lOMoARcPSD| 12263423
Test bank for High Acuity Nursing 7th Edition Wagne
g g g g g g g gg
r Pierce Welsh -latest-2023-2024
g g g
Chapterg1.gHigh-
AcuitygNursinggQuestiong1
Type:gMCSA
Thegpatientgwhoghadgsurgerygyesterdaygreportsghisgchestgfeelsgtight.gAssessmentgrevealsgrespirat
orygrategofg29,ginspiratorygwheezes,gstridor,gandgangoxygenationgsaturationgofg80%.gThegnursegw
ouldgconsidergthisgpatientgtogbegwhichgprioritygforgtransfergtogthegintensivegcaregunitg(ICU)?
1. Priorityg1
2. Priorityg2
3. Priorityg3
4. Priorityg4
CorrectgAnswer:g1
Rationaleg1:gThisgpatientgisgexhibitinggsignsgofgangacutegrespiratorygeventgforgwhichgintubationg
orgothergintensivegtreatmentgmaygbegnecessary.gPriorityg1gpatientsgaregacutelygillgandgneedginten
sivegtreatmentgandgmonitoringgnotgprovidedgoutsidegofgthegICU.
Rationaleg2:gPriorityg2grefersgtogpatientsgneedinggintensivegmonitoringgandgmaygpotentiallygneedg
additionalginterventions.gTheygaregtypicallygnotgevolvinggangacutegeventgasgisgthegcasegwithgthisg
patient.
Rationaleg3:gPriorityg3gpatientsgaregcriticallygillgbutghaveglittlegchancegofgrecoverygfromgtheirgilln
esses.gLimitsgaregplacedgongtherapeuticginterventionsgandgtheygcangbegcaredgforgingareasgothergtha
ngthegICUgifgnecessary.
Rationaleg4:gPriorityg4gpatientsghavegnogsignsgorgsymptomsgthatgindicategintensivegmonitoringgor
gtreatmentgaregnecessary.
GlobalgRationale:
CognitivegLevel:gAnalyzing
ClientgNeed:gSafegEffectivegCaregEnvironmentgCli
entgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gPlanninggLearn
inggOutcome:g1-1
Questiong2gTyp
e:gMCSA
Thegdaughtergofgagpatientgwhogisgdyinggquestionsgthegplacementgofghergfathergongthegmedicalsur
gicalgcaregunitg(MSCU).gShegrequestsghegbegplacedgingthegintensivegcaregunitg(ICU)gbecausegofgc
oncernghergfathergmaygnotgreceivegclosegobservationgongagbusyghospitalgunit.gWhichgactiongisgind
icatedgbygthegnurse?
1. Notifygthegintensivegcaregunitgofgangimpendinggtransfer.
2. Tellgthegdaughtergthatghergfathergdoesgnotgmeetgcriteriagforgplacementgingthegmoregexpensiv
egICU.
3. Discussgthegcaregthatgcangbegprovidedgongthegunitgwithgthegfamilygmember.
4. Contactgthegphysician.
CorrectgAnswer:g3
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Rationaleg1:gThegnursegcannotgmakegthisgtransfergdecisiongindependently.
Rationaleg2:gTellinggthegdaughtergthatghergfathergdoesgnotgmeetgcriteriagforgtransfergisgnotgtherap
eutic.gBringinggupgthegissuegofgcostgmaygcausegthegdaughtergtogoffergtogpaygthegdifferencegbetwee
ngthegcostsgofgthegtwogunits.gThisgwouldgcreategagseriousgethicalgdilemma.
Rationaleg3:gThegbestginitialgresponsegisgtoghelpgthegdaughtergunderstandgtheglevelgofgcaregandgob
servationgthatgwillgbegprovidedgongthegMSCUgsogasgtoghelpghergunderstandgthatghergfathersgcareg
willgbegagpriority.
