Pаtient's Clinicаl Recоrd Nurse's Trаnsfer Nоte frоm the Emergency Department Patient admitted to the emergency department at 3 pm complaining of shortness of breath, which patient reported became worse over the last few days. Sputum culture and metabolic panel and complete blood count (CBC) drawn and sent to laboratory. Oxygen ordered at 2 L per minute via nasal canula, acetaminophen 650 mg administered at 5 pm. Patient transferred to 5 South with a diagnosis of R/O (rule out) pneumonia at 6 pm. Vital Signs Sheet Oxygen Saturation 6:15 pm 85% 2L Oxygen Nasal Canula Temperature 6:15 pm 102.4°F, temporal Heart Rate 6:15 pm 92 beats per minute, radial Blood Pressure 6:15 pm 160/90, Left Upper Arm Respirations 6:15 pm 28 breaths per minute Nurses Progress Note 7 pm: IV 0.45% sodium chloride running at 100 mL per hour. IV site is clean, dry, and intact. Patient has a productive cough, and respirations are 28 breaths per minute related to excessive respiratory secretions. Called attending provider for an order for chest physiotherapy. Patient states feeling tired and nauseated. patient had 4 oz of soup and 3 oz of water and refused rest of dinner. Patient assisted to the bathroom to void; no dizziness reported by the patient. ________________________________________________________________________________________________________________________________________________________________ Which statement from the documentation demonstrates the nurse is functioning in the Analyze Cues step of the CJMM?