A nurse is caring for a client diagnosed with pneumonia who has labored breathing and copious tracheobronchial secretions.

What priority action should the nurse encourage with the client?

Choice A rationale
While ensuring that nurses demonstrate competency by passing a medication administration test is important, it is not the first step in developing a program to decrease medication administration errors. This strategy focuses on the individual skills of the nurses, but does not address the systemic issues that may have contributed to the errors.
Choice B rationale
Reviewing the circumstances leading up to each medication error is the first step in understanding why the errors occurred. This process allows the committee to identify patterns and common factors that contribute to errors. It is a crucial step in the development of effective strategies to prevent future errors.
Choice C rationale
Developing a quality improvement program for nurses involved in medication errors is a strategy that could be implemented after understanding the root causes of the errors. This approach ensures that the program addresses the specific issues that led to the errors.
Choice D rationale
Conducting an in-service training on medication administration for all nurses is a valuable strategy for preventing medication errors. However, it should be based on the findings from the review of the circumstances leading up to each error. Therefore, it is not the first strategy to consider.

Choice A rationale
Culturally incompetent caregivers can be a significant barrier to appropriate communication with clients. Cultural competence involves understanding and respecting the cultural differences and preferences of clients, which can greatly influence how they perceive and respond to healthcare communication.
Choice B rationale
Proper training in healthcare communication is not a barrier, but rather a facilitator of appropriate communication with clients. It equips healthcare professionals with the necessary skills and knowledge to communicate effectively with clients.
Choice C rationale
Excellent health literacy is not a barrier, but rather a facilitator of appropriate communication with clients. Clients with excellent health literacy are better able to understand and engage in healthcare communication.
Choice D rationale
Implicit bias can be a significant barrier to appropriate communication with clients. It refers to the unconscious attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner.
Choice E rationale
Lack of diversity can be a significant barrier to appropriate communication with clients. Diversity in the healthcare workforce can enhance the understanding of the cultural and social needs of diverse client populations, thereby improving communication.