A nurse is assisting a postoperative client.

The client is alert and oriented to person, place, and time, and reports incisional pain of 9 on a scale of 1 to 10. Morphine 8 mg was administered subcutaneously as prescribed at 0900.

The client is now sleeping and is difficult to arouse.

Pupils are 3 mm, equal and reactive to light.

Temperature is 37.5 C (99.5°), respirations are 10/min, and pulse oximetry is 87% on room air.

Which documentation in the client’s medical record requires further action by the nurse?

Choice A rationale
Contact with infected blood or bodily fluids is a major risk factor for Hepatitis B. The virus is present in the blood and bodily fluids of infected individuals and can be transmitted through direct contact.
Choice B rationale
Unprotected sex is a significant risk factor for Hepatitis B. The virus can be transmitted through sexual contact with an infected person.
Choice C rationale
Sharing dirty needles is a well-known risk factor for Hepatitis B. This is particularly a concern among individuals who inject drugs.
Choice D rationale
Sharing eating utensils is not typically a risk factor for Hepatitis B. The virus is not usually transmitted through casual contact or sharing of utensils.
Choice E rationale
Contact with contaminated food or water is not a risk factor for Hepatitis B. The virus is not transmitted through food or water.
Choice F rationale
Exposure to chemicals or toxins is not a risk factor for Hepatitis B. While certain chemicals and toxins can damage the liver, they do not directly cause Hepatitis B3.
Choice G rationale
Contact with infected feces is not typically a risk factor for Hepatitis B. The virus is primarily transmitted through blood and bodily fluids, not fecal matter.
Choice H rationale
Heavy alcohol consumption is not a direct risk factor for Hepatitis B. However, it can contribute to liver damage and complicate the course of the disease if a person is infected.

Choice A rationale
Discussing facility policies with coworkers. While understanding facility policies is important, it does not necessarily contribute to maintaining clinical competence.
Choice B rationale
Attending a professional conference. This is the correct answer. Professional conferences often provide opportunities for continuing education, learning about the latest research and best practices, and networking with other professionals in the field.
Choice C rationale
Joining a nurses’ union. While a union can provide support and advocacy for nurses, joining a union does not directly maintain clinical competence.
Choice D rationale
Removing expired supplies from the storage area. This is an important task for maintaining a safe and effective work environment, but it does not contribute to maintaining clinical competence.