A nurse is caring for a client who fell while walking to the bathroom. Which of the following actions should the nurse take when completing the incident report?
Use direct quotes made by the client to describe the incident.
Make a notation in the client's medical record that an incident report was completed.
Draw a conclusion regarding the cause of the incident.
Place a copy of the incident report in the client's medical record.
The Correct Answer is A
Choice A Reason:Using direct quotes from the client in the incident report is appropriate because it provides an accurate and objective account of the client's perspective. This is an important part of documenting the incident.
Choice B Reason:Incident reports are meant to be internal documents used for quality improvement and risk management. Noting in the medical record that an incident report was completed is not appropriate, as it could imply liability or affect the legal status of the report.
Choice C Reason:The nurse should not draw conclusions about the cause of the incident in the incident report. The report should contain only objective facts, not assumptions or interpretations.
Choice D Reason:
The nurse should not draw conclusions about the cause of the incident in the incident report. The report should contain only objective facts, not assumptions or interpretations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Consuming probiotic sources is recommendable. Probiotics are beneficial bacteria that can promote gut health. Including probiotic sources in the diet, such as yogurt with live cultures or other fermented foods, can help maintain a healthy balance of gut bacteria and alleviate constipation.
Choice B Reason:
Using a laxative every day is not recommendable. Regular use of laxatives is generally not recommended for chronic constipation, as it can lead to dependence and may not address the underlying causes.
Choice C Reason:
Baking with white flour is not recommendable. Consuming refined white flour may not contribute significantly to relieving constipation. Whole grains, high-fiber foods, and adequate fluid intake are more beneficial.
Choice D Reason:
Taking a calcium supplement is not recommendable. While calcium is important for overall health, taking a calcium supplement is not typically recommended as the primary intervention for chronic constipation. Dietary and lifestyle measures, such as increasing fiber intake and staying hydrated, are more commonly recommended.
Correct Answer is B
Explanation
Choice A Reason:
"I'll listen to my favorite music to take my mind off the pain." This statement refers to distraction techniques, like listening to music, which can help manage pain but isn't specifically guided imagery.
Choice B Reason:
"I'll think about my grandfather's farm to reduce pain." This statement indicates an understanding of this technique. Guided imagery involves creating a detailed mental image or scenario that promotes relaxation and diminishes pain perception. In this case, the client visualizing a familiar, pleasant place like their grandfather's farm can be an effective form of guided imagery to alleviate pain by diverting attention and inducing relaxation.
Choice C Reason:
"I'll use focused breathing to control my pain." This statement does not indicate an understanding of this technique.
Focused breathing, while beneficial for relaxation and pain management, is a different technique from guided imagery.
Choice D Reason:
"I'll learn to notice the sensation of muscle tension." This statement refers to progressive muscle relaxation, a technique involving systematically tensing and relaxing muscle groups, which isn't guided imagery.
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