A nurse is uncharacteristically extroverted on today's shift, with an unsteady gait. The manager suspects that the nurse may be chemically Impaired. What is the manager's most appropriate action?

Promptly confront the nurse to discuss this suspicion

Ask the other nurses and staff members on the unit if they have noticed the same thing

Document this finding and communicate with the personnel department

Monitor the nurse's behavior closely for the remainder of the shift

Answer and Explanation

The Correct Answer is D

A.   While it is important to address concerns about impairment, confronting the nurse directly can be counterproductive and may escalate the situation. It is essential to approach the situation with caution and follow established protocols for dealing with suspected substance impairment.
B.   While gathering observations from colleagues may seem reasonable, it can create a culture of gossip and may violate confidentiality. This approach can also lead to misinformation and should not be the first step in addressing a serious concern about a colleague's safety and well-being.
C.   Documenting observations is important, but it should not be the sole action taken at this point. Communicating with the personnel department is part of the process if the situation escalates, but immediate action is necessary to ensure patient safety.
D.   This option is the most appropriate initial action. By closely monitoring the nurse’s behavior, the manager can gather more information before taking further steps. This approach allows for the collection of objective data and ensures patient safety while avoiding premature accusations.

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Correct Answer is ["B","D","F"]

Explanation

A. While nonsteroidal anti-inflammatories (NSAIDs) are commonly used medications, they do not typically have a high potential for abuse or addiction. Monitoring these medications for diversion is generally not a primary concern compared to other classifications.
B. Opioids are one of the most commonly abused medication classes due to their pain-relieving properties and high potential for addiction. They are frequently monitored closely for signs of diversion and theft in healthcare settings.
C. Although some antidepressants may have mild abuse potential, they are not generally associated with the same level of diversion or abuse as opioids, benzodiazepines, or stimulants. Therefore, they are not typically monitored as closely.
D. Benzodiazepines are known for their sedative effects and potential for dependency and abuse. They are often misused for their calming effects, making them a priority for monitoring in medication inventories.
E. Anticholinergics are not commonly associated with abuse or diversion. They are used primarily for specific medical conditions and do not have a high potential for addiction, so monitoring these medications is not a primary focus.
F. Central nervous system (CNS) stimulants, such as those used to treat ADHD, have significant potential for abuse and dependency. These medications can lead to feelings of euphoria and are often misused, making them important to monitor closely for diversion.

A. Providing oral care every 3 to 4 hours. B. Help the client change position every 2 hours. C. Administering 0.45% saline by IV line. D. Record urine output when client voids. E. Monitoring for indications of dehydration. F. Assessing daily weights for trends.

Correct Answer is ["A","B","D"]

Explanation

A. This task is appropriate for UAP, as it involves basic hygiene care. UAP can assist with routine oral care
B. Assisting with repositioning is a basic care activity that UAP can perform. This helps prevent pressure ulcers and maintains client comfort, and it does not require advanced clinical skills.
C. Administering IV fluids or medications requires specialized training and knowledge of nursing assessments, potential complications, and monitoring. This task should only be performed by a licensed nurse, not by UAP.
D. UAP can document basic measurements such as urine output. This is a straightforward task that does not require clinical judgment, but the UAP should understand how to accurately measure and record this information.
E. While UAP can observe and report general changes, monitoring for clinical indications of dehydration requires nursing assessment skills and judgment. This task should be performed by an RN, as it involves interpreting signs and symptoms.
F. UAP can weigh clients, but the assessment of weight trends requires clinical judgment and interpretation of data. The RN should evaluate and interpret this information to determine its significance in the client's care.

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A nurse is uncharacteristically extroverted on today's shift, with an unsteady gait. The manager suspects that the nurse may be chemically Impaired. What is the manager's most appropriate action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When monitoring medication inventories for possible diversion or theft by nurses who abuse chemicals, what medication classifications should be monitored most closely? [SELECT ALL THAT APPLY]

Correct Answer is ["B","D","F"]

Explanation

The care of a client is assigned to a newly-graduated RN. What actions can the newly-graduated RN delegate to the unlicensed assistive personnel (UAP)? [SELECT ALL THAT APPLY]

Correct Answer is ["A","B","D"]

Explanation

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