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Resources to support and coordinate patient care

7 original SNLE questions on resources to support and coordinate patient care, each with an explanation for all four options. Part of Nursing Management and Leadership, worth 10% of the Saudi Nursing Licensure Examination.

Q01 / 07medium0 correct
Nursing Management and Leadershipmediumq017

In the emergency department, four patients arrive simultaneously. Applying the ABC (airway, breathing, circulation) priority framework, which patient should the nurse assess first?

All 7 questions

Every question below, with the reasoning for all four options. Try to answer before you open one.

  1. Resources to support and coordinate patient care · medium

    In the emergency department, four patients arrive simultaneously. Applying the ABC (airway, breathing, circulation) priority framework, which patient should the nurse assess first?

    • AA 30-year-old with a closed forearm fracture and intact distal pulses
    • BA 22-year-old with a 4 cm superficial laceration and controlled bleeding
    • CA 45-year-old with an audible stridor and increasing facial swelling after eating shellfish
    • DA 68-year-old with a two-day history of dysuria and low-grade fever
    Show the answer and why the others fail

    Answer: C. A 45-year-old with an audible stridor and increasing facial swelling after eating shellfish

    A
    A closed fracture with intact neurovascular status is urgent but stable and can safely wait.
    B
    Controlled bleeding from a superficial wound poses no immediate threat to life.
    C — correct
    Stridor with rapidly progressing facial swelling signals impending airway obstruction from anaphylaxis. Airway compromise always takes highest priority and requires immediate intramuscular epinephrine.
    D
    No airway, breathing, or circulatory compromise is reported for this patient, so under the ABC framework the presentation ranks below airway obstruction. This does not make the patient low priority overall — older adults with urinary symptoms and fever require prompt vital signs and mental status assessment, because urosepsis is easily missed in this group.

    TakeawayTriage follows airway, breathing, circulation — stridor with progressing angioedema outranks every stable injury in the queue.

  2. Resources to support and coordinate patient care · medium

    A charge nurse on a medical-surgical unit is planning assignments for the next shift. The team consists of one registered nurse (RN), one licensed practical nurse (LPN), and one unlicensed assistive personnel (UAP). Which of the following patients is most appropriate to assign to the LPN?

    • AA patient who is 2 days post-operative after a hip replacement and needs assistance with bathing and ambulation.
    • BA patient with newly diagnosed diabetes who needs comprehensive education on insulin self-injection.
    • CA patient who was admitted 2 hours ago with acute chest pain and is awaiting cardiac enzyme results.
    • DA patient with a stage 2 pressure injury who requires a dressing change and oral antibiotic administration.
    Show the answer and why the others fail

    Answer: D. A patient with a stage 2 pressure injury who requires a dressing change and oral antibiotic administration.

    A
    Assistance with activities of daily living can be delegated to the UAP; assigning this patient to the LPN is not the most effective use of the LPN's skills.
    B
    Initial teaching and complex patient education are the responsibility of the RN, not the LPN.
    C
    This patient is newly admitted and potentially unstable, requiring initial and ongoing assessment by an RN.
    D — correct
    The patient is stable with predictable outcomes; wound care and oral medication administration are within the LPN's scope of practice.

    TakeawayAssign stable patients with predictable outcomes to LPNs, while reserving RNs for initial assessments, unstable patients, and complex education.

  3. Resources to support and coordinate patient care · medium

    A charge nurse on a medical-surgical unit is planning care for the day shift. The team includes one registered nurse (RN), one licensed practical nurse (LPN), and one unlicensed assistive personnel (UAP). Which of the following patient care activities should the charge nurse delegate to the UAP?

    • AA patient with a chest tube who requires assessment of the insertion site and drainage system.
    • BA patient receiving total parenteral nutrition (TPN) who needs a new intravenous tubing set-up.
    • CA patient 2 days after total hip replacement who is stable and needs assistance ambulating to the bathroom.
    • DA patient newly diagnosed with diabetes who needs instruction on self-injection of insulin.
    Show the answer and why the others fail

    Answer: C. A patient 2 days after total hip replacement who is stable and needs assistance ambulating to the bathroom.

    A
    Assessment of a chest tube site and drainage requires clinical judgment to detect complications, which is a nursing responsibility and cannot be delegated to UAP.
    B
    Changing IV tubing for TPN requires aseptic technique and knowledge of IV therapy, which is outside the UAP scope of practice.
    C — correct
    Assisting a stable patient with ambulation is a routine task that can be delegated to UAP after the nurse has assessed the patient and confirmed the UAP understands any necessary precautions.
    D
    Patient teaching requires assessment of learning needs and evaluation of understanding, which are within the RN scope of practice and cannot be delegated to UAP.

