A nurse enters the hospital cafeteria for lunch and overhears two assistive personnel (AP) discussing a client who is currently hospitalized. Which of the following actions should the nurse take?
Complete an incident report.
Report the incident to the provider.
Document the occurrence in the client's medical record.
Quietly tell the APs that the conversation is inappropriate.
The Correct Answer is D
If a nurse overhears two assistive personnel (AP) discussing a client who is currently hospitalized in the hospital cafeteria, the appropriate action for the nurse to take is to quietly tell the APs that the conversation is inappropriate. This will allow the nurse to address the issue in a respectful and professional manner and remind the APs of their responsibility to maintain client confidentiality.
Option A is incorrect because completing an incident report may be necessary, but it should not be the first action taken.
Option B is incorrect because reporting the incident to the provider is not an appropriate action in this situation.
Option C is incorrect because documenting the occurrence in the client's medical record is not an appropriate action in this situation.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is Choice C.
Choice A rationale: A client who had a blood transfusion and has a blood pressure of 138/76 mm Hg. This client is stable. The blood pressure is within normal range, indicating that the client is not experiencing a transfusion reaction, which could cause hypotension. Therefore, this client is not the highest priority.
Choice B rationale: A client who has skeletal traction for a femur fracture and reports incisional discomfort of 4 on a scale of 0 to 10. While pain management is an important aspect of client care, a pain level of 4 indicates that the client’s pain is manageable. Therefore, this client is not the highest priority.
Choice C rationale: A client who is 4 hours postoperative following a total hip arthroplasty and has a urinary output of 15 mL/hr. This client is showing signs of oliguria, which could indicate a serious complication such as hypovolemia or acute kidney injury. This client is the highest priority because these complications can lead to further serious issues such as shock or end-organ damage if not addressed promptly.
Correct Answer is A
Explanation
If an assistive personnel (AP) refuses to take a specimen to the laboratory, the nurse should first discuss the incident with the AP. This allows the nurse to understand the reasons for the refusal and to address any concerns or issues that may have led to the refusal.
Option B may be necessary at some point, but it should not be the first response.
Option C may also be necessary to ensure that the specimen is delivered to the laboratory in a timely manner, but it does not address the underlying issue.
Option D may also be necessary at some point, but it should not be the first response.
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