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
If a nurse overhears two assistive personnel (AP) discussing a client who is currently hospitalized in the hospital cafeteria, the appropriate action for the nurse to take is to quietly tell the APs that the conversation is inappropriate. This will allow the nurse to address the issue in a respectful and professional manner and remind the APs of their responsibility to maintain client confidentiality.
Option A is incorrect because completing an incident report may be necessary, but it should not be the first action taken.
Option B is incorrect because reporting the incident to the provider is not an appropriate action in this situation.
Option C is incorrect because documenting the occurrence in the client's medical record is not an appropriate action in this situation.
Correct Answer is A
Explanation
The nurse should request the client's son, who has a durable power of attorney, to sign the client's informed consent. A durable power of attorney is a legal document that allows an individual to appoint someone to make decisions on their behalf in the event that they become unable to do so. If the client has dementia and is unable to provide informed consent for the procedure, the individual with a durable power of attorney has the legal authority to make decisions on their behalf.
The other individuals are not the appropriate person to sign the client's informed consent. The client's sister [b] and daughter [c] may be involved in the client's care and decision-making, but they do not have the legal authority to provide informed consent on behalf of the client unless they have been designated as such in a legal document. Advance directives [d] are legal documents that allow individuals to communicate their wishes about medical treatment and end-of-life care, but they do not grant decision-making authority to another individual.
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