A staff nurse may be exhibiting manifestations of a substance use disorder and is diverting controlled medications while at work. Which of the following actions should the nurse manager take first?
Confront the nurse regarding their behavior.
Ask the nurse to sign an action plan for behavior improvement.
Document the suspicious behavior.
Collect data on the nurse's behavior.
The Correct Answer is D
Choice A reason: Confronting the nurse immediately without objective evidence can lead to defensiveness, denial, or legal complications. Managers must avoid premature confrontation because it lacks the foundation of documented proof and may compromise the integrity of the investigation.
Choice B reason: Asking the nurse to sign an action plan assumes guilt before evidence is collected. This step is appropriate only after data has been gathered and a formal process initiated. Implementing corrective measures prematurely undermines fairness and due process.
Choice C reason: Documentation is essential but should follow systematic data collection. Recording suspicious behavior without first gathering objective evidence risks bias and incomplete reporting. Documentation becomes meaningful only when supported by collected data.
Choice D reason: Collecting data is the first and most critical step. Objective evidence ensures that any subsequent actions—documentation, confrontation, or disciplinary measures—are based on facts rather than assumptions. This protects both patient safety and the nurse’s rights, while also meeting regulatory and legal standards.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Reporting that the client was provided with a breakfast tray at 0800 is not clinically significant information for a change-of-shift report. Shift reports should focus on pertinent clinical updates, ongoing concerns, and interventions that impact patient safety and care continuity. Meal times are routine and do not provide meaningful information for the incoming nurse.
Choice B reason: Nausea immediately after surgery is expected and would have occurred 36 hours earlier. This information is outdated and not relevant to the current status of the client. Change-of-shift reports should emphasize current or ongoing issues rather than resolved postoperative symptoms. Therefore, this option is not appropriate to include.
Choice C reason: Checking for peripheral IV blood return prior to administering antibiotics is a standard nursing practice and does not need to be included in a shift report unless there was a complication, such as infiltration or loss of IV access. Routine procedural details are not necessary unless they affect ongoing care. Thus, this option is not the best choice.
Choice D reason: Reporting that the client’s pain was relieved by position change is clinically relevant because it provides information about the client’s current pain management needs and effective interventions. Pain control is a critical aspect of postoperative care, and knowing what measures are effective helps ensure continuity of care. This is the correct answer because it directly impacts the incoming nurse’s ability to manage the client’s comfort and recovery.
Correct Answer is B
Explanation
Choice A reason: A productive cough with a normal temperature of 36° C (96.8° F) is not immediately concerning. While the cough should be monitored for signs of infection or respiratory compromise, the absence of fever or abnormal vital signs makes this a lower priority compared to other findings.
Choice B reason: Tingling in the fingers following a thyroidectomy is an urgent finding because it suggests hypocalcemia, likely due to accidental removal or injury to the parathyroid glands during surgery. Hypocalcemia can progress to tetany, laryngospasm, and airway obstruction, which are life-threatening complications. This requires immediate intervention, such as notifying the provider and preparing to administer calcium gluconate.
Choice C reason: A client with a long leg cast and +2 pedal pulses bilaterally indicates adequate circulation. The presence of palpable pulses suggests that there is no immediate risk of compartment syndrome or ischemia. This client should be monitored, but they are stable and not the highest priority.
Choice D reason: Dark, foul-smelling urine with low output over 8 hours suggests a urinary tract infection and possible dehydration. While this requires provider notification and treatment, it is not immediately life-threatening compared to airway compromise from hypocalcemia.
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