HESI Exit RN with NGN Proctored Exam
An older adult client with a history of heart failure is admitted to the medical unit after falling at home and has become increasingly confused. The client's spouse is designated as the client's power of attorney. When reporting to the healthcare provider using SBAR (Situation, Background, Assessment, Recommendation) communication, which information should the nurse provide first?
Explanation & Rationale
Choice A reason: While the fall is important, it is not the most immediate concern for the healthcare provider in the context of SBAR communication. Choice B reason: Increasing confusion can indicate a change in the client's condition and may require immediate intervention, making it the priority in SBAR communication. Choice C reason: The client's healthcare power of attorney is important for legal and consent purposes but is not the first piece of information to provide in an SBAR report. Choice D reason: Currently prescribed medications are part of the background information and would follow after the immediate situation has been described.
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