You are the nursing supervisor on the 11 PM to 7 AM shift. When making rounds, the charge nurse on the unit reports that one of the patients is dyspneic
What action would be expected from a nurse in the expertise stage of clinical competence when assessing shortness of breath in a patient?
a. Recognizes the patient may have pulmo-nary edema and orders (or asks the physi-cian for an order) an IVP diuretic
b. Places a patient complaining of shortness of breath in high-Fowler's position after hearing coarse crackles and rhonchi and obtaining a pulse oxygenation of 88%
c. Increases the oxygen concentration
d. Notifies the instructor of the patient's complaints
ANS: A
The expert nurse typically is the advanced nurse practitioner who has the ability to make clinical judgments and direct care. The other options are appropriate for a nurse at a different level of nursing.
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