A nurse manager observes a licensed practical nurse who has a strong odor of alcohol on their breath. Which of the following actions should the nurse manager take?

Document an objective description of the situation

Schedule a formal meeting with the LPN within 48 hr

Interview clients about the nurse’s actions

Check the unit narcotic records for discrepancies

Answer and Explanation

The Correct Answer is A

a. Document an objective description of the situation:

It is important to start by documenting the observed behavior objectively. This documentation can serve as a factual record of the incident.

b. Schedule a formal meeting with the LPN within 48 hours:

While addressing the issue promptly is important, scheduling a formal meeting should come after documenting the situation. The initial step is to gather information and document observations.

c. Interview clients about the nurse’s actions:

Interviewing clients may be necessary later in the investigation process, but the immediate action should be to document the observed behavior and then proceed with a more formal investigation if needed.

d. Check the unit narcotic records for discrepancies:

The issue at hand appears to be related to alcohol use rather than narcotics. While discrepancies in narcotic records might be a concern, it may not be the most relevant action based on the situation described.

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Correct Answer is C

Explanation

a. Ask the client if she would like a sedative to help her relax:

Offering a sedative may not address the underlying reasons for the client's desire to leave. Moreover, administering a sedative without addressing the client's concerns or obtaining informed consent would not be appropriate.

b. Inform the client that she cannot leave without a discharge prescription from the provider:

While informing the client of the discharge process is important, presenting this information as a restriction may not be the most therapeutic approach. Additionally, in many healthcare settings, patients have the legal right to leave against medical advice, so presenting it as a requirement may not be accurate.

c. Have the client sign the Against Medical Advice form:

When a client decides to leave against medical advice, it is standard practice to have them sign an Against Medical Advice (AMA) form. This form documents the client's decision and acknowledges that they are leaving the hospital against the advice of the healthcare provider.

d. Assign a security officer to the client's room until the provider can speak with the client:

Assigning a security officer may be appropriate in situations where there are concerns for the safety of the client or others, such as if the client is agitated or threatening harm. However, in this scenario, the client has expressed a desire to leave, and assigning a security officer may escalate the situation unnecessarily.

A. A client who is scheduled for an endoscopy later today and requires an enema B. A newly admitted client who has sickle cell anemia and requires the development of an initial plan of care C. A client who had a myocardial infraction and will be transferring to the unit from the CCU D. A newly admitted client who has diabetes mellitus and requires initial teaching on self- administration of insulin

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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A nurse manager observes a licensed practical nurse who has a strong odor of alcohol on their breath. Which of the following actions should the nurse manager take?

Nursing Test Bank

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