A nurse manager suspects a health care worker is experiencing chemical impairment. Which of the following actions should the nurse manager take first?

Discuss the incident with the health care worker.

Document the findings of the incident.

Remove the health care worker from the work environment.

Place the health care worker on probation.

Answer and Explanation

The Correct Answer is C

A. Discuss the incident with the health care worker: While addressing the suspected impairment with the worker is important, immediate removal from the work environment takes priority to ensure patient safety and prevent potential harm. Confrontation can follow after securing a safe environment.

B. Document the findings of the incident: Documentation is essential for legal and professional accountability, but it is secondary to protecting patients from immediate risk. Recording observations does not prevent ongoing exposure to unsafe practice.

C. Remove the health care worker from the work environment: The first priority is ensuring patient safety. Suspected chemical impairment can impair judgment, coordination, and response time, creating a high risk for errors or accidents. Immediate removal prevents potential harm to clients and coworkers.

D. Place the health care worker on probation: Probation is a disciplinary measure that may follow an investigation, but it is not the first step. Immediate action must focus on safety, and probation does not address the urgent risk posed by active impairment.

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

Explanation

A. "Attempt to gag": Gagging stimulates the vagus nerve and can worsen bradycardia. Clients should be instructed to avoid actions that trigger the gag reflex, so this instruction is not recommended.

B. "Take an antiemetic when feeling nauseated.": Nausea and vomiting can increase vagal stimulation. Taking an antiemetic as prescribed helps prevent excessive vagal nerve activation, which can reduce the risk of further slowing the heart rate.

C. "Apply firm pressure to the eyes": Applying pressure to the eyes can stimulate the vagus nerve, potentially exacerbating bradycardia. Clients should avoid eye rubbing or pressure.

D. "Eat a high-fiber diet to keep stools soft": Straining during defecation stimulates the vagus nerve and can worsen bradycardia. A high-fiber diet promotes regular, soft stools and helps prevent straining, thereby reducing vagal stimulation.

E. "Bear down to slow the pulse rate": Bearing down (Valsalva maneuver) directly increases vagal stimulation, which can dangerously slow the heart rate in clients with bradycardia. This action should be avoided.

Correct Answer is {"dropdown-group-1":"C"}

Explanation

Rationale for correct choice

• Fall risk: The client experiences sudden episodes of leg weakness, intermittent muscle spasms, and gait changes, all of which significantly increase the risk of falls. Falls in clients with multiple sclerosis can lead to serious injury and further functional decline. Addressing safety and fall prevention is the most immediate priority to prevent harm while other concerns, such as memory or employment, are addressed.

Rationale for incorrect choices

• Memory: Although the client reports struggling to remember things, cognitive issues are not immediately life-threatening. Memory deficits should be addressed through ongoing assessment and cognitive support interventions, but they are not the first priority compared with safety risks.

• Blood pressure: Vital signs are within normal limits, and there is no evidence of hypertensive crisis or acute cardiovascular instability. Blood pressure monitoring remains part of routine care but does not require immediate intervention.

• BMI: The client’s BMI indicates overweight status but does not pose an immediate safety threat. Weight management is important for long-term health but is not the first priority in the context of neurological deficits and fall risk.

• Employment: Reduced work hours due to exacerbation episodes reflect functional limitations and psychosocial impact. Employment concerns are important for quality of life but are secondary to preventing physical injury from falls.

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A nurse manager suspects a health care worker is experiencing chemical impairment. Which of the following actions should the nurse manager take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has bradycardia about how to prevent vagal stimulation. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

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

Explanation

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Correct Answer is {"dropdown-group-1":"C"}

Explanation

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