Interdisciplinary Team Collaboration

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NCLEX-PN › Interdisciplinary Team Collaboration

Questions 1 - 10
1

A 68-year-old client is being discharged from the hospital after a right total knee arthroplasty; current data include pain 3/10 at rest, blood pressure 132/78 mm Hg, heart rate 88/min, and the client ambulates 40 feet with a walker and one-person assist. The LPN/VN is preparing discharge teaching and must coordinate services with the social worker and physical therapist. The nurse should PRIORITIZE communication with which team member to address the client's discharge planning?

Unit manager (RN) to rewrite the discharge orders for home therapy

Hospital chaplain to discuss coping resources at home

Social worker to arrange home equipment delivery and transportation based on mobility status

Physical therapist to confirm safe transfer technique and stair training needs before discharge

Explanation

This question tests interdisciplinary collaboration and communication in discharge planning after knee surgery. The key client need requiring collaboration is coordinating safe discharge with appropriate equipment and services based on the client's current mobility limitations (walker with one-person assist). The social worker (C) should be prioritized because they arrange essential discharge services including home equipment delivery and transportation, which must be coordinated based on the physical therapist's mobility assessment. The physical therapist (A) has already provided mobility data, the chaplain (B) addresses psychosocial needs which are secondary to safety equipment, and the unit manager (D) cannot rewrite physician orders. The decision-making principle is to prioritize the team member who coordinates concrete discharge resources based on functional assessments already completed. When prioritizing interdisciplinary collaboration for discharge, focus on the professional who translates assessment data into practical home services and equipment.

2

During a routine care meeting at a skilled nursing facility, a 76-year-old client with Parkinson disease coughs and has a wet voice after taking pills with water; vital signs are blood pressure 136/74 mm Hg, heart rate 78/min, respiratory rate 18/min, and oxygen saturation 96% on room air. The LPN/VN is communicating with the nurse practitioner and the speech-language pathologist about swallowing safety. The nurse should PRIORITIZE communication with which team member to address the client's discharge planning?

Registered nurse to independently change the diet order to nothing by mouth

Nurse practitioner to prescribe a new antiparkinson medication immediately

Speech-language pathologist to recommend safe swallowing strategies and diet texture modifications

Activities coordinator to encourage group dining for socialization

Explanation

This question tests interdisciplinary collaboration and communication regarding aspiration risk in Parkinson's disease. The key client need requiring collaboration is preventing aspiration in a patient with neurological dysphagia signs (coughing, wet voice after pills). The speech-language pathologist (A) should be prioritized because they can evaluate swallowing function and recommend safe strategies for both liquids and medications, which is essential before discharge planning. Prescribing new medications (B) doesn't address the swallowing issue, changing to NPO status (C) requires physician orders and may be unnecessarily restrictive, and group dining (D) could increase aspiration risk without proper swallowing assessment. The decision-making principle is to collaborate with the specialist who can comprehensively evaluate and provide strategies for safe swallowing of all consistencies. When prioritizing interdisciplinary collaboration for neurological dysphagia, the speech-language pathologist provides the foundation for all other interventions.

3

An LPN/VN is preparing a 69-year-old client for discharge after an exacerbation of chronic obstructive pulmonary disease. Data: oxygen saturation 92% on 2 L/min nasal cannula, respiratory rate 20/min, uses a rolling walker due to deconditioning; client states, “I can’t afford my oxygen or inhalers.” The nurse should PRIORITIZE communication with which team member to address the client's discharge planning?

Volunteer services to provide transportation vouchers without assessment

Pulmonologist to discontinue oxygen therapy

Physical therapist to increase endurance exercises before discharge

Social worker to assist with financial resources and durable medical equipment coverage

Explanation

This question tests interdisciplinary collaboration and communication. The key client need requiring collaboration is addressing financial barriers to oxygen and medication access for a COPD client at discharge. Prioritizing the social worker reflects effective team collaboration because they can assist with resources for durable medical equipment and coverage. The physical therapist focuses on exercises, the pulmonologist on therapy orders, and volunteer services on transportation without assessing needs. Effective team communication involves identifying socioeconomic barriers and consulting support services. Nurses should advocate for clients by communicating unmet needs clearly. A transferable strategy is to engage social workers for resource coordination in discharge planning.