Rationaleg4:gThegnursegshouldgtrygtogintervenegingthisgsituationgbeforeginvolvinggthegphysician.gG
lobalgRationale:
CognitivegLevel:gAnalyzing
ClientgNeed:gSafegEffectivegCaregEnvironmentgCli
entgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gImplementation
gLearninggOutcome:g1-1
Questiong3gTyp
e:gMCSA
Agnursegwhogisgcontemplatinggtakinggagpositiongingangintensivegcaregunitgisgreviewingghergstreng
thsgandgweaknesses.gWhichgcharacteristicsgofgthegnursegwillgbegofgtheggreatestgbenefitgingtheginte
nsivegcaregenvironment?
1. Feelsgcomfortablegingevergchanginggsituations
2. Closelygevaluatesgthegprosgandgconsgofgeachgdecisiongforgaglonggperiodgofgtimegbeforegmaking
gagdecision
3. Isgquietgandgintroverted
4. Isgexcitedgaboutgallgnewgexperience
sgCorrectgAnswer:g1
Rationaleg1:gThegnursegingthegintensivegcaregunitgmustgbegopengtogever-
changinggsituations.gThegnursegmustgbegflexible.
Rationaleg2:gThegrapidgchangesgingthegintensivegcaregunitgdognotgallowgforgextendedgtimegwhengc
onsideringgactions.
Rationaleg3:gAgquietgandgintrovertedgnursegmaygnotgbegaggoodgmatchgforgtheghighgpacedghigh-
gacuitygcaregunitgduegtogthegneedgforgteamworkgandginteraction.
Rationaleg4:gExcitementgaboutgallgexperiencesgisgagbeneficialgcharacteristicginghealthcaregbutgisg
notgthegmostgimportantgfactorgforgthisgparticulargcaregunit.
GlobalgRationale:
CognitivegLevel:gAnalyzing
ClientgNeed:gSafegEffectivegCaregEnvironmentgCli
entgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gAssessmen
tgLearninggOutcome:g1-2
Questiong4gTyp
e:gMCSA
Thegregisteredgnursegisgworkinggasgchargegnursegongagbusyghigh-
acuitygcaregunit.gUnexpectedly,gagcoworkergbecomesgillgandgneedsgtogleave.gTheregisgagperiodgofg
timegingwhichgthegunitgisgshort
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staffedgwhilegthegillgcoworkersgreplacementgtravelsgingtogwork.gWhatgactiongbygthegchargegnursegisgindicat
ed?
1. Makegnogchangesguntilgthegreplacementgnursegarrives.
2. Assigngtheglessgacutegpatientsgtogbegcaredgforgbygthegunlicensedgassistivegpersonnel.
3. Assigngthegunlicensedgassistivegpersonnelgtogwatchgthegmonitorsgandgcallgforghelpgifgagpatie
ntggetsgintogtrouble.
4. Contactgtheghousegsupervisorgandgaskgforgagfloatgnursegtogbegsentgtogtheguni
t.gCorrectgAnswer:g4
Rationaleg1:gThegunitgisgunderstaffed.gReplacementghelpgmustgbegprovided.gItgisginappropriategtog
waitgforgthegreplacementgnurse.
Rationaleg2:gThegunlicensedgassistivegpersonnelgaregonlygablegtogprovidegcaregundergthegdirectgsu
pervisiongofgthegnurse.
Rationaleg3:gWatchinggmonitorsgisgnotgwithingthegjobgdescriptiongofgthegunlicensedgassistiv
egpersonnelgandgisgnotgappropriate.gThegmanagergwouldgbegputtinggbothgpatientgsafetygandg
thegunlicensedgassistivegpersonnelgatgrisk.
Rationaleg4:gThegmanagergshouldgobtainghelpguntilgthegreplacementgnursegarrives.gContactinggthe
ghousegsupervisorgandgaskinggforgagtemporarygfloatgnursegisgthegbestgintervention.
GlobalgRationale:
CognitivegLevel:gAnalyzing
ClientgNeed:gSafegEffectivegCaregEnvironmentgCli
entgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gImplementation
gLearninggOutcome:g1-2
Questiong5gTyp
e:gMCSA
Agrecentgnursinggschoolggraduategreportsghavingganginterviewgwithgagmagnetghospital.gWhengpre
paringgforgtheginterview,gtheggraduategnursegresearchesgthegconceptgofgmagnetgstatus.gWhichgperc
eptionsgbygthegnursegindicategangadequategunderstanding?
