A nurse is caring for a client who has refused medications. Which of the following actions should the nurse take? (Select all that apply.)

Document the client's statement in the medical record.

Reinforce teaching about the purposes of the medications.

Tell the client they can take their medications later in the day.

Record non administration in the client's medication administration record.

Inform the pharmacy the client's medications will be wasted.

Answer and Explanation

Correct Answer : A,B,D

A.   Document the client's statement in the medical record. Accurate documentation is essential to provide a complete record of the client's care and decisions.
B.   Reinforce teaching about the purposes of the medications. Providing information can help the client make informed decisions and reconsider their refusal.
C.   Tell the client they can take their medications later in the day. This may not be appropriate, depending on the medication schedule and therapeutic requirements.
D.   Record non-administration in the client's medication administration record (MAR). This ensures an accurate medication history and alerts other providers to the missed dose.
E.   Inform the pharmacy the client's medications will be wasted. Medications are not automatically wasted upon refusal; they can often be returned or rescheduled.

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Correct Answer is B

Explanation

A. Asking a staff member from another unit to complete the evaluation: Staff from other units may not have direct knowledge of the nurse's work performance.
B. Linking the evaluation to predetermined standards: Using predetermined standards ensures objectivity and consistency in evaluations.
C. Focusing primarily on areas that need improvement: Evaluations should be balanced, recognizing both strengths and areas for improvement.
D. Discussing the evaluation with the nurse manager: The evaluation should first be completed independently before discussing it with a manager if needed.

A. Establish eye contact with the other person. B. Passively listen to the other party. C. Use "you" rather than "I" statements to express thoughts. D. Focus on the person, not the problem.

Correct Answer is A

Explanation

A. Establish eye contact with the other person: Maintaining eye contact demonstrates attentiveness and respect during communication, fostering trust.
B. Passively listen to the other party: Passive listening is ineffective and may lead to misunderstandings. Active listening is preferred for conflict resolution.
C. Use "you" rather than "I" statements to express thoughts: "You" statements can be perceived as accusatory and escalate conflicts. "I" statements help express concerns without blame.
D. Focus on the person, not the problem: Effective conflict resolution focuses on addressing the problem, not assigning blame or targeting individuals.

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Nursing Test Bank

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