Choice A rationale:

A podiatrist specializes in foot-related issues. Osteoarthritis primarily affects joints, so referring the client to a podiatrist would not directly address their difficulty in buttoning clothes.

Choice B rationale:

A social worker typically addresses psychosocial needs, including emotional and financial concerns. While important, this role wouldn't directly address the client's physical difficulty with buttoning clothes due to osteoarthritis.

Choice C rationale:

Paramedical technologists are skilled in various diagnostic tests and procedures. However, they are not directly involved in assisting clients with activities of daily living or improving physical function.

Choice D rationale:

An occupational therapist (OT) specializes in helping clients regain and enhance their ability to perform daily activities, such as dressing, grooming, and self-care. For the client with osteoarthritis struggling to button clothes, an OT would assess their physical limitations and provide strategies or adaptive tools to improve independence in these activities.

The answer isb. "Check the urinary output at 11:00 for John Doe and report it to me immediately.”

This instruction follows the five rights of delegation by including the requirements for right direction/communication: the data to collect, client-specific information, a timeline for data collection, and the expectation for communicating the findings back to the nurse.

a. "Take vital signs every 2 hours for the client who had a cholecystectomy in room 6122.” is wrong because it does not specify which client to monitor.The AP should know the client’s name and room number for identification and safety purposes.

c. "Report to me if the chest tube drainage is excessive for Jane Doe in room 2438.” is wrong because it does not define what constitutes excessive drainage.The nurse should provide clear and measurable criteria for the AP to follow.

d. "Please notify me of any clients whose vital signs or blood glucose levels are significant.” is wrong because it is vague and does not indicate which clients to check, how often to check them, or what values are significant.The nurse should provide specific and individualized instructions for each client

Choice A rationale:

Since the client speaks a different language than the nurse, involving an interpreter is crucial to ensure effective communication during the preoperative teaching. This will help the client fully understand the procedure, potential risks, and postoperative care instructions.

Choice B rationale:

A social worker primarily addresses psychosocial needs and resources. While they play an important role, their involvement wouldn't directly address the language barrier during the preoperative teaching.

Choice C rationale:

An occupational therapist assists with physical function and daily activities. While they might be involved postoperatively, their role is not as crucial for overcoming the language barrier during preoperative teaching.

Choice D rationale:

A spiritual advisor provides support based on religious or spiritual beliefs. While emotional and spiritual support are important, their involvement in this scenario doesn't address the language barrier and the need for accurate information during preoperative teaching.

Choice A rationale:

Digoxin is a medication used to treat heart conditions like heart failure and atrial fibrillation. A digoxin level of 1.0 ng/mL is within the therapeutic range (usually 0.5-2.0 ng/mL), indicating that the client's digoxin dosage is appropriate. However, this value doesn't indicate an urgent need for a home visit.

Choice B rationale:

A white blood cell count (WBC) of 6,000/mm³ falls within the normal range (typically 4,500-11,000/mm³). While this value could suggest a stable immune system, it doesn't provide information requiring immediate attention or a home visit.

Choice C rationale:

Platelets are essential for blood clotting. A platelet count of 100,000/mm³ is significantly below the normal range (usually 150,000-450,000/mm³), indicating a risk of bleeding and potentially a serious medical condition. This client is at risk for spontaneous bleeding and requires prompt assessment and intervention, making this choice the correct answer.

Choice D rationale:

A serum potassium level of 4.0 mEq/L falls within the normal range (typically 3.5-5.0 mEq/L). While maintaining electrolyte balance is important, this potassium level doesn't indicate an immediate need for a home visit.

Choice A rationale:

The National League for Nursing (NLN) focuses on nursing education standards and resources for nursing faculty. While it could provide useful insights, it's not the primary resource for policy creation related to procedures like catheter insertion.

Choice B rationale:

The American Academy of Nursing (AAN) is a professional organization that promotes leadership and education within nursing. While it might offer recommendations, it's not the primary resource for policy related to procedural changes in clinical settings.

Choice C rationale:

The Agency for Healthcare Research and Quality (AHRQ) is involved in research and quality improvement initiatives in healthcare. While it could provide evidence-based practices, it's not the primary source for policies specific to nursing procedures.