1. MagnetgstatusgisgangaccreditationgfromgthegNationalgLeaguegforgNurses.
2. Magnetgstatusgfacilitiesgpaygsubstantialgrecruitmentgbonuses.
3. Magnetgstatusgfacilitiesgpromotegtheginterestsgofgprofessionalgnursing.
4. Magnetgstatusghospitalsgmustgestablishgnurse-to-
patientgratios.gCorrectgAnswer:g3
Rationaleg1:gMagnetgstatusgisgagdesignationgdevelopedgbygthegAmericangNursesgCredentialinggCe
nter.
Rationaleg2:gFacilitiesgwithgmagnetgdesignationgattractgnursesgbecausegofgtheirgworkgenvironmen
t.gOftengtheregisgnogneedgtogpaygrecruitmentgbonuses.
Rationaleg3:gMagnetgstatusgisgawardedgtoghospitalsgthatgaregablegtogprovegtheirgcommitmentgtogpr
ofessionalgnursinggpractices.
Rationaleg4:gNurse-to-
patientgratiosgaregnotgpartgofgthegmagnetghospitalgdesignation.gGlobalgRationale:
CognitivegLevel:gAnalyzing
ClientgNeed:gSafegEffectivegCaregEnvironment
, ClientgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gEvaluationgLea
rninggOutcome:g1-2
Questiong6gTyp
e:gMCSA
Agteamgofgnursesgwouldglikegtogresearchgoutcomesgofgintensivegcaregthatgexpandgbeyondgthosegth
atgaregnormallygstudied.gThisgteamgwouldgrecognizegwhichgoutcomegasgmostgcommonlygstudied?
1. Patientgcomfort
2. Patientgperceivedgqualitygofglife
3. Functionalgstatus
4. Mortality
CorrectgAnswer:g4
Rationaleg1:gPatientgcomfortgisgagverygimportantgoutcome,gbutgisgnotgthegonegmostgcommonlygstu
died.
Rationaleg2:gQualitygofglifegaftergintensivegcaregisgagverygimportantgoutcome,gbutgisgnotgthegoneg
mostgcommonlygstudied.
Rationaleg3:gFunctionalgstatusgaftergtreatmentgingthegintensivegcaregunitgisgagverygimportantgoutco
me,gbutgisgnotgthegonegmostgcommonlygstudied.
Rationaleg4:gMortalitygisgthegmostgcommonlygstudiedgoutcomegofgintensivegcaregtreatment.gGlo
balgRationale:
CognitivegLevel:gApplying
ClientgNeed:gSafegEffectivegCaregEnvironmentgCli
entgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gAssessmen
tgLearninggOutcome:g1-2
Questiong7gTyp
e:gMCSA
Agnewlygemployedgnursegisgworkinggwithgangexperiencedgregisteredgnurse.gDuringgthegshift,gtheg
experiencedgnursegroutinelygusesghergpersonalgdigitalgassistant.gHowgwouldgthegnursegexplaingthe
gusegofgthisgdevicegtogthegnovicegnurse?
1. IgusegmygPDAgasgagreferencegtoolgseveralgtimesgeverygday.
2. IgcangaccessgmygpatientsgoldgmedicalgrecordsgongthisgPDA.
3. IgusegmygPDAgtogletgthegpharmacygknowgwhengIgneedgmedications.
4. IgusegmygPDAgtogwritegnursinggnotes
.gCorrectgAnswer:g1
Rationaleg1:gThegpersonalgdigitalgassistantg(PDA)gisgusedgtogprovidegquickgbedsideginformationgt
ogthegnurse.
Rationaleg2:gThegpatientsgpersonalgmedicalgrecordsgwouldgnotgbegaccessiblegthroughgthegPDA.gR
ationaleg3:gThegPDAgwouldgnotgbegusefulgforgthisgapplication.
