasal cannula:

Removing the nasal cannula would decrease the client’s oxygenation further, worsening the situation. This is not an appropriate action when oxygen saturation is already low.

D. Increase the oxygen to 3 L/minute:

Increasing the oxygen flow rate is a reasonable intervention to improve oxygen saturation. However, this should typically be done after verifying the accuracy of the oxygen saturation reading. If the reading is correct, this is a valid next step to improve the client’s oxygenation.

A. "I am sorry to disturb you at a difficult time. This can walt until later." B. “While touching the client's forearm, asks, "Would you like to talk about it?" C. "This is a bad time. I can see you are upset. I can come back later." D. “Gives the client a hug and says, "It is okay to cry when you are sad."

Correct Answer is B

Explanation

A. "I am sorry to disturb you at a difficult time. This can wait until later."

This response acknowledges the client's distress but does not actively engage with the client's emotions or offer support. It also suggests postponing the assessment, which may not be necessary if the client is willing to discuss their feelings.

B. “While touching the client's forearm, asks, 'Would you like to talk about it?'"

This response demonstrates empathy and offers the client an opportunity to express their feelings if they wish to do so. By gently touching the client's forearm and asking if they would like to talk, the nurse conveys support and openness to the client's emotional needs.

C. "This is a bad time. I can see you are upset. I can come back later."

While this response acknowledges the client's emotions and offers to return later, it may not be the most helpful approach. It assumes that the client does not want to engage in conversation at that moment without giving them the opportunity to express their preferences.

D. “Gives the client a hug and says, 'It is okay to cry when you are sad.'"

While offering physical comfort like a hug can be appropriate in some situations, it's important to respect the client's personal boundaries and preferences, especially if they are in distress. Additionally, some clients may not feel comfortable with physical touch from healthcare providers. This response also assumes the client's emotions without directly addressing their needs or offering them an opportunity to express themselves verbally.

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The nurse plans to use the Situation, Background, Assessment, and Recommendation (SBAR) format of communication during which interaction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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