A nurse on an obstetrics-gynecology unit is planning care for four clients after receiving change of shift report. Which of the following clients should the nurse assess first?
A client who is 4 days postpartum and has mastitis
A client who had a bilateral tubal ligation 12 hr previously
A client admitted 1 hr ago for an ectopic pregnancy
A client who is a 1 day postpartum after a late term miscarriage
The Correct Answer is C
Rationale:
A. A client who is 4 days postpartum and has mastitis should be assessed, but this condition is less acute compared to the others.
B. A client who had a bilateral tubal ligation 12 hr previously requires post-operative monitoring, but this is less urgent than the client with an ectopic pregnancy.
C. A client admitted 1 hr ago for an ectopic pregnancy is the priority as this condition can be life-threatening and requires immediate assessment.
D. A client who is 1 day postpartum after a late-term miscarriage requires care, but the immediacy is less than that of the ectopic pregnancy client.
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Correct Answer is B
Explanation
Rationale:
A. "If you let us know ahead of time that you plan to perform a procedure, we could do better job of having the supplies available." may be perceived as placing blame and does not address the immediate concern of the provider's anger.
B. "It must be very frustrating when you don't have what you need to perform the procedure." acknowledges the provider's frustration and validates their feelings, which can help de-escalate the situation and improve communication.
C. "I will help you with this procedure instead of the staff nurse." does not address the underlying issue and might not resolve the conflict or improve the situation.
D. "You should think about how you make others feel when you lose your temper." is confrontational and may escalate the situation further rather than resolving it.
Correct Answer is C
Explanation
Rationale:
A. False imprisonment involves restricting a person’s freedom of movement, not administering medication against their will.
B. Assault involves the threat of harm, not the actual administration of medication.
C. Battery is the intentional touching of another person without consent, which includes administering medication to a competent person who has refused it.
D. Negligence involves failure to meet the standard of care, but administering medication against a patient’s wishes is more accurately described as battery.