Rationaleg4:gThegnursegshouldgnotgrecordgnursinggnotesgongthegPDA.gGl
obalgRationale:
CognitivegLevel:gApplying
ClientgNeed:gSafegEffectivegCaregEnvironment
Test bank for High Acuity Nursing 7th Edition Wagne
g g g g g g g gg
r Pierce Welsh -latest-2023-2024
g g g
Chapterg1.gHigh-
AcuitygNursinggQuestiong1
Type:gMCSA
Thegpatientgwhoghadgsurgerygyesterdaygreportsghisgchestgfeelsgtight.gAssessmentgrevealsgrespirat
orygrategofg29,ginspiratorygwheezes,gstridor,gandgangoxygenationgsaturationgofg80%.gThegnursegw
ouldgconsidergthisgpatientgtogbegwhichgprioritygforgtransfergtogthegintensivegcaregunitg(ICU)?
1. Priorityg1
2. Priorityg2
3. Priorityg3
4. Priorityg4
CorrectgAnswer:g1
Rationaleg1:gThisgpatientgisgexhibitinggsignsgofgangacutegrespiratorygeventgforgwhichgintubationg
orgothergintensivegtreatmentgmaygbegnecessary.gPriorityg1gpatientsgaregacutelygillgandgneedginten
sivegtreatmentgandgmonitoringgnotgprovidedgoutsidegofgthegICU.
Rationaleg2:gPriorityg2grefersgtogpatientsgneedinggintensivegmonitoringgandgmaygpotentiallygneedg
additionalginterventions.gTheygaregtypicallygnotgevolvinggangacutegeventgasgisgthegcasegwithgthisg
patient.
Rationaleg3:gPriorityg3gpatientsgaregcriticallygillgbutghaveglittlegchancegofgrecoverygfromgtheirgilln
esses.gLimitsgaregplacedgongtherapeuticginterventionsgandgtheygcangbegcaredgforgingareasgothergtha
ngthegICUgifgnecessary.
Rationaleg4:gPriorityg4gpatientsghavegnogsignsgorgsymptomsgthatgindicategintensivegmonitoringgor
gtreatmentgaregnecessary.
GlobalgRationale:
CognitivegLevel:gAnalyzing
ClientgNeed:gSafegEffectivegCaregEnvironmentgCli
entgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gPlanninggLearn
inggOutcome:g1-1
Questiong2gTyp
e:gMCSA
Thegdaughtergofgagpatientgwhogisgdyinggquestionsgthegplacementgofghergfathergongthegmedicalsur
gicalgcaregunitg(MSCU).gShegrequestsghegbegplacedgingthegintensivegcaregunitg(ICU)gbecausegofgc
oncernghergfathergmaygnotgreceivegclosegobservationgongagbusyghospitalgunit.gWhichgactiongisgind
icatedgbygthegnurse?
1. Notifygthegintensivegcaregunitgofgangimpendinggtransfer.
2. Tellgthegdaughtergthatghergfathergdoesgnotgmeetgcriteriagforgplacementgingthegmoregexpensiv
egICU.
3. Discussgthegcaregthatgcangbegprovidedgongthegunitgwithgthegfamilygmember.
4. Contactgthegphysician.
CorrectgAnswer:g3
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Rationaleg1:gThegnursegcannotgmakegthisgtransfergdecisiongindependently.
Rationaleg2:gTellinggthegdaughtergthatghergfathergdoesgnotgmeetgcriteriagforgtransfergisgnotgtherap
eutic.gBringinggupgthegissuegofgcostgmaygcausegthegdaughtergtogoffergtogpaygthegdifferencegbetwee
ngthegcostsgofgthegtwogunits.gThisgwouldgcreategagseriousgethicalgdilemma.
Rationaleg3:gThegbestginitialgresponsegisgtoghelpgthegdaughtergunderstandgtheglevelgofgcaregandgob
servationgthatgwillgbegprovidedgongthegMSCUgsogasgtoghelpghergunderstandgthatghergfathersgcareg
willgbegagpriority.
Rationaleg4:gThegnursegshouldgtrygtogintervenegingthisgsituationgbeforeginvolvinggthegphysician.gG
lobalgRationale:
CognitivegLevel:gAnalyzing
ClientgNeed:gSafegEffectivegCaregEnvironmentgCli
entgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gImplementation
gLearninggOutcome:g1-1
Questiong3gTyp
e:gMCSA
Agnursegwhogisgcontemplatinggtakinggagpositiongingangintensivegcaregunitgisgreviewingghergstreng
thsgandgweaknesses.gWhichgcharacteristicsgofgthegnursegwillgbegofgtheggreatestgbenefitgingtheginte
nsivegcaregenvironment?
