Coordination of Care 3

Question 1

A nurse working in a medical-surgical unit receives shift report and has four patients. Which patient should the nurse assess first?

Accepted Answer

A 48-year-old patient who returned from bronchoscopy 30 minutes ago and has a new oxygen saturation of 89%

Answer

An oxygen saturation of 89% in a post-bronchoscopy patient is a potential airway emergency requiring immediate assessment. Bronchoscopy carries risks of laryngospasm, bronchospasm, and bleeding. This is a life-threatening priority (ABCs — airway/breathing first).

Question 2

A charge nurse is delegating tasks to a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP). Which task is appropriate to delegate to the UAP?

Accepted Answer

Measuring and recording urine output for a patient with a Foley catheter

Answer

Measuring and recording urine output for a patient with a Foley catheter is a task that falls within the UAP's scope of practice. It does not require clinical judgment or nursing assessment skills. Assessment, medication administration, and initial wound care require licensed nursing judgment.

Question 3

A nurse is preparing to discharge a 68-year-old patient with newly diagnosed heart failure. Which action best ensures care coordination across the continuum?

Accepted Answer

Schedule a follow-up appointment with the cardiologist and arrange home health nursing visits

Answer

Effective discharge planning for heart failure requires coordinated follow-up care including a timely cardiology appointment (ideally within 7 days) and home health nursing to monitor weight, symptoms, and medication adherence. This addresses continuity of care and reduces 30-day readmission rates.

Question 4

A nurse is receiving a hand-off report using the SBAR format. Which information belongs in the 'Background' section?

Accepted Answer

The patient's medical history, admitting diagnosis, and relevant lab results

Answer

In SBAR communication, Background includes the patient's medical history, admitting diagnosis, current medications, allergies, and pertinent lab/diagnostic results. This provides the context needed to understand the current situation.

Question 5

A nurse is caring for a patient whose family demands to speak with the surgeon immediately regarding the patient's prognosis. The nurse knows the surgeon is currently in the operating room. What is the most appropriate response?

Accepted Answer

Contact the surgeon's office to leave a message and offer to have the charge nurse speak with the family

Answer

The nurse should take action to meet the family's needs while respecting the patient currently in surgery. Contacting the surgeon's office and having the charge nurse or attending physician speak with the family is the appropriate coordination response — it addresses the family's urgent need without compromising another patient's care.

NCLEX Practice Test

NCLEX Practice Test

Coordination of Care 3