A nurse is caring for several clients on a medical-surgical unit. Which of the following client care situations requires the nurse to complete an incident report?
The nurse disagrees with the nurse manager about inadequate staffing.
A staff member has not arrived at the facility to work an assigned shift.
A client tells the nurse that his dentures are missing.
The nurse discovers that the client does not have advanced directives.
The Correct Answer is C
An incident report should be filed whenever an unexpected event occurs. The rule of thumb is that any time a patient makes a complaint, a medication error occurs, a medical device malfunctions, or anyone— patient, staff member, or visitor—is injured or involved in a situation with the potential for injury, an incident report is required ⁴. In this case, the client's missing dentures would be considered a complaint and would require the nurse to complete an incident report.
The other options do not require an incident report. Disagreeing with the nurse manager about inadequate staffing [a], a staff member not arriving at the facility to work an assigned shift [b], and discovering that the client does not have advanced directives [d] are not situations that would require an incident report according to the information provided in my sources.
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Correct Answer is D
Explanation
When resolving a conflict with an assistive personnel (AP) who refuses a client assignment, it would be appropriate for the nurse to say "I need to talk to you about the unit policies regarding client assignments." This comment addresses the issue directly and professionally and provides an opportunity for the nurse to clarify the unit policies and expectations.
Option A is accusatory and unprofessional.
Option B may be necessary at some point, but it should not be the first response.
Option C is also accusatory and unprofessional.
Correct Answer is B
Explanation
The State Board of Nursing is responsible for regulating the practice of nursing within a specific state. It establishes the scope of practice for LPNs and sets the standards for their education, licensure, and practice. Therefore, the State Board of Nursing would be the best source of information regarding the roles of an LPN in a med-surg setting.
The other options may provide some information about the roles of an LPN in a med-surg setting, but they are not the primary source. The facility Human Resources Department [a] may have information about job descriptions and responsibilities specific to that facility. Nursing textbooks [c] may provide general information about the roles of LPNs. Coworkers on your unit [d] may have personal experience and knowledge about the roles of LPNs in that specific unit, but their information may not be comprehensive or up-to-date.
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