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 C

Explanation

A. While monitoring temperature is important in assessing for infection, it is not the priority assessment before administering morphine. Temperature does not directly relate to the immediate effects or risks associated with opioid administration.
B. Blood pressure monitoring is essential, especially in a postoperative patient. However, opioids primarily impact the respiratory system rather than directly causing significant changes in blood pressure. While hypotension can occur with opioids, it is not the most immediate concern when administering morphine.
C. This is the priority assessment. Opioids, including morphine, can cause respiratory depression, which is a serious and potentially life-threatening side effect. Before administering morphine, it is crucial to assess the respiratory rate to ensure the patient is not at risk for respiratory distress. If the respiratory rate is low (typically less than 12 breaths per minute), the nurse may need to hold the medication and notify the healthcare provider.
D. While it is important to monitor heart rate, especially in postoperative patients, the primary concern with morphine administration is its effect on respiration. The heart rate may not be as critical to assess immediately before administering morphine as the respiratory rate is.

A. "A client address would be an example of personally identifiable information" B. "HIPPA is a federal law, not a state law." C. "Information about a client can be disclosed to family members at any time." D. "HIPPA established regulations of individually identifiable health information in verbal, electronic, or written form"

Correct Answer is C

Explanation

A. A client's address is indeed considered personally identifiable information (PII) under HIPAA, which protects an individual's health information that can be used to identify them.
B. This statement is true. HIPAA is a federal law that sets standards for the protection of health information. However, state laws can provide additional protections but cannot be less stringent than HIPAA.
C. This statement indicates a need for further teaching. Under HIPAA, health information can only be disclosed to family members if the client has given consent or if it is in the best interest of the client (such as in emergencies). Without patient authorization, healthcare providers cannot disclose information freely.
D. This statement is accurate. HIPAA indeed regulates how individually identifiable health information is managed and protected, regardless of the format in which it is stored or communicated (verbal, electronic, or written).

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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

A nurse is caring for a client who is postoperative following abdominal surgery and reports incisional pain. The surgeon has prescribed morphine 4 mg IV bolus every 6 hr as needed. Before administering this medication, the nurse should complete which priority assessment?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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In which situation would the nurse be justified in overriding a client's right to confidentiality?

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