A nurse is observing a newly licensed nurse perform a sterile dressing change on a client who has a central venous catheter. Which of the following actions should the newly licensed nurse take?

Choice A rationale:

Informing the staff of the penalties that can result from medication errors represents an authoritarian approach to managing the issue. This approach relies on authority and fear to enforce compliance. By emphasizing the potential consequences, the nurse manager is attempting to control behavior through fear of punishment. While this might create a short-term change in behavior, it does not address the root causes of the errors or promote a culture of safety.

Choice B rationale:

Encouraging the staff to have two nurses verify medication orders to prevent errors is not an authoritarian approach. It involves collaboration and peer support to enhance medication safety. This approach promotes shared responsibility and accountability, which are not associated with authoritarian leadership.

Choice C rationale:

Providing a suggestion box for the staff to submit ideas for error prevention is not an authoritarian approach. This strategy fosters a participative and democratic leadership style. It encourages staff engagement and input, which contrasts with the top-down nature of authoritarian leadership.

Choice D rationale:

Asking three experienced nurses to help investigate common causes of the errors is not an authoritarian approach. It involves a collaborative and problem-solving approach that seeks input from knowledgeable staff members. This approach aims to identify systemic issues contributing to errors rather than focusing solely on punitive measures.

Choice A rationale:

A client who has a penetrating head injury and a respiratory rate of 4/min requires immediate attention due to the critical nature of the head injury and the dangerously low respiratory rate. However, in an emergency situation like this, the priority would be a condition that could be rapidly fatal if not addressed promptly.

Choice B rationale:

A client with a comminuted fracture of the femur has a serious injury that requires assessment and treatment, but it is not an immediately life-threatening condition. It falls lower in the priority compared to conditions that directly impact respiratory and cardiovascular function.

Choice C rationale:

A client with a 15.2-cm laceration to the scalp with clotted blood visible also requires attention, but it is not as time-sensitive as a life-threatening condition. Controlling bleeding and cleaning the wound can be addressed after addressing more critical cases.

Choice D rationale:

Correct. A client with a sucking chest wound has a high risk of tension pneumothorax, a condition where air accumulates in the pleural space, leading to lung collapse and compromised circulation. This condition can be rapidly fatal. Immediate intervention is required to seal the wound and prevent further air from entering the pleural space.