Choice D rationale:

The State Nurse Practice Act (NPA) outlines the scope of nursing practice within a particular state. It governs what nurses are allowed to do, including procedures like catheter insertion. The NPA ensures that nursing actions are within legal and regulatory bounds, making it the most relevant resource for creating a policy about catheter insertion.

Choice A rationale:

Following a total hip arthroplasty, monitoring the surgical incision is crucial to identify any signs of infection or complications. Assessing the incision every 8 hours for the first 48 hours allows for timely intervention if any issues arise, such as redness, swelling, or drainage. This choice aligns with best practices for postoperative care.

Choice B rationale:

Informing assistive personnel about the client's weight-bearing status is important to prevent complications, but it is not the nurse's primary responsibility. The nurse should directly oversee the assessment and care of the surgical site.

Choice C rationale:

Instructing the client to cross their legs at the ankles when sitting in a chair is relevant advice for maintaining proper circulation and preventing blood clots, but it doesn't directly address the immediate postoperative care of the incision site.

Choice D rationale:

Teaching the client's partner to assist the client to flex the hip at least 120° each hour is important for preventing complications such as stiffness and deep vein thrombosis. However, this choice does not address the primary responsibility of the nurse immediately after the surgery, which is assessing the incision site.

Choice A rationale:

Showing the AP how to remove an indwelling urinary catheter may not provide sufficient evidence of their competency to perform the task safely and effectively. This approach assumes that observation alone is enough to determine competence, which is not necessarily the case. It's important to have a more structured assessment of the AP's skills.

Choice B rationale:

Reviewing the AP's skill competency checklist is the most appropriate action to ensure the AP is qualified to remove the indwelling urinary catheter. Competency checklists outline specific skills and steps required for a task, and they serve as a standardized way to assess the AP's capabilities. This process ensures that the AP has received proper training and has demonstrated competence before performing the procedure independently.

Choice C rationale:

Simply asking the AP if they know how to remove an indwelling urinary catheter is not a comprehensive method for verifying their qualifications. Self-assessment can be unreliable and may not accurately reflect the AP's actual skill level. Relying solely on self-reporting could compromise patient safety and quality of care.

Choice D rationale:

Pairing the newly hired AP with an experienced AP might provide some guidance, but it doesn't systematically assess the individual's competence. The level of experience of the experienced AP may vary, and their ability to teach or evaluate the new AP's skills may not be standardized.

Choice A rationale:

Informing the client of the consequences of decreased cerebral circulation is premature without understanding the client's specific reasons for refusing the surgery. Jumping to consequences might not address the underlying fears or concerns the client has, potentially leading to increased resistance or anxiety.

Choice B rationale:

Initiating a mental health consultation is a valuable step if the client's refusal appears to be influenced by psychological or emotional factors. However, before involving mental health professionals, it's important for the nurse to engage in a direct conversation with the client to explore their thoughts, fears, and reservations.

Choice C rationale:

Discussing the client's concerns about having the surgery is the most appropriate action in this scenario. Engaging in an open and nonjudgmental conversation allows the nurse to understand the client's perspective, provide information, clarify misconceptions, and address any fears or uncertainties. This approach respects the client's autonomy and promotes shared decision-making.

Choice D rationale:

Providing the client with information on additional treatment options might be premature if the client's main concern is related to the current recommended surgery. It's crucial to first address the client's specific reservations before exploring other treatment possibilities.

Choice A rationale:

Reminding the staff members that viewing the electronic medical record of a celebrity client without proper authorization is a breach of confidentiality is the immediate action required in this situation. It addresses the ethical and legal concerns related to patient privacy and ensures that the staff members are reminded of their professional responsibilities.

Choice B rationale:

Discussing the issue with the nurse manager is a step that can be taken after addressing the immediate breach of confidentiality. While involving the manager is important for handling the situation more comprehensively, the first priority is to stop the unauthorized access.

Choice C rationale:

Requesting an administrative restriction on the client's record access is an option that can be considered, but it may not be the first step to take. Before implementing such a restriction, the breach of confidentiality should be addressed directly with the staff members involved.

Choice D rationale:

Preparing a memo for the facility ethics committee is not the initial action to take in response to the breach of confidentiality. This step might be appropriate for addressing systemic issues or policy changes related to confidentiality breaches, but it doesn't directly address the immediate situation at hand.

