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Nclexrn · Question of the Day

Nclexrn Question of the Day

A fresh daily question to build accuracy, reinforce recall, and turn practice into a steady habit.
Friday, August 28, 2026

In a long-term care facility, a nurse notes an urgent change in a 79-year-old client with dementia and a history of stroke; the client has a new fever 38.9°C (102.0°F), heart rate 112/min, blood pressure 88/54 mm Hg, respiratory rate 24/min, oxygen saturation 90% on room air, and is more lethargic than baseline with cloudy urine. What information should the nurse include in the SBAR report when calling the healthcare provider?

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Question of the Day

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In a long-term care facility, a nurse notes an urgent change in a 79-year-old client with dementia and a history of stroke; the client has a new fever 38.9°C (102.0°F), heart rate 112/min, blood pressure 88/54 mm Hg, respiratory rate 24/min, oxygen saturation 90% on room air, and is more lethargic than baseline with cloudy urine. What information should the nurse include in the SBAR report when calling the healthcare provider?

  1. Background: The client has lived in the facility for 3 years, likes to sit by the window, and needs reminders to drink fluids.
  2. Situation/Assessment: The client has fever, hypotension, tachycardia, increased lethargy, and low oxygen saturation with cloudy urine, suggesting possible infection with poor perfusion. (correct answer)
  3. Recommendation: Ask for an order for a sleep aid because the client was awake several times last night.
  4. Assessment: The client has cloudy urine and a fever; do not include blood pressure because it may improve after rest.

Explanation: This question tests SBAR communication and clinical judgment when reporting an urgent change in a long-term care setting. SBAR is important for ensuring effective handoffs by providing a framework that conveys critical information efficiently, supporting client safety in vulnerable populations. The correct answer, choice B, is the most effective SBAR communication because it captures the situation and assessment of signs like fever, hypotension, and lethargy suggesting infection and poor perfusion, prioritizing immediate needs. Choice A includes non-urgent background on facility life and fluid reminders, choice C recommends a sleep aid unrelated to the acute issue, and choice D omits vital signs like blood pressure, potentially delaying recognition of instability. The decision-making principle in SBAR communication is to focus on objective data indicating deterioration to guide prompt provider actions. This helps in early detection and management of conditions like sepsis. A transferable strategy for improving communication skills is to document SBAR elements before calls, ensuring comprehensive and organized reporting in any care environment.