A nurse responds to the room of a client who is recovering from a cardiac arrest where CPR was performed. The client's child is distraught and tells the nurse that their parent has a do-not-resuscitate (DNR) prescription in their medical record. Which of the following actions should the nurse take first?

Report the occurrence to the nursing supervisor,

Complete an incident report stating the facts of the situation.

Verify the DNR prescription is current in the medical record.

Request a meeting with the ethics committee.

Answer and Explanation

The Correct Answer is C

A. Report the occurrence to the nursing supervisor:

While reporting the occurrence is important, verifying the DNR status takes precedence. The nurse needs to gather information and confirm whether the patient has a current DNR order before escalating the issue to a higher authority.

B. Complete an incident report stating the facts of the situation:

Completing an incident report is a part of the process, but it should not be the first action. The immediate concern is to determine if the patient has a valid DNR order. An incident report can be completed later to document the situation and any actions taken.

C. Verify the DNR prescription is current in the medical record.

Verifying the DNR (do-not-resuscitate) prescription is the first and most immediate action the nurse should take. It is crucial to confirm the current status of the DNR order to ensure that the healthcare team is following the patient's wishes. If the DNR is indeed valid and up-to-date, it means the resuscitation efforts, including CPR, were contrary to the patient's expressed wishes.

D. Request a meeting with the ethics committee:

Contacting the ethics committee may be necessary depending on the circumstances, but it is not the first step. Verifying the DNR status is an immediate action that can guide subsequent decisions. If there are ethical concerns or conflicts, involving the ethics committee can be considered after confirming the facts surrounding the DNR order.

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Correct Answer is A

Explanation

A. Complete an incident report.

Reporting a needlestick injury through an incident report is crucial. It documents the details of the incident, which is important for the nurse's safety and for initiating appropriate follow-up actions.

B. Receive a hepatitis C immunization:

There is no specific hepatitis C vaccine available. While there are vaccines for hepatitis A and hepatitis B, there is currently no vaccine to prevent hepatitis C. Seeking post-exposure prophylaxis and follow-up is more relevant in this case.

C. Notify the health department:

Notifying the health department might be necessary in some cases, but the immediate action for the nurse is to report the incident through an incident report within the facility. This allows for prompt internal investigation and necessary measures.

D. Start prophylactic antibiotic therapy:

Prophylactic antibiotic therapy is not the standard protocol for preventing hepatitis C transmission after a needlestick injury. Antiviral medications might be considered in certain cases for post-exposure prophylaxis for hepatitis C, but this decision should be made after consulting with a healthcare provider or infectious disease specialist based on the specific circumstances of the exposure. Reporting the incident remains the immediate priority.

A. An RN coordinates the care provided by other team members. B. An RN cares for the same clients throughout their hospitalization. C. An RN links community resources with clients to ensure quality care. D. An RN provides every aspect of care for a group of clients during a shift.

Correct Answer is A

Explanation

A. In team nursing, an RN assumes the role of a team leader or coordinator. The RN oversees and coordinates the care provided by other team members, which may include licensed practical nurses (LPNs), nursing assistants, and other healthcare professionals. The team collaborates to meet the needs of a group of clients.

B. Caring for the same clients throughout their hospitalization is more characteristic of primary nursing, where an RN takes primary responsibility for the care of a specific group of clients.

C. Linking community resources with clients to ensure quality care is more aligned with case management or community health nursing, where the focus is on coordinating services across healthcare settings and connecting clients with appropriate resources.

D. Providing every aspect of care for a group of clients during a shift is not consistent with team nursing. In team nursing, the workload is distributed among team members, and an RN typically coordinates and oversees the care provided by the team.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse has sustained a needlestick injury from a needle he used to give an injection to a client who has hepatitis C. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is discussing common models of nursing care with other nurses. Which of the following information should the nurse Include when discussing team nursing?

Correct Answer is A

Explanation

A nurse is caring for a 16-year-old client who was in a motor-vehicle crash and needs surgical intervention immediately. The staff cannot reach either of the client's parents. The nurse should identify that which of the following is true about obtaining consent?

A nurse working in a long-term care facility is giving change-of-shift report on a client who had a stroke. Which of the following information should the nurse include in the report?

A nurse is reinforcing teaching with a client who has a new diagnosis of chlamydia. Which of the following instructions should the nurse include in the teaching?

A nurse is collecting data from a client who is experiencing abdominal pain. The nurse states that they will return as soon as possible with pain medication. The nurse is demonstrating which of the following ethical principles?

A nurse is attending a quality improvement meeting. Which of the following actions should the nurse take first when initiating a quality improvement program to address health care-associated infections?

A nurse is reviewing medications prescribed for a client. For which of the following prescriptions should the nurse contact the provider for clarification?

A nurse is reviewing the prescriptions for a client who is postoperative following a total hip arthroplasty. Which of the following prescriptions should the nurse clarify with the provider?

A nurse enters a client's room and sees smoke coming from a wall outlet. After removing the client from the room, which of the following actions should the nurse take next?