Question 1 See full question

Several hours into a shift, a nurse on a very busy medical-surgical unit privately asks

the charge nurse to change her assignment. She is frustrated because she has had to

devote so much time and energy to helping a newly licensed nurse provide discharge

teaching for clients with diabetes mellitus. The charge nurse should:

Correct response:

• offer to assist with the discharge teaching needs.

Explanation:

Staff members need to know the charge nurse is a supportive leader who respects their

honesty and stands behind them. By offering to help with discharge teaching, the

charge nurse is actively engaging with her staff at a time of need. Changing all the

assignments on this extremely busy floor would be counterproductive. Insisting that the

staff member follow through with her assignment disrespects her request and genuine

need. Providing a float nurse could help, but there are no guarantees a float nurse is

available.

Remediation:

• Discharge

Question 2 See full question

During chemotherapy, an oncology client has a nursing diagnosis of Impaired oral

mucous membrane related to decreased nutrition and immunosuppression secondary

to the cytotoxic effects of chemotherapy. Which nursing intervention is most likely to

decrease the pain of stomatitis

Correct response:

• Providing a solution of viscous lidocaine for use as a mouth rinse

Explanation:

To decrease the pain of stomatitis, the nurse should provide a solution of hydrogen

viscous lidocaine for the client to use as a mouth rinse. (Commercially prepared

mouthwashes contain alcohol and may cause dryness and irritation of the oral mucosa.)

The nurse also may administer systemic analgesics as ordered. Stomatitis occurs 7 to

10 days after chemotherapy begins; thus, stopping chemotherapy wouldn't be helpful or

practical. Instead, the nurse should stay alert for this potential problem to ensure prompt

treatment. Monitoring platelet and leukocyte counts may help prevent bleeding and

infection but wouldn't decrease pain in this highly susceptible client. Checking for signs

and symptoms of stomatitis also wouldn't decrease the pain.

Remediation: