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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Administer an antibiotic to the child for 10 days: RSV is a viral infection, and antibiotics are ineffective against viruses. Antibiotics are only indicated if a secondary bacterial infection develops. Routine antibiotic therapy does not treat RSV and should not be included in teaching.
B. Cyclophosphamide can be given to decrease the duration of the infection: Cyclophosphamide is an immunosuppressive chemotherapy agent and has no role in treating RSV. Administering this medication would be inappropriate and harmful in a child with a viral respiratory infection.
C. Wear an N95 mask when in direct contact with the child: Standard precautions for RSV involve contact and droplet precautions, typically including a surgical mask, gloves, and gown. An N95 mask is not required for routine care of RSV, as transmission risk is primarily via contact with secretions and large respiratory droplets.
D. RSV is transmitted by direct contact with respiratory secretions: RSV spreads through close contact with contaminated secretions from coughing, sneezing, or touching surfaces. Teaching guardians about transmission helps prevent spread and reinforces the importance of hand hygiene and infection control measures in the home.
Correct Answer is ["A","C","D","E","G","H","I"]
Explanation
Rationale for correct choices
• Sudden onset of dyspnea and chest discomfort: These symptoms may indicate acute cardiopulmonary compromise such as pulmonary embolism, acute heart failure, or infection. Sudden dyspnea in a post-op orthopedic client requires immediate assessment and intervention to prevent deterioration.
• Tachypnea and appearance of distress: Rapid, labored breathing indicates the client is struggling to maintain adequate oxygenation and may signal hypoxemia or respiratory failure. Immediate follow-up is necessary to prevent further compromise.
• Crackles heard in bilateral lungs: Bilateral crackles suggest fluid accumulation in the alveoli, possibly from pulmonary edema or early pneumonia. This finding correlates with respiratory distress and requires prompt evaluation.
• S3 and S4 heart sounds noted: Extra heart sounds can indicate left ventricular dysfunction or volume overload, suggesting acute heart failure. Timely assessment is critical to prevent worsening cardiac output and pulmonary congestion.
• Temperature 38.9° C (102° F): Fever indicates possible infection, which in a post-operative patient could suggest pneumonia, surgical site infection, or sepsis. Early recognition and treatment are essential.
• Heart rate 112/min: Tachycardia may be a compensatory response to hypoxia, fever, or fluid overload. Persistent elevation increases cardiac workload and risk of decompensation.
• Respiratory rate 34/min: A significantly elevated respiratory rate confirms respiratory distress and inadequate oxygenation, warranting immediate intervention such as supplemental oxygen adjustment or further diagnostics.
Rationale for incorrect choices
• Client is awake and oriented x4: The client’s alertness and orientation indicate that cerebral perfusion and cognitive function are intact at this time. While this is important to note, it does not indicate acute cardiopulmonary compromise or a life-threatening event, so it does not require immediate follow-up.
• Surgical site is dressed, dry, and intact: The dressing being clean, dry, and intact indicates there is currently no active bleeding or wound complication. While ongoing monitoring is important post-operatively, this finding does not necessitate urgent intervention compared with the client’s acute respiratory and cardiovascular symptoms.
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