Choice A rationale:

Reporting the findings to the hospital ethics committee is not the appropriate action in this scenario. Ventilator-associated pneumonia (VAP) is a clinical issue related to patient care and safety, not an ethical concern. The hospital ethics committee is generally responsible for addressing ethical dilemmas and conflicts.

Choice B rationale:

Alerting central supply is not the correct action in this situation. Central supply typically handles the procurement and distribution of medical supplies, equipment, and materials. While maintaining proper equipment and supplies is important, addressing VAP requires a focus on infection prevention and patient care practices.

Choice C rationale:

Filling out an incident report is not the best course of action for addressing an increase in ventilator-associated pneumonia. Incident reports are typically used to document unexpected events, accidents, or errors that occur in the healthcare setting. However, addressing the rise in VAP involves implementing measures to prevent and control infections, which falls under the purview of the quality improvement team.

Choice D rationale:

The correct action is to notify the quality improvement team. Ventilator-associated pneumonia is a healthcare-associated infection that can lead to serious complications for patients on ventilators. The quality improvement team is responsible for monitoring and improving the quality of patient care, including infection prevention and control. By notifying the quality improvement team, the nurse manager can initiate a comprehensive review of current practices, identify potential areas for improvement, and implement evidence-based interventions to reduce the incidence of VAP.

Choice A rationale:

Delegating the task of instructing a client on how to take their blood pressure to an assistive personnel (AP) is appropriate. This task involves providing education to the client on a non-invasive procedure that they can perform independently. APs are often trained to assist with patient education and activities of daily living that do not require clinical judgment.

Choice B rationale:

Administering subcutaneous medications to a client is not suitable for delegation to an assistive personnel. Medication administration requires a higher level of training and expertise to ensure patient safety and accurate dosing. Only licensed healthcare professionals, such as nurses, should administer medications.

Choice C rationale:

Determining a client's intake and output involves assessing and documenting the amounts of fluids a patient consumes and eliminates. This task requires clinical judgment and the ability to accurately interpret data, making it unsuitable for delegation to an assistive personnel.

Choice D rationale:

Providing a status update to a client's family member is not a task that should be delegated to an assistive personnel. Sharing medical information with family members involves communication skills, empathy, and the ability to address potential questions or concerns. This task is better handled by a nurse who has the necessary training and knowledge to provide accurate and sensitive information.

Choice A rationale:

Providing the client with information about advance directives is an appropriate intervention. Advance directives are legal documents that allow individuals to communicate their preferences for medical treatment in the event they become unable to make decisions for themselves. Educating the client about the importance and benefits of advance directives empowers them to make informed decisions about their care.

Choice B rationale:

Encouraging the client to contact an attorney to create advance directives is not the primary responsibility of the hospice nurse. While legal assistance might be helpful, the nurse should first ensure that the client understands the concept of advance directives and their significance before suggesting legal involvement.

Choice C rationale:

Informing the client that they will need a relative to witness their advance directives is not accurate. While witnesses are often required when signing legal documents, the specific requirements for advance directives can vary by jurisdiction. It's important for the nurse to provide accurate information and not make assumptions about legal processes.

Choice D rationale:

Telling the client that The Joint Commission requires clients to have advance directives is not accurate. While The Joint Commission emphasizes the importance of patient rights and informed decision-making, it does not mandate that all clients must have advance directives. The decision to create advance directives is a personal choice and should be based on the individual's values and preferences.

Choice A rationale:

Role model a positive approach to the changes. Rationale: The correct choice. As a charge nurse, leading by example is crucial. Demonstrating a positive attitude toward the changes sets a tone for the unit and encourages staff members to approach the situation with an open mind.

Choice B rationale:

Redirect the conversation when staff members make negative comments about the changes. Rationale: The correct choice. Addressing negativity and redirecting the conversation helps maintain a constructive and respectful work environment. This approach allows for open dialogue while discouraging excessive negativity that can hinder the adaptation process.

Choice C rationale:

Encourage staff members who support the changes to discuss the issue with resistant staff. Rationale: While encouraging open communication is important, it might not be sufficient to address the resistance completely. The charge nurse should take a more active role in managing negativity and facilitating a positive transition.

Choice D rationale:

Suggest that resistant staff members transfer to a different unit. Rationale: Transferring staff members might not be a productive solution and can lead to further discord within the unit. It's important to address the issues within the current team before considering such drastic measures.

