An experienced medical-surgical nurse chooses to work in obstetrics. Which level of proficiency is the nurse upon initial transition to the obstetrical floor?
Competent
Proficient
Novice
Advanced beginner
The Correct Answer is C
A. Competent nurses have typically worked in a specific area for 2-3 years, developing an understanding of patient care specific to that field.
B. Proficient nurses have advanced understanding and experience, allowing them to see care situations as whole parts rather than in separate steps.
C. In a new specialty area, the nurse is considered a novice, as they lack experience and expertise in obstetrics despite previous nursing experience.
D. Advanced beginners have some experience but still need support; however, this would apply only if the nurse had some previous obstetric experience.
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Correct Answer is B
Explanation
A. "Risk for infection related to chest x-ray procedure" is not an appropriate diagnosis because a chest x-ray is a diagnostic tool, and pneumonia itself is the concern for infection.
B. "Impaired gas exchange related to alveolar-capillary membrane changes" is correct as pneumonia causes inflammation and consolidation in the lungs, which directly impacts gas exchange.
C. "Risk for deficient fluid volume related to dehydration" does not apply specifically to pneumonia unless the patient presents signs of dehydration, which is not indicated in the scenario.
D. "Ineffective breathing pattern related to pneumonia" could also be a valid diagnosis, but the primary concern given the information provided is gas exchange impairment.
Correct Answer is D
Explanation
A. Explaining the importance of morning hygiene may overlook the patient's established routine and could create resistance.
B. Stating that morning baths are the "normal" routine does not acknowledge the patient's preferences, potentially causing the patient to feel invalidated.
C. Canceling hygiene for the day disregards the patient's needs and preferred routine.
D. Deferring the bath until evening respects the patient’s routine and preference, promoting patient-centered care and improving comfort and compliance with hygiene practices.