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:

Leaving the medication on the client's bedside table is not appropriate because it doesn't address the client's concerns and may result in the client not taking the medication at all. This choice does not promote the client's well-being.

Choice B rationale:

Returning in 1 hour to administer the medication doesn't address the client's immediate concerns and also doesn't provide adequate information about the medication's importance. Delaying the medication administration without proper communication is not ideal.

Choice C rationale:

Mixing the medication in applesauce may be appropriate in some cases, but it doesn't address the client's reluctance to take the medication due to fatigue. Additionally, the client's Crohn's disease might require specific instructions for medication administration that should not be altered without consulting the healthcare provider.

Choice D rationale:

The correct answer. Informing the client of the consequences of refusing the medication is the most appropriate action. The nurse should engage in a therapeutic conversation with the client, explaining the importance of the medication in managing Crohn's disease symptoms and preventing complications. This choice respects the client's autonomy while providing necessary information for an informed decision.

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.