A nurse takes actions to avoid liability when caring for a client with a psychiatric disorder. Which action is not appropriate in the prevention of liability?

The nurse establishes rapport with the client in an inpatient psychiatric setting.

The nurse documents accurately and honestly in the electronic health record.

The nurse refuses to care for someone who reminds her of a family member after interviewing the client upon admission.

The nurse refers to the policy of the inpatient psychiatric setting when uncertain of a standard of care.

Answer and Explanation

The Correct Answer is C

The nurse refuses to care for someone who reminds her of a family member after interviewing the client upon admission. This action is not appropriate in the prevention of liability because it violates the client’s right to receive care and may be considered as discrimination or abandonment. The nurse has a duty to provide care to all clients regardless of their personal feelings or preferences.

Choice A is wrong because establishing rapport with the client in an inpatient psychiatric setting is an appropriate action to prevent liability. It helps to build trust and communication between the nurse and the client and reduces the risk of misunderstanding or conflict.

Choice B is wrong because documenting accurately and honestly in the electronic health record is an appropriate action to prevent liability. It provides evidence of the care provided, the client’s condition and response, and any incidents or complications that occurred.

Choice D is wrong because referring to the policy of the inpatient psychiatric setting when uncertain of a standard of care is an appropriate action to prevent liability. It helps the nurse to follow the best practices and guidelines for providing safe and effective care to the client.

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Correct Answer is C

Explanation

The nurse should complete an incident report when he or she contaminates and discards two indwelling catheters during the insertion procedure. This is because an incident report is a tool for documenting any event that is not consistent with the routine operation of a health care unit or the routine care of a client. An incident report helps to identify potential risks and improve quality and safety.

Choice A is wrong because not completing the care plan for a newly admitted client before leaving the unit is not an incident that requires reporting.

It is a matter of time management and prioritization.

Choice B is wrong because recording a client’s refusal to take prescribed medication on the chart is not an incident that requires reporting.

It is a part of the nursing documentation and communication.

Choice D is wrong because experiencing back pain after moving a client up in the bed is not an incident that requires reporting.

It is a personal injury that may be related to improper body mechanics or ergonomics.

A. Adding a nursing diagnosis of lowered self-esteem to the care plan. B. Giving praise for every decision the client makes. C. Eliciting client input into planning care. D. Modeling competent care for the client.

Correct Answer is C

Explanation

This would help the client to feel valued, respected and involved in their own care, which can enhance their self-esteem.

Choice A is wrong because adding a nursing diagnosis of lowered self-esteem to the care plan does not address the underlying causes of the problem or provide any interventions to improve it.

It may also label the client and make them feel worse.

Choice B is wrong because giving praise for every decision the client makes is not realistic or sincere.

It may also undermine the client’s confidence and autonomy by implying that they need constant approval from others.

Choice D is wrong because modeling competent care for the client does not necessarily help them to maintain their self-esteem.

It may even make them feel inadequate or dependent on the nurse.

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A nurse takes actions to avoid liability when caring for a client with a psychiatric disorder. Which action is not appropriate in the prevention of liability?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which situation requires a nurse to complete an incident report? The nurse:.

Correct Answer is C

Explanation

Which nursing intervention would best assist a hospitalized client to maintain self-esteem?

Correct Answer is C

Explanation

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