A nurse is caring for several clients. For which of the following situations should the nurse complete an incident report?
The nurse identifies a broken piece of equipment.
The nurse has a disagreement with the nursing supervisor about inadequate staffing.
A staff member does not show up to work her assigned shift.
A client discovers that his dentures are missing.
The Correct Answer is D
Choice A reason:
The statement “The nurse identifies a broken piece of equipment” is important for safety and should be reported to the appropriate department for repair or replacement. However, it does not typically require an incident report unless the broken equipment caused harm or had the potential to cause harm to a patient. Incident reports are generally used to document events that are not consistent with the routine operation of the healthcare unit or the standard care of a patient.
Choice B reason:
The statement “The nurse has a disagreement with the nursing supervisor about inadequate staffing” reflects an internal issue that should be addressed through appropriate channels, such as a staff meeting or a discussion with human resources. It does not typically require an incident report unless the disagreement led to a situation that compromised patient safety or care. Incident reports are meant to document events that directly affect patient care and safety.
Choice C reason:
The statement “A staff member does not show up to work her assigned shift” is a staffing issue that should be managed by the nursing supervisor or the staffing coordinator. While it can affect the workflow and staffing levels, it does not usually require an incident report unless it directly impacts patient care or safety. Incident reports are used to document specific events that deviate from standard care practices and have the potential to harm patients.
Choice D reason:
The statement “A client discovers that his dentures are missing” is a situation that requires an incident report. The loss of a client’s personal belongings, especially something as essential as dentures, can significantly impact the client’s well-being and quality of care. Documenting this incident helps to investigate the circumstances, prevent future occurrences, and ensure that appropriate measures are taken to address the client’s needs. Incident reports are crucial for tracking and addressing issues that affect patient care and safety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
The statement “Muffled heart sounds” is a classic sign of cardiac tamponade. This condition occurs when fluid accumulates in the pericardium (the sac around the heart), compressing the heart and preventing it from functioning properly. Muffled heart sounds are due to the fluid dampening the sound of the heartbeats. This is part of Beck’s triad, which also includes hypotension and jugular venous distension.
Choice B reason:
The statement “Sudden lethargy” is not a specific indicator of cardiac tamponade. While lethargy can occur due to decreased cardiac output and poor perfusion, it is not a definitive sign of cardiac tamponade. Lethargy can be caused by various conditions and is not specific enough to support the suspicion of cardiac tamponade.
Choice C reason:
The statement “Flattened neck veins” is incorrect. In cardiac tamponade, one would expect to see distended (bulging) neck veins due to increased central venous pressure. Flattened neck veins are not consistent with the hemodynamic changes seen in cardiac tamponade.
Choice D reason:
The statement “Bradycardia” is not typically associated with cardiac tamponade. Instead, tachycardia (an increased heart rate) is more commonly seen as the body attempts to compensate for decreased cardiac output. Bradycardia can occur in severe cases or as a pre-terminal event, but it is not a primary indicator of cardiac tamponade.
Correct Answer is B
Explanation
Choice A reason: Cardiac glycosides are primarily used to treat heart conditions such as heart failure and atrial fibrillation. They do not typically affect bone density or contribute to osteoporosis.
Choice B reason: Thyroid hormones can increase the risk of osteoporosis, especially if taken in excess. Over-replacement of thyroid hormone can accelerate bone loss, leading to decreased bone density and increased fracture risk.
Choice C reason: Anticoagulants are used to prevent blood clots but are not generally associated with an increased risk of osteoporosis. Their primary side effects are related to bleeding and bruising.
Choice D reason: NSAIDs (nonsteroidal anti-inflammatory drugs) are used to reduce inflammation and pain. They do not typically affect bone density or contribute to osteoporosis.
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