A nurse manager is receiving report and is faced with the following situations that require interventions. Which of the following should the nurse manager address first?
A client is refusing care from an assistive personnel of the opposite gender
No transport assistance is available to take a client to physical therapy
Two nurses had a heated disagreement about a scheduling issue
Three staff members have called to say they will be absent
The Correct Answer is D
a. A client is refusing care from assistive personnel of the opposite gender:
This situation involves the client's right to refuse care based on personal preferences or cultural beliefs. While it requires attention and respect for the client's wishes, it may not pose an immediate risk to patient care or staff safety.
b. No transport assistance is available to take a client to physical therapy:
This can be resolved by contacting the transportation department or finding an alternative solution, but it is not a critical issue that requires immediate attention.
c. Two nurses had a heated disagreement about a scheduling issue:
While workplace conflicts should be addressed to promote a positive work environment, a heated disagreement about a scheduling issue may not pose an immediate threat to patient care. However, if the disagreement escalates or affects staff morale, it could impact unit functioning and require intervention.
d. Three staff members have called to say they will be absent:
This situation has the most immediate impact on the overall functioning of the unit. Staffing shortages can affect patient care and safety, so it is crucial to address this issue promptly to ensure adequate coverage and maintain the quality of care.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is C
Explanation
a. Document in the client’s chart that an incident report has been filed:
Documenting that an incident report has been filed is an important step in the process of addressing the client's complaint. It ensures that there is a record of the incident and initiates the appropriate follow-up procedures.
b. Call risk management to interview the client:
In long-term care facilities, risk management departments are responsible for investigating incidents and ensuring that appropriate measures are taken to prevent future occurrences. In this situation, involving risk management may be necessary to conduct a thorough investigation.
c. Contact the nurse manager:
The nurse manager is responsible for overseeing the nursing staff and ensuring that quality care is provided to clients. Contacting the nurse manager allows for immediate notification of the incident and enables them to initiate the appropriate steps to address the situation.
d. Reassure the client that the staff is well trained:
While it's important to provide reassurance to the client, simply reassuring them without taking any further action may not adequately address their concerns or prevent similar incidents from occurring in the future.
Correct Answer is A
Explanation
a. A client who is scheduled for an endoscopy later today and requires an enema:
Administering an enema involves basic nursing care, which falls within the scope of practice of an LPN. LPNs are trained to perform such tasks under the supervision of a registered nurse (RN).
b. A newly admitted client who has sickle cell anemia and requires the development of an initial plan of care:
Developing an initial plan of care involves comprehensive assessment, critical thinking, and the ability to formulate nursing diagnoses and interventions. This task typically falls within the scope of practice of the RN, who has advanced education and training in care planning and coordination.
c. A client who had a myocardial infarction and will be transferring to the unit from the CCU:
Transferring a client from one unit to another may involve coordinating care, ensuring continuity of care, and communicating with other members of the healthcare team. This task may be more appropriate for an RN, who has the knowledge and skills to manage such transitions safely and effectively.
d. A newly admitted client who has diabetes mellitus and requires initial teaching on self-administration of insulin:
Providing client education, especially on self-care management such as insulin administration, requires knowledge of disease processes, medication administration, and patient teaching techniques. This task is typically within the scope of practice of the RN, who can assess the client's learning needs, provide tailored education, and evaluate the client's understanding and competency.
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