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 B
Explanation
The nurse should intervene when the AP tears a document with client information in half before disposing of it in a waste basket. This is because client information is confidential and should be disposed of properly to protect the client's privacy. Tearing a document in half is not sufficient to ensure that the information is protected.
Option A is incorrect because logging off the computer after entering a client's intake and output totals is an appropriate action.
Option C is incorrect because denying a request by another AP to use her password to enter the client's vital signs is an appropriate action to protect the client's information.
Option D is incorrect because removing a clipboard with client information from the room during visiting hours may be necessary to protect the client's privacy.
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