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A nurse has just completed assessment charging on the electronic record for an assigned client. An assistive personnel who just measured the client’s vital signs asks to chart them while the nurse is still logged into the record. Which of the following actions should the nurse take?

Recommend the AP come back later when the record is available

Log out so the AP can log in to document the vital signs

Offer to chart the vital signs for the AP

Allow the AP to document the vital signs prior to logging out

Answer and Explanation

The Correct Answer is B

a. Recommend the AP come back later when the record is available:

This option delays the documentation process unnecessarily and may inconvenience the AP.

It doesn't address the issue of maintaining patient confidentiality and accurate documentation.

b. Log out so the AP can log in to document the vital signs:

This is the correct choice as it ensures that each individual's documentation is attributed to the correct user.

It maintains patient confidentiality and adheres to HIPAA regulations.

It allows the AP to complete their task efficiently while preserving the integrity of the electronic record.

c. Offer to chart the vital signs for the AP:

This option involves the nurse taking over the responsibility of documenting the vital signs for the AP, which could lead to confusion and potential errors.

It's not the most appropriate solution as it may not be feasible for the nurse to document the vital signs accurately without directly measuring them.

d. Allow the AP to document the vital signs prior to logging out:

Allowing the AP to document vital signs under the nurse's login compromises the integrity of the electronic record and violates HIPAA regulations.

It's not an acceptable practice as it can lead to inaccuracies in the documentation and compromises patient confidentiality.

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Correct Answer is C

Explanation

a. Educate the client about the risks of refusing the procedure:

This option suggests providing information about the potential consequences of not undergoing the gastroscopy. While educating the client about risks is essential, the immediate concern is the client's lack of understanding about the procedure itself.

b. Complete the incident report:

Filling out an incident report is typically reserved for situations where there has been an actual incident, such as a medical error or adverse event. In this case, the client's lack of understanding does not constitute an incident but rather a need for clarification.

c. Inform the provider that the client requires clarification about the procedure:

This is the correct action. It involves escalating the issue to the provider responsible for performing the gastroscopy. The provider can then address the client's concerns, answer questions, and provide additional information to ensure informed consent.

d. Answer the client’s questions concerning the procedure:

While answering the client's questions is important, it's not solely the nurse's responsibility to ensure the client understands the procedure. The provider, who will perform the gastroscopy, should be informed of the client's confusion so they can address it effectively.

A. Assault B. Libel C. Battery D. False Imprisonment

Correct Answer is C

Explanation

a. Assault:

Assault involves the threat of bodily harm or unwanted physical contact that creates fear or apprehension in the victim. In this scenario, there is no indication of a threat being made against the client; instead, the nurse administers the medication without their consent.

b. Libel:

Libel refers to a false written statement that damages a person's reputation. This option is not applicable to the scenario described, as it does not involve written communication or defamation of character.

c. Battery:

Battery occurs when there is unauthorized physical contact with another person that results in harm or offense. In this scenario, the nurse administers the injection against the client's will, which constitutes unauthorized physical contact, making it an example of battery.

d. False imprisonment:

False imprisonment involves unlawfully restraining or confining a person against their will. While administering medication without consent could potentially be perceived as a form of restraint, false imprisonment typically involves physical confinement or restriction of movement, which is not the case in this scenario.

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A nurse has just completed assessment charging on the electronic record for an assigned client. An assistive personnel who just measured the client’s vital signs asks to chart them while the nurse is still logged into the record. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse enters a client’s room to witness an informed consent for a gastroscopy. The client states he does not understand the procedure. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is caring for a client who reports acute pain but refuses IM medication. The nurse distracts the client and quickly administers the injection. This illustrates which of the following?

Correct Answer is C

Explanation

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A nurse has just completed assessment charging on the electronic record for an assigned client. An assistive personnel who just measured the client’s vital signs asks to chart them while the nurse is still logged into the record. Which of the following actions should the nurse take?

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