Several nurses who work on a postoperative surgical unit have reported to the charge nurse their concerns about a particular surgeon's treatment of clients during invasive procedures.
Adult clients are often in tears after this particular physician performs central IV line insertions or other invasive procedures. After the charge nurse confronts the healthcare provider who dismisses the concerns, the charge nurse reports the surgeon's behavior to the nurse manager who listens but does nothing about the situation.
What action is most important for the charge nurse to take?
Confront the nurse manager as a group and ask why nothing has been done to change the surgeon's behavior.
Attend procedures performed by the surgeon and demand halting the procedure if the client becomes distressed.
Document client reactions to invasive procedures performed by the physician in their medical record.
Report the physician's lack of concern for clients' pain during invasive procedures to the Director of Nursing.
The Correct Answer is D
Choice A reason: Confronting the nurse manager as a group may not be effective or appropriate, as it may create more conflict and resentment. The charge nurse should follow the chain of command and escalate the issue to a higher authority if the nurse manager fails to act.
Choice B reason: Attending procedures performed by the surgeon and demanding halting of the procedure if the client becomes distressed may be seen as insubordination and interference by the surgeon, who may have legal authority to perform the procedure. It may also jeopardize the client's safety and outcome.
Choice C reason: Documenting client reactions to invasive procedures performed by the physician in their medical record is important, but not sufficient. It does not address the root cause of the problem, which is the surgeon's lack of empathy and respect for clients' pain and dignity.
Choice D reason: Reporting the physician's lack of concern for clients' pain during invasive procedures to the Director of Nursing is the most important action for the charge nurse to take, as it may lead to an investigation and corrective measures. The Director of Nursing has more power and responsibility than the nurse manager to deal with such issues and protect clients' rights and welfare.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason: Remaining with this client and monitoring the vital signs while the nurse takes the call is not an appropriate instruction for the unit clerk. The unit clerk is not qualified to monitor vital signs or provide direct care to clients. The nurse should delegate this task to another licensed nurse or UAP who has been trained and validated in this skill.
Choice B Reason: Asking the healthcare provider to remain on "hold" until the nurse can confirm the prescription is not an appropriate instruction for the unit clerk. The unit clerk is not authorized to take verbal or telephone orders from healthcare providers. Only licensed nurses or pharmacists can do so, following specific policies and procedures.
Choice C Reason: Writing down what is prescribed and then repeating it back to the healthcare provider is not an appropriate instruction for the unit clerk. The unit clerk is not authorized to take verbal or telephone orders from healthcare providers. Only licensed nurses or pharmacists can do so, following specific policies and procedures.
Choice D Reason: Telling the healthcare provider the nurse will return the phone call as soon as possible is an appropriate instruction for the unit clerk. The unit clerk can relay messages between the healthcare provider and the nurse, but cannot take orders or give information about clients. The nurse should prioritize calling back the healthcare provider after stabilizing the unstable client.
Correct Answer is B
Explanation
Choice A Reason: Asking the client why he does not want to be weighed is not a priority action because it does not address the need to obtain his daily weight. The nurse should first try to find a way to weigh the client without causing him discomfort or distress.
Choice B Reason: This is the correct answer because weighing the client using a bed scale can avoid the need for
transferring him from the bed to a standing scale, which may be difficult or painful for him. The bed scale can provide an accurate measurement of his weight and help monitor his fluid status.
Choice C Reason: Directing the UAP to delay weighing the client until later is not an appropriate action because it may result in missing or inaccurate data. The nurse should ensure that the client is weighed at the same time every day, preferably in the morning, before any fluid intake or output.
Choice D Reason: Documenting that the client refused daily weights is not an adequate action because it does not reflect the nurse's responsibility to provide quality care for the client. The nurse should try to resolve the issue of weighing the client and documenting the outcome and any interventions.

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