In which of the following situations would the nurse be most justified in implementing trial-and-error problem solving?
A) The nurse is attempting to landmark an obese client's apical pulse.
B) The nurse is attempting to determine the range of motion of a client's hip joint following hip surgery.
C) The nurse is attempting to determine which PRN (as needed) analgesic to offer a client who is in pain.
D) The nurse is attempting to determine whether a poststroke client has a swallowing deficit.
Ans: A
Trial-and-error problem solving can be dangerous to the client. Testing range of motion by trial-and-error could result in dislocation; trial-and-error drug administration could result in over- or under-medicating; trial-and-error assessment of a potential swallowing deficit could result in aspiration. Each of these situations warrants more systematic problem solving. Trial-and-error landmarking of an anatomically difficult point, such as the apex of an obese client's heart, does not pose a threat to the client and a reasonable amount of "hunting" for the apical pulse may be necessary.
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