Choice E rationale:

Reprimand staff members who are resistant to the changes. Rationale: Adopting a punitive approach can escalate tensions and foster a negative work environment. It's better to focus on positive reinforcement and facilitating open conversations to manage resistance effectively.

Choice A rationale:

A client who is scheduled for a tubal ligation in 2 hr and is crying. Rationale: While the emotional well-being of this client is important, the absence of pulse in the right foot of the client in choice B indicates a potentially critical vascular issue that requires immediate attention.

Choice B rationale:

A client who has peripheral vascular disease and has an absent pulse in the right foot. Rationale: The correct choice. An absent pulse in a client with peripheral vascular disease suggests compromised blood flow and potential tissue ischemia. This is a critical situation that requires urgent intervention to prevent further complications.

Choice C rationale:

A client who has type 1 diabetes mellitus and needs the first dressing change for an ulcer. Rationale: While dressing changes are important, they are not as time-sensitive as addressing compromised blood flow and potential tissue damage seen in choice B.

Choice D rationale:

A client who has methicillin-resistant Staphylococcus aureus (MRSA) and has an axillary temperature of 38°C (100.4°F). Rationale: Although an elevated temperature can be concerning, the absence of a pulse in a peripheral vascular disease client (choice B) takes precedence as it suggests a more immediate threat to the client's limb and overall health.

Choice A rationale:

Leaving the medication on the client's bedside table is not appropriate because it doesn't address the client's concerns and may result in the client not taking the medication at all. This choice does not promote the client's well-being.

Choice B rationale:

Returning in 1 hour to administer the medication doesn't address the client's immediate concerns and also doesn't provide adequate information about the medication's importance. Delaying the medication administration without proper communication is not ideal.

Choice C rationale:

Mixing the medication in applesauce may be appropriate in some cases, but it doesn't address the client's reluctance to take the medication due to fatigue. Additionally, the client's Crohn's disease might require specific instructions for medication administration that should not be altered without consulting the healthcare provider.

Choice D rationale:

The correct answer. Informing the client of the consequences of refusing the medication is the most appropriate action. The nurse should engage in a therapeutic conversation with the client, explaining the importance of the medication in managing Crohn's disease symptoms and preventing complications. This choice respects the client's autonomy while providing necessary information for an informed decision.

Answer is: Wear an N95 respirator mask when in the client’s room.

Explanation: Pulmonary tuberculosis (TB) is a contagious disease caused by bacteria that can spread through the air. The most common way of transmission is through respiratory droplets that are expelled when a person with active TB coughs, sneezes, or speaks1. Therefore, the charge nurse should expect the newly licensed nurse to take precautions to protect themselves and the client from exposure to TB. One of these precautions is to wear an N95 respirator mask when in the client’s room2. An N95 respirator mask is a type of personal protective equipment (PPE) that filters out at least 95% of airborne particles, including bacteria and viruses3. It can prevent the nurse from inhaling or spreading TB to others.

The other options are incorrect because:

Place the client on droplet precautions: Droplet precautions are not enough to prevent transmission of TB, as they only protect against respiratory droplets that are less than 5 micrometers in diameter1. However, TB bacteria can be found in larger droplets that can travel farther and infect people who are not in direct contact with the source1.
Place the client in a room with positive-pressure airflow: Positive-pressure airflow is not effective against TB, as it does not reduce the concentration of airborne particles or prevent them from escaping through cracks and gaps in doors and windows. Moreover, positive-pressure airflow can create negative pressure in other areas of the facility, which can increase the risk of cross-contamination.
Wear a surgical mask when taking the client out of the room: A surgical mask is not sufficient to protect against TB, as it only filters out particles that are larger than 5 micrometers in diameter3. It also does not fit properly on the face and may allow some particles to pass through3.

Choice A rationale:

A nurse cannot provide basic treatment information to the client's employer without the client's explicit consent. This information falls under the client's confidentiality rights and cannot be shared without proper authorization.

Choice B rationale:

While a nurse can inform the client about the risks and benefits of electroconvulsive therapy, this statement does not encompass the entirety of the client's rights. Clients have the right to be informed about the risks and benefits of all treatments, not just electroconvulsive therapy.

Choice C rationale:

Clients on a mental health unit who are admitted voluntarily have the right to leave against medical advice, as long as they are deemed capable of making that decision. Voluntary admission does not negate a client's autonomy to make decisions about their own care.