    TakeawayUAP can be delegated routine tasks for stable patients, such as assisting with ambulation, after the nurse has assessed the patient and confirmed the UAP's competence. Tasks requiring assessment, teaching, or aseptic technique must be performed by licensed nurses.

  4. Resources to support and coordinate patient care · medium

    A nurse is planning discharge for a patient who had a colostomy created 2 days ago. The patient states, "I don't think I can manage this at home." Which resource should the nurse coordinate to best support the patient's transition?

    • AWound, ostomy, and continence (WOC) nurse for specialized education
    • BHome health aide to assist with daily ostomy care
    • CSocial worker to arrange long-term care placement
    • DPhysical therapist to improve mobility for ostomy care
    Show the answer and why the others fail

    Answer: A. Wound, ostomy, and continence (WOC) nurse for specialized education

    A — correct
    A WOC nurse has advanced expertise in ostomy care and can provide the patient with the education, skills, and confidence needed to manage the ostomy independently at home.
    B
    Home health aides provide personal care and assistance with activities of daily living but are not trained to provide specialized ostomy care education or management.
    C
    A social worker addresses psychosocial and financial concerns, but the patient's immediate need is for specialized ostomy education, not necessarily long-term care placement.
    D
    Physical therapy focuses on mobility and functional strength, which may be helpful but does not address the patient's primary need for ostomy self-care education.

    TakeawayA wound, ostomy, and continence (WOC) nurse provides specialized education and support for patients with new ostomies, promoting self-care and a smooth transition to home.

  5. Resources to support and coordinate patient care · easy

    A nurse is planning care for a patient newly diagnosed with type 2 diabetes. The patient is uninsured and expresses concern about the cost of insulin and testing supplies. Which team member should the nurse consult to address the patient's financial barriers?

    • APharmacist
    • BRegistered dietitian
    • CClinical nurse specialist
    • DSocial worker
    Show the answer and why the others fail

    Answer: D. Social worker

    A
    A pharmacist provides medication education and reviews drug interactions but does not typically coordinate financial assistance programs.
    B
    A registered dietitian provides nutritional counseling and meal planning but does not address the cost of medications or supplies.
    C
    A clinical nurse specialist provides advanced clinical expertise and education but does not primarily address financial or social resource needs.
    D — correct
    Social workers are trained to assist patients with financial concerns, medication assistance programs, and community resources to overcome barriers to care.

    TakeawaySocial workers are essential resources for addressing financial barriers and connecting patients with medication assistance programs and community support.

  6. Resources to support and coordinate patient care · medium

    A nurse is caring for a patient who had a stroke 3 days ago. During meals, the patient coughs frequently and pockets food in the left cheek. The nurse suspects dysphagia. Which interprofessional team member should the nurse consult to evaluate the patient's swallowing?

    • ASpeech-language pathologist
    • BRegistered dietitian
    • COccupational therapist
    • DPhysical therapist
    Show the answer and why the others fail

    Answer: A. Speech-language pathologist

    A — correct
    Speech-language pathologists are trained to evaluate and manage swallowing disorders (dysphagia), including clinical swallowing assessments and modified barium swallow studies.
    B
    Dietitians manage nutritional needs and diet consistency modifications after a swallowing evaluation has been completed, but they do not assess the physiological swallowing mechanism.
    C
    Occupational therapists address fine motor skills and activities of daily living, such as feeding techniques, but do not perform diagnostic swallowing evaluations.
    D
    Physical therapists focus on mobility, balance, and gross motor function, not swallowing or oropharyngeal assessment.

    TakeawayA speech-language pathologist is the appropriate resource for evaluating and managing dysphagia to prevent aspiration and coordinate safe oral intake.

  7. Resources to support and coordinate patient care · medium

    A nurse is preparing for discharge of a patient who had a stroke and now requires ongoing physical therapy, occupational therapy, and a home health aide. The patient’s insurance requires preauthorization for these services. The family asks, “Who will help us arrange all of these services and handle the insurance approvals?” Which interdisciplinary team member should the nurse consult?

    • APhysical therapist
    • BCase manager
    • CHome health aide
    • DSocial worker
    Show the answer and why the others fail

    Answer: B. Case manager

    A
    The physical therapist focuses on assessing and improving mobility and function but does not coordinate multiple services or manage insurance authorizations.
    B — correct
    The case manager coordinates the full discharge plan, arranges post-discharge services, and handles insurance preauthorizations to ensure continuity of care.
    C
    The home health aide provides personal care and assistance with activities of daily living but does not coordinate services or manage insurance matters.
    D
    The social worker addresses psychosocial needs, financial concerns, and community resources, but the case manager is primarily responsible for arranging clinical services and insurance approvals.

    TakeawayThe case manager is responsible for coordinating complex discharge plans, arranging post-discharge services, and managing insurance authorizations to ensure a safe transition from hospital to home.