The charge nurse in the emergency department assigns a client to a new nurse who has been off orientation for a week. Which client assignment is most appropriate?

Question

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A fractured clavicle (collarbone) is not uncommon in children age <10 years and is usually treated conservatively. A new nurse should be competent in performing the basic skills needed to care for a client with a musculoskeletal injury (eg, pain and neurovascular assessments, analgesia administration, sling application). The 8-year-old client, who has minimal pain as indicated by the score of 2 on the FACES pain assessment tool, is the most stable. As a result, this is the most appropriate assignment for the new nurse. (Option A) A seizure can be associated with a fever-related illness (febrile seizure). This client who is very irritable and has fever may have an underlying serious infection such as meningitis and should undergo diagnostic testing (eg, blood cultures, imaging, lumbar puncture). Therefore, this is not an appropriate assignment. (Option C) A peak flow meter measures airflow out of the lungs. The client who has a severely reduced peak expiratory flow rate (<50% of personal best) needs emergency intervention and is not an appropriate assignment. (Option D) The client with dyspnea and a maculopapular drug rash is most likely experiencing an antibiotic-related allergic reaction, which can range from mild to life-threatening anaphylaxis. This client is not an appropriate assignment. Educational objective: A new nurse should be competent in performing the basic skills needed to care for a client with a musculoskeletal injury (eg, pain and neurovascular assessments).

The Charge Nurse in the Emergency Department Assigns a Client