Choice D rationale:

The correct answer. Clients on a mental health unit have the right to refuse their medication, as long as they are deemed competent to make that decision. This is an important aspect of respecting a client's autonomy and informed consent, even in a mental health setting. However, if a client's refusal poses a serious risk to their health or the health of others, healthcare providers may need to take appropriate actions while respecting legal and ethical standards.

Choice A rationale:

Taking extra wheelchairs to the emergency department is not a priority action during an external disaster. The focus should be on following the disaster plan and coordinating efforts as instructed.

Choice B rationale:

Sending PACU assistive personnel to assist with triage might seem helpful, but during an external disaster, the charge nurse's immediate role is to coordinate within their unit and follow the established disaster plan. Triage is generally handled by designated personnel, and PACU staff should stay within their unit's responsibilities.

Choice C rationale:

Identifying stable clients for transfer to a surgical unit may be necessary in certain scenarios, but during an external disaster, the charge nurse's primary responsibility is to follow the disaster plan and adhere to the chain of command. Transfers should be coordinated as directed by the plan and command center.

Choice D rationale:

Reporting to the command center for further instructions is the correct action during an external disaster. The command center is the central hub for coordinating resources, information, and actions during a disaster. Reporting to the command center ensures that the charge nurse is aligned with the overall disaster response plan, allowing for efficient coordination and utilization of resources.

Choice A rationale:

Determining the swallowing ability of a client who has had a stroke requires clinical judgment and assessment skills that fall within the scope of a registered nurse's practice. This task involves assessing potential risks and complications related to the client's condition.

Choice B rationale:

Providing an enteral feeding to a client who has Crohn's disease is within the scope of an LPN's practice. LPNs are trained to administer enteral feedings and manage stable clients with chronic conditions, such as Crohn's disease, under the supervision of a registered nurse.

Choice C rationale:

Developing a teaching plan for a client with a new diagnosis of type 2 diabetes mellitus involves comprehensive assessment, education, and planning. This task requires the expertise of a registered nurse, as it encompasses various aspects of disease management and requires tailored education based on individual client needs.

Choice D rationale:

Weighing a client who is 3 days postoperative following coronary artery bypass grafting involves monitoring for postoperative complications and assessing the client's stability. This task requires clinical judgment and the ability to recognize potential issues, making it more appropriate for a registered nurse to perform.

Choice A rationale:

The client who had abdominal surgery 3 days ago reporting feeling constipated is an important assessment, but an inability to void after indwelling urinary catheter removal takes precedence due to the risk of urinary retention and potential complications such as bladder distention.

Choice B rationale:

The client who had a hip replacement reporting pain as 4 on a scale of 0 to 10 requires assessment and intervention, but an inability to void is a higher priority concern due to the potential impact on renal function and the urinary system.

Choice C rationale:

The client who had an indwelling urinary catheter removed 8 hours ago reporting an inability to void is the correct choice. This situation raises concerns about urinary retention, which can lead to serious complications such as bladder distention, urinary tract infections, and potential damage to the urinary system.

Choice D rationale:

The client scheduled for discharge today expressing readiness to sign paperwork is not an urgent concern compared to the other options. While discharge planning is important, addressing potential physiological issues takes precedence over administrative tasks.

Choice A rationale:

Verifying informed consent is crucial before performing any procedure that involves potential harm or discomfort to the patient. Removal of staples from a surgical wound is a procedure that can cause pain or potential complications, such as wound dehiscence. Informed consent ensures that the patient is aware of the procedure, its risks, benefits, and alternatives. The nurse should provide a detailed explanation to the patient about the staple removal process, including the possibility of pain or discomfort during the procedure and the potential for wound complications.

Choice B rationale:

Providing a sputum specimen is a routine procedure that usually does not require informed consent. Collecting a sputum specimen is a non-invasive procedure that patients are generally well-informed about. It is commonly performed for diagnostic purposes, and the risks or discomfort associated with it are minimal.

Choice C rationale:

Receiving moderate sedation is a procedure that requires informed consent. However, the question asks for the procedure that the nurse should verify informed consent for. While informed consent is important for procedures involving sedation, it is not the first priority in this scenario. Procedures with higher potential risks, such as staple removal, should take precedence in verifying informed consent.

