Level: Foundational
Difficulty: Easy
Subtopic: Respiratory gas exchange
NCLEX: A 45-year-old client in the emergency department is being evaluated for nursing care related to respiratory gas e…
Anatomy & Physiology I/II Physiological Adaptation
Case Study
A 45-year-old client in the emergency department is being evaluated for nursing care related to respiratory gas exchange. Assessment data include pain increases from 3/10 to 8/10 over 30 minutes. Which communication to the oncoming nurse or provider is most appropriate?
Question
A. "The client is doing fine; no issues to report."
B. Vague statements without measurable assessment data.
C. Blaming the client for nonadherence instead of stating facts.
D. SBAR format with specific objective findings, current status, and a clear recommendation.
B. Vague statements without measurable assessment data.
C. Blaming the client for nonadherence instead of stating facts.
D. SBAR format with specific objective findings, current status, and a clear recommendation.
Rationale
Correct answer: D. SBAR format with specific objective findings, current status, and a clear recommendation.
Rationale: Handoff and escalation require concise, objective communication such as SBAR with current assessment data.
Hint: Apply ABCs, client stability, and NCSBN clinical judgment steps before choosing an intervention.
Rationale: Handoff and escalation require concise, objective communication such as SBAR with current assessment data.
Hint: Apply ABCs, client stability, and NCSBN clinical judgment steps before choosing an intervention.