A nurse is admitting a new client.
Which of the following steps of the nursing process is the nurse performing when formulating goals for a positive outcome?

The correct answer is: A

Choice A reason: Providing the nurse administering medications with an identifying vest can help reduce medication errors by making it easier for other staff and patients to identify the nurse responsible for medication administration. This can minimize interruptions and distractions, which are common causes of medication errors. It also serves as a visual reminder to the nurse of their critical role in medication safety.

Choice B reason: Removing medications from automatic dispensing systems before they are reviewed by pharmacists is not a recommended practice. Pharmacists play a crucial role in reviewing prescriptions for accuracy and potential drug interactions before dispensing. Therefore, medications should remain in the dispensing system until they have been properly reviewed and approved by a pharmacist.

Choice C reason: Waiting to document medications given to clients until the end of a shift is not advisable. Accurate and timely documentation is essential in healthcare, particularly when it comes to medication administration. Documentation should occur as soon as the medication is given to ensure that all healthcare providers have up-to-date information and to prevent errors such as omissions or duplications.

Choice D reason: Preparing medications for multiple clients at the same time increases the risk of errors, such as mix-ups between patients or incorrect dosing. It is best practice to prepare and administer medications for one client at a time, following the ‘five rights’ of medication administration: the right patient, the right drug, the right dose, the right route, and the right time.

The correct answer is Choice B.

Choice A rationale: Advanced beginners are newly graduated nurses who rely on limited experience and follow guidelines strictly. They cannot yet mentor others effectively because they lack the necessary comprehensive knowledge and practical skills for precepting new staff members.

Choice B rationale: Proficient nurses have a deep understanding of clinical situations through experience. They can recognize patterns, predict outcomes, and provide effective mentorship as preceptors. They are skilled at guiding new staff members and improving their clinical performance.

Choice C rationale: Expert nurses possess an intuitive grasp of clinical situations and make decisions rapidly. While they are highly skilled, the role of preceptor is generally better suited to proficient nurses who are adept at breaking down complex tasks for new learners.

Choice D rationale: Competent nurses have a few years of practice and can plan and manage patient care efficiently. However, they are not yet at the stage where they can fluidly adapt to varying situations or mentor new staff as effectively as proficient nurses.