4

During a routine care meeting, a 71-year-old client with dementia frequently holds liquids in the mouth and then coughs after swallowing. Data: respiratory rate 21/min, oxygen saturation 94% on room air, temperature 99.6°F (37.6°C). The nurse should PRIORITIZE communication with which team member to address the client's swallowing difficulties?

Unit educator to schedule staff annual competencies

Speech-language pathologist to evaluate swallowing and recommend safe feeding techniques

Dietary services to provide extra thin liquids

Social worker to apply for long-term care insurance

Explanation

This question tests interdisciplinary collaboration and communication. The key client need requiring collaboration is addressing unsafe swallowing behaviors in dementia. Prioritizing the speech-language pathologist reflects effective team collaboration because they can evaluate and recommend feeding techniques. The social worker applies for insurance, dietary provides liquids inappropriately, and the educator schedules training unrelated to assessment. Effective team communication involves sharing respiratory data. Nurses should observe swallowing patterns. A transferable strategy is to consult speech specialists for behavioral dysphagia in cognitive impairment.

5

An outpatient clinic client, age 60, started atorvastatin 3 weeks ago and reports new muscle aches in both thighs and “dark tea-colored urine.” Data: blood pressure 130/78 mm Hg, heart rate 88/min, temperature 98.4°F (36.9°C). Which detail should the nurse report to the physician about the client's medication response?

That the client should continue the medication and increase exercise

That the client’s cholesterol level was elevated last month

That the client prefers not to take medications long-term

New muscle pain with dark urine since starting atorvastatin

Explanation

This question tests interdisciplinary collaboration and communication. The key client need requiring collaboration is reporting signs of possible rhabdomyolysis from atorvastatin. Reporting new muscle pain with dark urine reflects effective team collaboration because it prompts urgent evaluation for serious side effects. Past cholesterol levels, continuation advice, and preferences are less urgent. Effective team communication entails highlighting red-flag symptoms. Nurses should document urine changes. A transferable strategy is to report musculoskeletal and urinary changes promptly in statin users.

6

During a routine care meeting in a rehabilitation unit, a 72-year-old client after a mild stroke coughs when drinking thin liquids; vital signs are blood pressure 140/82 mm Hg, heart rate 90/min, respiratory rate 20/min, temperature 99.1°F (37.3°C), and oxygen saturation 95% on room air. The LPN/VN is discussing the plan with the nurse practitioner and the speech-language pathologist. Which team member should the nurse collaborate with FIRST to address the client's dietary needs?

Physical therapist to begin gait training to improve endurance

Registered dietitian to add high-protein supplements immediately

Nurse practitioner to prescribe antibiotics for possible pneumonia

Speech-language pathologist to evaluate swallowing and recommend a safe diet consistency

Explanation

This question tests interdisciplinary collaboration and communication regarding aspiration risk in a stroke patient. The key client need requiring collaboration is preventing aspiration pneumonia in a patient showing signs of dysphagia (coughing with thin liquids). The speech-language pathologist (A) is the correct first collaboration because they are the experts in evaluating swallowing function and recommending safe diet consistencies to prevent aspiration. The dietitian (B) would need the SLP's recommendations before adding supplements, prescribing antibiotics (C) is premature without confirmed aspiration pneumonia, and physical therapy (D) doesn't address the immediate swallowing safety concern. The decision-making principle is to collaborate first with the specialist whose expertise directly addresses the safety risk - swallowing evaluation before nutritional supplementation. When prioritizing interdisciplinary collaboration for dysphagia, always involve the speech-language pathologist first to establish safe swallowing parameters.

7

An LPN/VN is preparing a 70-year-old client for discharge after a mild ischemic stroke. Data: left-sided weakness, requires a cane and supervision; blood pressure 144/86 mm Hg; client’s spouse works nights and the client will be alone most evenings. The nurse should PRIORITIZE communication with which team member to address the client's discharge planning?

