What is the priority action of the nurse as the assessment process is started for a patient who came to the hospital with acute shortness of breath?

Reassure the patient that the shortness of breath will be relieved shortly.

Pull the curtain around the bed and ensure patient privacy.

Tell the patient that the physician will be in shortly to start treatment.

Listen to the patient’s lung sounds and check the pulse oximetry level.

Answer and Explanation

The Correct Answer is D

Choice A reason: This is an incorrect choice because reassuring the patient that the shortness of breath will be relieved shortly is not the priority action of the nurse as the assessment process is started. Reassurance is a communication technique that involves expressing confidence or support to the patient and alleviating their anxiety or fear. However, it is not the most urgent action for a patient with acute shortness of breath, which is a sign of respiratory distress that can have various causes and complications. The nurse should first assess the patient's condition and provide oxygen therapy if needed.

Choice B reason: This is an incorrect choice because pulling the curtain around the bed and ensuring patient privacy is not the priority action of the nurse as the assessment process is started. Privacy is a patient right that involves protecting the patient's personal information and dignity. However, it is not the most urgent action for a patient with acute shortness of breath, which is a sign of respiratory distress that can have various causes and complications. The nurse should first assess the patient's condition and provide oxygen therapy if needed.

Choice C reason: This is an incorrect choice because telling the patient that the physician will be in shortly to start treatment is not the priority action of the nurse as the assessment process is started. Communication is a nursing skill that involves informing the patient of the plan of care and collaborating with other health care professionals. However, it is not the most urgent action for a patient with acute shortness of breath, which is a sign of respiratory distress that can have various causes and complications. The nurse should first assess the patient's condition and provide oxygen therapy if needed.

Choice D reason: This is the correct choice because listening to the patient’s lung sounds and checking the pulse oximetry level is the priority action of the nurse as the assessment process is started. Assessment is a nursing process that involves collecting and analyzing data about the patient's health status and needs. Listening to the patient’s lung sounds and checking the pulse oximetry level are essential steps to evaluate the patient's respiratory function and oxygenation. These actions can help the nurse to identify the possible cause and severity of the patient's shortness of breath and to initiate appropriate interventions.

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Correct Answer is B

Explanation

Choice A reason: This is an incorrect choice because the hospital is affiliated with a nationally recognized medical school is not a characteristic that qualifies the hospital for Magnet Recognition status. Magnet Recognition status is a credential that recognizes excellence in nursing practice and quality of care. The hospital's affiliation with a medical school is not related to its nursing performance or outcomes.

Choice B reason: This is the correct choice because the hospital participates in nursing research and implements the findings is a characteristic that qualifies the hospital for Magnet Recognition status. Magnet Recognition status is a credential that recognizes excellence in nursing practice and quality of care. The hospital's participation in nursing research and implementation of the findings demonstrates its commitment to evidence-based practice and innovation in nursing.

Choice C reason: This is an incorrect choice because the hospital is owned by a religious order that offers daily prayer services is not a characteristic that qualifies the hospital for Magnet Recognition status. Magnet Recognition status is a credential that recognizes excellence in nursing practice and quality of care. The hospital's ownership and religious affiliation are not related to its nursing performance or outcomes.

Choice D reason: This is an incorrect choice because the hospital receives federal grant funding for advanced medical research is not a characteristic that qualifies the hospital for Magnet Recognition status. Magnet Recognition status is a credential that recognizes excellence in nursing practice and quality of care. The hospital's funding and research activities are not related to its nursing performance or outcomes.

A. The patient has a history of noncompliance with prescribed therapeutic regimens. B. The patient must be closely monitored in an intensive care unit. C. Prevention of septic shock is not a measurable patient outcome. D. Both nursing and physician-prescribed interventions are required.

Correct Answer is D

Explanation

Choice A reason: This is an incorrect choice because the patient has a history of noncompliance with prescribed therapeutic regimens is not a reason why this nursing diagnosis is considered to be a collaborative problem. A collaborative problem is a potential or actual health problem that requires the intervention of multiple health care professionals from different disciplines to achieve optimal patient outcomes. The patient's history of noncompliance is not related to the nature of the problem or the type of intervention required.

Choice B reason: This is an incorrect choice because the patient must be closely monitored in an intensive care unit is not a reason why this nursing diagnosis is considered to be a collaborative problem. A collaborative problem is a potential or actual health problem that requires the intervention of multiple health care professionals from different disciplines to achieve optimal patient outcomes. The patient's need for close monitoring is not related to the nature of the problem or the type of intervention required.

Choice C reason: This is an incorrect choice because prevention of septic shock is not a measurable patient outcome is not a reason why this nursing diagnosis is considered to be a collaborative problem. A collaborative problem is a potential or actual health problem that requires the intervention of multiple health care professionals from different disciplines to achieve optimal patient outcomes. The measurability of the patient outcome is not related to the nature of the problem or the type of intervention required.

Choice D reason: This is the correct choice because both nursing and physician-prescribed interventions are required is a reason why this nursing diagnosis is considered to be a collaborative problem. A collaborative problem is a potential or actual health problem that requires the intervention of multiple health care professionals from different disciplines to achieve optimal patient outcomes. The problem of septic shock is a complex and life-threatening condition that involves multiple organ systems and requires both medical and nursing interventions to prevent, treat, and monitor the patient's status.

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What is the priority action of the nurse as the assessment process is started for a patient who came to the hospital with acute shortness of breath?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which characteristic qualifies the hospital for Magnet Recognition status?

Correct Answer is B

Explanation

The nurse is caring for a patient with sepsis. The nurse includes potential complication: septic shock in the plan of care. Why is this nursing diagnosis considered to be a collaborative problem?

Correct Answer is D

Explanation

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