A nurse is preparing an in-service for a group of nurses about malpractice issues in nursing. Which of the following examples should the nurse include in the teaching as an example of malpractice?

Documenting communication with a provider in the progress notes of the client's medical record.

Placing a yellow bracelet on a client who is at risk for falls.

Administering potassium via iv bolus.

Leaving a nasogastric tube clamped after administering oral medication.

Answer and Explanation

The Correct Answer is C

A. Documenting communication with a provider in the progress notes of the client's medical record: Proper documentation of provider communication is standard nursing practice and does not constitute malpractice. It helps ensure continuity of care and legal protection.

B. Placing a yellow bracelet on a client who is at risk for falls: Implementing fall precautions, such as using a yellow wristband, is an appropriate safety measure and standard of care, not malpractice.

C. Administering potassium via IV bolus: Administering potassium as a rapid IV push is extremely dangerous and can cause cardiac arrest. This action violates the standard of care and constitutes malpractice due to potential harm to the client.

D. Leaving a nasogastric tube clamped after administering oral medication: A nasogastric (NG) tube is often clamped for a short period after administering medication to allow the medication to be absorbed. The nurse's action would only be considered negligent if they left the tube clamped for a prolonged period.

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Correct Answer is C

Explanation

Rationale:

A. Tetracycline 200 mg PO: This prescription is incomplete because it does not specify the frequency or duration of administration, making it unclear how the medication should be given safely.

B. Cimetidine PO twice daily: The prescription lacks the dosage strength in milligrams, which is essential for accurate administration and safe dosing.

C. Digoxin 0.25 mg PO daily: This prescription includes the medication name, dosage, route, and frequency, providing all essential components needed for safe administration.

D. Epoetin alfa 150 units/kg three times weekly: While it includes dose and frequency, it does not specify the route (subcutaneous or IV), which is required to complete the prescription safely.

A. Assess the client's breath sounds. B. Restrict the client's fluid intake. C. Perform chest percussion and vibration. D. Increase oxygen flow rate to 4 L/min. E. Instruct the client to perform diaphragmatic breathing. F. Place the client in a supine position.

Correct Answer is ["A","C","E"]

Explanation

A. Assess the client’s breath sounds: Auscultation helps determine how well interventions like albuterol and oxygen are working. Detecting changes such as worsening wheezes, crackles, or diminished sounds ensures early recognition of complications. This is vital given the client’s chronic smoking history and respiratory distress.

B. Restrict the client’s fluid intake: Adequate hydration thins mucus, making it easier to clear. Unless there is heart or kidney failure, fluids should be encouraged. Restricting intake could worsen secretion retention and impair gas exchange.

C. Perform chest percussion and vibration: These techniques loosen mucus and promote clearance in clients with COPD or chronic bronchitis. Because the client has a productive cough and abnormal lung sounds, this intervention supports better airway patency. It also works well alongside bronchodilators for improved breathing.

D. Increase oxygen flow rate to 4 L/min: In clients with chronic CO₂ retention, too much oxygen can suppress respiratory drive. The current prescription of 2 L/min should be maintained unless the provider reassesses and orders changes based on ABGs.

E. Instruct the client to perform diaphragmatic breathing: This method enhances airflow to the lower lungs, reduces accessory muscle use, and improves oxygen exchange. For a COPD client, it helps conserve energy and improve ventilation. Combined with pursed-lip breathing, it strengthens respiratory efficiency.

F. Place the client in a supine position: Lying flat limits lung expansion and can worsen dyspnea in clients with lung disease. An upright or high-Fowler’s position promotes maximal ventilation and better oxygenation.

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A nurse is preparing an in-service for a group of nurses about malpractice issues in nursing. Which of the following examples should the nurse include in the teaching as an example of malpractice?

Nursing Test Bank

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