1. Feelsgcomfortablegingevergchanginggsituations
2. Closelygevaluatesgthegprosgandgconsgofgeachgdecisiongforgaglonggperiodgofgtimegbeforegmaking
gagdecision
3. Isgquietgandgintroverted
4. Isgexcitedgaboutgallgnewgexperience
sgCorrectgAnswer:g1
Rationaleg1:gThegnursegingthegintensivegcaregunitgmustgbegopengtogever-
changinggsituations.gThegnursegmustgbegflexible.
Rationaleg2:gThegrapidgchangesgingthegintensivegcaregunitgdognotgallowgforgextendedgtimegwhengc
onsideringgactions.
Rationaleg3:gAgquietgandgintrovertedgnursegmaygnotgbegaggoodgmatchgforgtheghighgpacedghigh-
gacuitygcaregunitgduegtogthegneedgforgteamworkgandginteraction.
Rationaleg4:gExcitementgaboutgallgexperiencesgisgagbeneficialgcharacteristicginghealthcaregbutgisg
notgthegmostgimportantgfactorgforgthisgparticulargcaregunit.
GlobalgRationale:
CognitivegLevel:gAnalyzing
ClientgNeed:gSafegEffectivegCaregEnvironmentgCli
entgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gAssessmen
tgLearninggOutcome:g1-2
Questiong4gTyp
e:gMCSA
Thegregisteredgnursegisgworkinggasgchargegnursegongagbusyghigh-
acuitygcaregunit.gUnexpectedly,gagcoworkergbecomesgillgandgneedsgtogleave.gTheregisgagperiodgofg
timegingwhichgthegunitgisgshort
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staffedgwhilegthegillgcoworkersgreplacementgtravelsgingtogwork.gWhatgactiongbygthegchargegnursegisgindicat
ed?
1. Makegnogchangesguntilgthegreplacementgnursegarrives.
2. Assigngtheglessgacutegpatientsgtogbegcaredgforgbygthegunlicensedgassistivegpersonnel.
3. Assigngthegunlicensedgassistivegpersonnelgtogwatchgthegmonitorsgandgcallgforghelpgifgagpatie
ntggetsgintogtrouble.
4. Contactgtheghousegsupervisorgandgaskgforgagfloatgnursegtogbegsentgtogtheguni
t.gCorrectgAnswer:g4
Rationaleg1:gThegunitgisgunderstaffed.gReplacementghelpgmustgbegprovided.gItgisginappropriategtog
waitgforgthegreplacementgnurse.
Rationaleg2:gThegunlicensedgassistivegpersonnelgaregonlygablegtogprovidegcaregundergthegdirectgsu
pervisiongofgthegnurse.
Rationaleg3:gWatchinggmonitorsgisgnotgwithingthegjobgdescriptiongofgthegunlicensedgassistiv
egpersonnelgandgisgnotgappropriate.gThegmanagergwouldgbegputtinggbothgpatientgsafetygandg
thegunlicensedgassistivegpersonnelgatgrisk.
Rationaleg4:gThegmanagergshouldgobtainghelpguntilgthegreplacementgnursegarrives.gContactinggthe
ghousegsupervisorgandgaskinggforgagtemporarygfloatgnursegisgthegbestgintervention.
GlobalgRationale:
CognitivegLevel:gAnalyzing
ClientgNeed:gSafegEffectivegCaregEnvironmentgCli
entgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gImplementation
gLearninggOutcome:g1-2
Questiong5gTyp
e:gMCSA
Agrecentgnursinggschoolggraduategreportsghavingganginterviewgwithgagmagnetghospital.gWhengpre
paringgforgtheginterview,gtheggraduategnursegresearchesgthegconceptgofgmagnetgstatus.gWhichgperc
eptionsgbygthegnursegindicategangadequategunderstanding?