Choice D rationale:

Collection of a blood specimen for arterial blood gas analysis (ABG) is a common procedure that does not usually require informed consent. ABG analysis is a diagnostic test that helps assess the patient's acid-base balance and respiratory function. It involves drawing blood from an artery, and while there may be some discomfort, it is a routine procedure with minimal risks compared to the potential complications of staple removal.

Choice A rationale:

Conducting an in-service that reviews proper catheter insertion and maintenance is a useful intervention to address urinary tract infections. However, this action focuses on education rather than identifying the root causes of the problem. The nurse manager needs to understand why infections are increasing before implementing educational interventions.

Choice B rationale:

Performing a chart review to gather data about the clients who developed infections is a valuable step to identify patterns and potential contributing factors. However, this action is retrospective and does not address potential issues related to catheter insertion techniques or adherence to infection control practices.

Choice C rationale:

Observing each staff nurse perform a urinary catheter insertion is the first action the nurse manager should take. By directly observing the procedure, the manager can assess if there are deviations from proper technique, identify areas for improvement, and gather real-time data. This action allows for immediate feedback and targeted interventions to address the problem.

Choice D rationale:

Requiring completion of a self-paced instruction program is a useful intervention to reinforce knowledge and skills, but it should be implemented after the nurse manager has identified the specific issues contributing to the increased infections. This action may not address underlying problems related to technique, equipment, or adherence to protocols.

Choice A rationale:

Writing a memorandum emphasizing the importance of attending staff meetings might help remind the staff about the significance of these meetings. However, it does not address the root causes of the poor attendance issue. Exploring the reasons behind the lack of attendance should come before issuing reminders.

Choice B rationale:

Appointing a task force to promote attendance at the meetings is a proactive step. However, it might be premature without understanding the reasons for the poor attendance. The task force's efforts could be more effective if informed by a thorough analysis of the underlying issues.

Choice C rationale:

Exploring the reasons that staff are not attending the meetings is the crucial first step. Understanding the factors contributing to the poor attendance allows the charge nurse to tailor interventions appropriately. Reasons could include scheduling conflicts, lack of engagement, or dissatisfaction with meeting content.

Choice D rationale:

Reducing the number of meetings staff are required to attend might address the attendance issue, but it doesn't address the root causes. It's important to identify the reasons behind poor attendance before making decisions about changing meeting frequency.

Choice A rationale:

Request crutches from a medical equipment provider. This choice is not appropriate for a client with left-sided weakness due to a stroke. Crutches are primarily used for lower extremity support and would not address the client's mobility and safety needs related to their left-sided weakness.

Choice B rationale:

Advise the client to install grab bars in the bathroom at home. This is the correct choice. Installing grab bars in the bathroom will enhance the client's safety and independence. Left-sided weakness can result in balance issues, and having grab bars near the toilet and in the shower can help prevent falls and provide the client with support while using these facilities. This intervention promotes the client's functional autonomy and reduces the risk of injury.

Choice C rationale:

Encourage the client to allow a home care aide to perform ADLs for them. While it might be necessary for a client with severe disability to receive assistance with Activities of Daily Living (ADLs), the question does not provide enough information to suggest that the client's condition warrants this level of intervention. Encouraging independence is generally preferred to maintain the client's self-esteem and engagement in daily life activities.

Choice D rationale:

Contact hospice to provide follow-up care for the client. Hospice care is intended for clients with terminal illnesses who are in the final stages of life. A client who has had a stroke and is experiencing left-sided weakness does not automatically qualify for hospice care. The client's condition can be managed with rehabilitation and support, and hospice care is not appropriate in this context.

Choice A rationale:

Notify the charge nurse of the client's request for transfer. This action might be taken eventually, but it is not the first step. The nurse should directly address the client's concerns before escalating the situation to the charge nurse.

Choice B rationale:

Assure the client that their concern has been shared with the staff. Tell the client that future calls will be answered in a timely manner. While it's important to reassure the client, promising timely responses to calls before understanding their expectations might not effectively address the underlying issue. It's better to communicate openly with the client first.

Choice C rationale:

Ask the client to verbalize their expectations. This is the correct choice. By asking the client to express their expectations, the nurse can gather crucial information about the client's concerns and needs. This allows the nurse to address the specific issues that led to the client's dissatisfaction and work toward a resolution that aligns with the client's preferences.