Neurologist to determine long-term disability benefits

Social worker to evaluate caregiver support and arrange community resources

Transport team to take the client to the car at discharge

Speech-language pathologist to teach word-finding strategies

Explanation

This question tests interdisciplinary collaboration and communication. The key client need requiring collaboration is ensuring caregiver support for a stroke client alone evenings. Prioritizing the social worker reflects effective team collaboration because they can evaluate and arrange community resources. The speech-language pathologist teaches strategies, the neurologist handles benefits, and transport aids immediate exit but not planning. Effective team communication requires discussing family dynamics. Nurses should identify supervision gaps. A transferable strategy is to engage social workers for post-discharge support networks.

8

During a routine care meeting, a 66-year-old client with head and neck cancer reports painful swallowing and is taking very small sips. Data: weight down 6 lb (2.7 kg) in 2 weeks, heart rate 102/min, oral mucosa dry. The nurse should PRIORITIZE communication with which team member to address the client's swallowing difficulties?

Speech-language pathologist to assess swallowing and recommend strategies

Physical therapist to begin strengthening exercises

Hospital chaplain to discuss coping

Dietary aide to remove liquids from meal trays

Explanation

This question tests interdisciplinary collaboration and communication. The key client need requiring collaboration is managing painful dysphagia in cancer to improve intake. Prioritizing the speech-language pathologist reflects effective team collaboration because they can assess and recommend strategies for safe swallowing. The physical therapist strengthens unrelated areas, the dietary aide removes liquids inappropriately, and the chaplain addresses coping but not swallowing. Effective team communication requires sharing weight and vital changes. Nurses should monitor for dehydration signs. A transferable strategy is to collaborate with speech therapists for oncology-related swallowing issues.

9

During a routine care meeting, a 74-year-old client after a stroke pockets food in the cheek and needs multiple swallows to clear liquids. Data: oxygen saturation 95% on room air, respiratory rate 18/min, temperature 98.9°F (37.2°C). The nurse should PRIORITIZE communication with which team member to address the client's swallowing difficulties?

Pharmacist to change all medications to liquid form without an order

Maintenance to adjust the bed height

Dietary aide to add extra beverages to meals

Speech-language pathologist to perform a swallowing evaluation

Explanation

This question tests interdisciplinary collaboration and communication. The key client need requiring collaboration is addressing dysphagia signs in a post-stroke client to ensure safe swallowing. Prioritizing the speech-language pathologist reflects effective team collaboration because they can evaluate and recommend safe strategies. The pharmacist cannot change forms without orders, maintenance adjusts beds unrelated to swallowing, and the dietary aide adds beverages without assessment. Effective team communication involves recognizing pocketing and referring promptly. Nurses should document symptoms for team review. A transferable strategy is to collaborate with speech therapists for any observed swallowing impairments.

10

During a routine care meeting, a 79-year-old client with a history of aspiration pneumonia coughs when taking pills with water and states, “They get stuck.” Data: temperature 100.2°F (37.9°C), oxygen saturation 92% on room air, lung sounds with coarse crackles at bases. The nurse should PRIORITIZE communication with which team member to address the client's swallowing difficulties?

Nursing assistant to encourage faster eating to finish meals

Speech-language pathologist to assess swallowing and recommend safe medication administration strategies

Primary provider’s office clerk to request medical records

Dietary manager to add extra fluids with meals

Explanation

This question tests interdisciplinary collaboration and communication. The key client need requiring collaboration is managing pill-swallowing difficulties in a client with aspiration risk. Prioritizing the speech-language pathologist reflects effective team collaboration because they can assess and recommend safe administration strategies. The dietary manager adds fluids without evaluation, the nursing assistant encourages speed inappropriately, and the clerk handles records unrelated to swallowing. Effective team communication involves sharing fever and lung findings. Nurses should advocate for assessments in high-risk clients. A transferable strategy is to consult speech specialists for medication-related dysphagia.

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