A nurse is caring for a group of clients.
For which of the following situations should the nurse complete an incident report? (Select all that apply.)
A client receives burns from a heating pad.
A client reports being dissatisfied with the temperature of the meals provided.
A client becomes disoriented and falls out of bed.
A client's visitor becomes dizzy and faints in the client's room.
A client is unable to afford the physical therapy that the provider recommends.
Correct Answer : A,C,D
Choice A rationale
A client who receives burns from a heating pad has experienced harm due to the healthcare setting or treatment. An incident report should be completed to document the injury and investigate the cause to prevent future occurrences.
Choice B rationale
A client's dissatisfaction with meal temperature does not typically require an incident report unless it leads to significant issues such as foodborne illness or other adverse effects. It is usually managed through the facility's complaint process.
Choice C rationale
If a client becomes disoriented and falls out of bed, it is crucial to complete an incident report to document the event, assess the cause, and implement measures to prevent similar incidents. This helps ensure client safety and continuous quality improvement.
Choice D rationale
When a client's visitor becomes dizzy and faints in the client's room, an incident report should be completed to document the occurrence and initiate an investigation into the cause. This helps in providing appropriate care and preventing future incidents.
Choice E rationale
A client's inability to afford recommended physical therapy is an important issue but does not typically require an incident report. This situation should be addressed through social services or financial counseling to find a solution.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale
Verbal consent alone is not sufficient for invasive procedures like urinary catheter insertion. Documented consent is necessary to ensure legal and ethical compliance.
Choice B rationale
Having another nurse co-sign the consent does not verify the client's explicit agreement to the procedure. It is important that the client’s direct consent is documented.
Choice C rationale
Checking the medical record for a previous consent form may not reflect the client's current willingness. Consent should be obtained fresh to confirm current understanding and agreement.
Choice D rationale
Witnessing the client's signature on a consent form ensures that the client has been informed and agrees to the procedure, fulfilling both legal and ethical requirements.
Correct Answer is A
Explanation
Choice A rationale
This statement indicates that the client understands advance directives allow them to make decisions about their care while they are still capable. This reflects the purpose of advance directives, which is to respect and uphold the client’s autonomy and choices regarding their medical care.
Choice B rationale
This statement is incorrect because clients can change their advance directives or living will at any time. The purpose of these documents is to provide flexibility and ensure that the client's current wishes are followed.
Choice C rationale
This statement is incorrect. Once a living will is signed and witnessed or notarized, it becomes legally binding without a waiting period. The delay mentioned here is not a part of the advance directive process.
Choice D rationale
This statement is not accurate. A living will usually includes decisions about life support, and a separate consent form is not typically needed for those decisions. The client’s wishes regarding life support would be documented in the living will itself.
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