1. MagnetgstatusgisgangaccreditationgfromgthegNationalgLeaguegforgNurses.
2. Magnetgstatusgfacilitiesgpaygsubstantialgrecruitmentgbonuses.
3. Magnetgstatusgfacilitiesgpromotegtheginterestsgofgprofessionalgnursing.
4. Magnetgstatusghospitalsgmustgestablishgnurse-to-
patientgratios.gCorrectgAnswer:g3
Rationaleg1:gMagnetgstatusgisgagdesignationgdevelopedgbygthegAmericangNursesgCredentialinggCe
nter.
Rationaleg2:gFacilitiesgwithgmagnetgdesignationgattractgnursesgbecausegofgtheirgworkgenvironmen
t.gOftengtheregisgnogneedgtogpaygrecruitmentgbonuses.
Rationaleg3:gMagnetgstatusgisgawardedgtoghospitalsgthatgaregablegtogprovegtheirgcommitmentgtogpr
ofessionalgnursinggpractices.
Rationaleg4:gNurse-to-
patientgratiosgaregnotgpartgofgthegmagnetghospitalgdesignation.gGlobalgRationale:
CognitivegLevel:gAnalyzing
ClientgNeed:gSafegEffectivegCaregEnvironment
, ClientgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gEvaluationgLea
rninggOutcome:g1-2
Questiong6gTyp
e:gMCSA
Agteamgofgnursesgwouldglikegtogresearchgoutcomesgofgintensivegcaregthatgexpandgbeyondgthosegth
atgaregnormallygstudied.gThisgteamgwouldgrecognizegwhichgoutcomegasgmostgcommonlygstudied?
1. Patientgcomfort
2. Patientgperceivedgqualitygofglife
3. Functionalgstatus
4. Mortality
CorrectgAnswer:g4
Rationaleg1:gPatientgcomfortgisgagverygimportantgoutcome,gbutgisgnotgthegonegmostgcommonlygstu
died.
Rationaleg2:gQualitygofglifegaftergintensivegcaregisgagverygimportantgoutcome,gbutgisgnotgthegoneg
mostgcommonlygstudied.
Rationaleg3:gFunctionalgstatusgaftergtreatmentgingthegintensivegcaregunitgisgagverygimportantgoutco
me,gbutgisgnotgthegonegmostgcommonlygstudied.
Rationaleg4:gMortalitygisgthegmostgcommonlygstudiedgoutcomegofgintensivegcaregtreatment.gGlo
balgRationale:
CognitivegLevel:gApplying
ClientgNeed:gSafegEffectivegCaregEnvironmentgCli
entgNeedgSub:gManagementgofgCare
Nursing/IntegratedgConcepts:gNursinggProcess:gAssessmen
tgLearninggOutcome:g1-2
Questiong7gTyp
e:gMCSA
Agnewlygemployedgnursegisgworkinggwithgangexperiencedgregisteredgnurse.gDuringgthegshift,gtheg
experiencedgnursegroutinelygusesghergpersonalgdigitalgassistant.gHowgwouldgthegnursegexplaingthe
gusegofgthisgdevicegtogthegnovicegnurse?
1. IgusegmygPDAgasgagreferencegtoolgseveralgtimesgeverygday.
2. IgcangaccessgmygpatientsgoldgmedicalgrecordsgongthisgPDA.
3. IgusegmygPDAgtogletgthegpharmacygknowgwhengIgneedgmedications.
4. IgusegmygPDAgtogwritegnursinggnotes
.gCorrectgAnswer:g1
Rationaleg1:gThegpersonalgdigitalgassistantg(PDA)gisgusedgtogprovidegquickgbedsideginformationgt
ogthegnurse.
Rationaleg2:gThegpatientsgpersonalgmedicalgrecordsgwouldgnotgbegaccessiblegthroughgthegPDA.gR
ationaleg3:gThegPDAgwouldgnotgbegusefulgforgthisgapplication.
Rationaleg4:gThegnursegshouldgnotgrecordgnursinggnotesgongthegPDA.gGl
obalgRationale:
CognitivegLevel:gApplying
ClientgNeed:gSafegEffectivegCaregEnvironment