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
The nurse should ask the AP to perform the task of taking an ABG (arterial blood gas) specimen to the laboratory first. This is because ABG specimens need to be analyzed promptly to ensure accurate results. Timely analysis of ABG specimens is important for making clinical decisions and providing appropriate care to the client.
Option A is incorrect because giving fresh water to clients who do not have NPO status is not as time-sensitive as taking an ABG specimen to the laboratory.
Option B is incorrect because obtaining a routine urine sample from a client right after admission is not as time-sensitive as taking an ABG specimen to the laboratory.
Option C is incorrect because transporting a client to the radiology department for an x-ray is not as time-sensitive as taking an ABG specimen to the laboratory.
Correct Answer is A
Explanation
If a nurse manager notices that a nurse who has a history of being resistant to change is not delivering care according to a new policy, the appropriate action for the nurse manager to take is to encourage the nurse to verbalize the reasons for their resistance to the change. This will allow the nurse manager to understand the nurse's concerns and work with them to address any issues and facilitate their acceptance of the new policy.
Option B is incorrect because ignoring the resistance and allowing peer pressure to facilitate a change in the nurse's behavior is not an effective or respectful way to address the issue.
Option C is incorrect because explaining the importance and rationale of implementing the new policy to the nurse may be necessary, but it should not be the first action taken.
Option D is incorrect because indicating that there will be disciplinary consequences if the nurse does not implement the new policy may be necessary, but it should not be the first action taken.
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