After arguing with a nurse, a disgruntled patient removes their peripheral venous catheter, gathers their belongings, and storms out of the room. Which of the following actions made by the nurse is most appropriate?

The nurse waits for the patient to leave, then files an incident report.

The nurse contacts the patient's next-of-kin on the telephone.

The nurse walks with the patient, attempting to explain the risks of leaving against medical advice.

The nurse calls security personnel to apprehend the patient.

Answer and Explanation

The Correct Answer is C

A.   Waiting for the patient to leave before filing an incident report is not the most appropriate response. The immediate priority should be addressing the situation to ensure the patient's safety and attempting to resolve any issues before the patient leaves.
B.   Contacting the patient’s next-of-kin can be appropriate if the nurse is concerned about the patient’s safety and if it’s necessary to inform the family about the patient’s condition or situation. However, this should be done only after attempting to address the situation directly with the patient, if feasible. It’s important to first try to resolve the issue directly with the patient before involving family members.
C.   Walking with the patient and explaining the risks of leaving against medical advice (AMA) shows a proactive approach to addressing the patient's concerns and ensuring they understand the potential consequences of their actions. This approach aims to de-escalate the situation, provide important information, and potentially encourage the patient to stay for necessary care.
D.   Calling security personnel should be a last resort and is generally used in situations where there is a safety threat or risk of harm. In this case, the patient is leaving in a disgruntled state but not exhibiting violent or threatening behavior.

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Correct Answer is B

Explanation

A. Recruiting volunteers might seem like a cost-effective solution, it can be problematic in terms of patient safety and quality of care. Volunteers generally lack the clinical training required to perform medical tasks safely and competently. Their involvement in direct patient care could pose risks to patient safety and may not effectively address staffing shortages in a meaningful way.
B. Developing a centralized staffing pool of float nurses is a strong intervention for addressing staffing shortages while securing patient safety and managing costs. Float nurses are experienced and can be deployed to various units as needed. This strategy ensures that staffing needs are met in a flexible and efficient manner, without compromising patient care. It also helps to balance the workload and prevents burnout among regular staff.
C. Assigning nurses from less busy units to understaffed ones can be effective, but it must be done with consideration for patient acuity. Nurses need to be assigned based on their skills and the needs of the unit to ensure that patient safety is maintained. If nurses from less busy units are assigned to areas with higher acuity patients without proper training or experience, it could compromise patient care and safety.
D. Implementing a mandatory overtime policy can address short-term staffing shortages but often leads to staff dissatisfaction, burnout, and decreased quality of care. Compelling nurses to work extra hours can negatively impact their well-being and job satisfaction, potentially leading to higher turnover rates and increased costs associated with recruiting and training new staff.

A. worsening health state. B. lack of motivation. C. lack of health literacy. D. early cognitive impairment.

Correct Answer is C

Explanation

A. While it's possible that a worsening health state could contribute to non-adherence, it's unlikely to be the sole factor, especially given that the patient has been explained the medication regimen multiple times.
B. While motivation is important for adherence, it's also unlikely to be the sole factor. Many patients with chronic conditions experience challenges with motivation, but effective education and support can help address this.

C. This is the most likely explanation for the patient's repeated non-adherence to the medication regimen. Health literacy refers to an individual's ability to understand and use health information to make informed decisions.
D. This is a possibility, but it's important to rule out other factors first. Cognitive impairment would likely manifest in other areas of the patient's life as well, and it's important to conduct a thorough assessment to determine if this is the case.

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After arguing with a nurse, a disgruntled patient removes their peripheral venous catheter, gathers their belongings, and storms out of the room. Which of the following actions made by the nurse is most appropriate?

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