A charge nurse is preparing to observe a newly licensed nurse perform a routine abdominal assessment. Which of the following actions should the charge nurse expect the newly licensed nurse to take?

Answer is b. Frequent use of restroom.

a. Spends free time conversing with other staff at the nurses' station: Socializing with colleagues during free time at the nurses' station is a common and acceptable behavior in many healthcare settings. While excessive socializing could potentially interfere with productivity, it does not necessarily indicate impairment. Engaging in conversations with coworkers can serve as a stress-reliever and contribute to a supportive work environment, rather than being a sign of impairment.

b. Frequent use of restroom: Correct. Frequent restroom use can be a red flag for substance abuse or other health issues. Individuals who are working while impaired may frequently visit the restroom to use drugs, manage their effects, or experience side effects of substance use. This behavior may be a tactic to conceal substance abuse from coworkers or supervisors, as frequent restroom breaks could be perceived as a normal bodily function. Therefore, the charge nurse should pay close attention to staff members who exhibit a pattern of frequent restroom use, especially if there are other signs of impairment or behavior changes.

c. Depends on other nurses to administer pain medication to their clients: While relying on other nurses to administer pain medication to clients could potentially raise concerns about the staff nurse's competence or workload management, it does not necessarily indicate impairment. There could be various reasons for a nurse to delegate medication administration tasks, such as being assigned to other critical tasks, adhering to hospital policies, or seeking assistance during busy periods. Without further evidence or observation of impaired behavior, depending on others to administer medications cannot be solely attributed to working while impaired.

d. Delegates tasks to assistive personnel: Delegating tasks to assistive personnel is a standard nursing practice and does not inherently suggest impairment. Nurses often delegate tasks to other healthcare team members, including certified nursing assistants or patient care technicians, to ensure efficient and effective patient care delivery. Delegation is guided by nursing standards, patient acuity, and the scope of practice of assistive personnel. Therefore, observing a nurse delegating tasks alone is not sufficient evidence to suspect impairment.

In summary, the correct answer is b because frequent use of the restroom can be indicative of substance abuse or other health issues, especially when observed in conjunction with other signs of impairment or behavior changes. The charge nurse should carefully monitor and investigate any concerning behaviors displayed by staff nurses to ensure patient safety and provide appropriate support and intervention.

Choice A rationale:

Leaving the medication on the client's bedside table is not appropriate because it doesn't address the client's concerns and may result in the client not taking the medication at all. This choice does not promote the client's well-being.

Choice B rationale:

Returning in 1 hour to administer the medication doesn't address the client's immediate concerns and also doesn't provide adequate information about the medication's importance. Delaying the medication administration without proper communication is not ideal.

Choice C rationale:

Mixing the medication in applesauce may be appropriate in some cases, but it doesn't address the client's reluctance to take the medication due to fatigue. Additionally, the client's Crohn's disease might require specific instructions for medication administration that should not be altered without consulting the healthcare provider.

Choice D rationale:

The correct answer. Informing the client of the consequences of refusing the medication is the most appropriate action. The nurse should engage in a therapeutic conversation with the client, explaining the importance of the medication in managing Crohn's disease symptoms and preventing complications. This choice respects the client's autonomy while providing necessary information for an informed decision.