A charge nurse observes that a staff nurse's behavior has changed over the past few weeks. Which of the following behaviors should the charge nurse identify as an indication that the staff nurse might be working while impaired?

Spends free time conversing with other staff at the nurses' station.

Frequent use of restroom.

Depends on other nurses to administer pain medication to their clients.

Delegates tasks to assistive personnel.

Answer and Explanation

The Correct Answer is B

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.

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Correct Answer is D

Explanation

The correct answer is choice D.

Choice A rationale:

“A client who is in balanced skeletal traction.” This client requires specialized orthopedic knowledge to manage the traction and monitor for complications. A nurse without orthopedic experience may not be familiar with the care required.

Choice B rationale:

“A client who had a total hip arthroplasty 3 days ago.” This client is likely to require specialized post-operative care, including pain management, mobility assistance, and monitoring for complications such as infection or dislocation. These tasks typically require specific orthopedic training.

Choice C rationale:

“A client who has a fractured femur with a new cast.” This client will require specialized care to manage the cast, monitor for complications such as compartment syndrome, and provide pain management. These tasks typically require specific orthopedic training.

Choice D rationale:

“A client who had a right above-the-knee amputation 24 hours ago.” This is the correct answer. While this client will require post-operative care, the care is likely to be similar to the post-operative care provided on a medical unit, such as pain management, wound care, and monitoring for complications. Therefore, a nurse from a medical unit could likely provide appropriate care for this client.

A. Assess the client's incision every 8 hours for the first 48 hours. B. Inform the assistive personnel of the client's weight-bearing status. C. Instruct the client to cross their legs at the ankles when sitting in a chair. D. Teach the client's partner to assist the client to flex the hip at least 120° each hour.

Correct Answer is B

Explanation

The correct answer is b. Inform the assistive personnel of the client’s weight-bearing status.

Choice A: Assess the client’s incision every 8 hours for the first 48 hours. While it is important to monitor the incision site for signs of infection, the frequency of every 8 hours for the first 48 hours may not be necessary unless specified by the surgeon or the patient’s condition warrants it.

Choice B: Inform the assistive personnel of the client’s weight-bearing status. This is the correct answer. After a total hip arthroplasty, it’s crucial to communicate the client’s weight-bearing status to all members of the healthcare team, including assistive personnel. This helps ensure that everyone is aware of the client’s mobility limitations and can assist the client safely.

Choice C: Instruct the client to cross their legs at the ankles when sitting in a chair. This is not recommended. After a hip arthroplasty, patients are typically advised not to cross their legs to prevent dislocation of the new hip joint.

Choice D: Teach the client’s partner to assist the client to flex the hip at least 120° each hour. This is not recommended. After a hip arthroplasty, patients are typically advised to avoid flexing the hip more than 90 degrees to prevent dislocation of the new hip joint1. Therefore, flexing the hip at least 120° each hour could potentially harm the patient.

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A charge nurse observes that a staff nurse's behavior has changed over the past few weeks. Which of the following behaviors should the charge nurse identify as an indication that the staff nurse might be working while impaired?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse from a medical unit is asked to work on an orthopedic unit. The medical nurse has no orthopedic experience. Which of the following clients should be assigned to the medical nurse?

Correct Answer is D

Explanation

A nurse is reviewing the plan of care for a client following a total hip arthroplasty. Which of the following actions should the nurse plan to take?

Correct Answer is B

Explanation

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