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.

Answer and Explanation

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

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Choice A Reason: This role is responsible for coordinating the continuum of care for clients with complex health needs, such as head injury. The nurse case manager collaborates with the interdisciplinary team, the client, and the family to plan, implement, and evaluate the client's care from admission to discharge.

Choice B Reason: This role is responsible for providing primary and specialty care to adults, such as diagnosing and treating acute and chronic conditions, prescribing medications, and ordering tests. The adult nurse practitioner may be involved in the client's care, but not in coordinating it.

Choice C Reason: This role is responsible for managing the daily operations of the neurology unit, such as staffing, budgeting, quality improvement, and staff development. The neurology unit supervisor may oversee the client's care while on the unit, but not throughout the continuum of care.

Choice D Reason: This role is responsible for identifying and preventing potential risks and liabilities in the healthcare setting, such as errors, injuries, infections, or lawsuits. The risk management nurse may monitor the client's care for quality and safety issues, but not for coordination.

A. Administered two medications to the same client at the wrong time. B. Documented data in the clinical record before assessing client's condition. C. Served a diet tray to a client who was NPO for a scheduled procedure. D. Changed work assignments without prior approval from charge nurse.

Correct Answer is B

Explanation

Choice A Reason: This is not the best action because it is a medication error that can be corrected and prevented by following the rights of medication administration. The nurse manager should counsel the staff nurse and provide education on safe medication practices.

Choice B Reason: This is the best action because it is a serious breach of professional ethics and standards. The nurse manager should report the staff nurse to the PRC for falsifying documentation and compromising client care.

Choice C Reason: This is not the best action because it is a mistake that can be rectified by removing the diet tray and notifying the healthcare provider. The nurse manager should reprimand the staff nurse and review the policy on NPO status.

Choice D Reason: This is not the best action because it is a minor issue that can be resolved by communicating with the charge nurse and other staff members. The nurse manager should remind the staff nurse of the importance of teamwork and collaboration.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An adult client is admitted via the Emergency Department with a head injury that will initially require intensive care. Which role is responsible for coordinating the progression of this client's care through rehabilitation and discharge?

Correct Answer is A

Explanation

The nurse manager decides to report a staff nurse to the Peer Review Committee (PRC). Which activity merits this action?

Correct Answer is B

Explanation

A fire is reported in the kitchen on the first floor of a three-floor community hospital, and the operator notifies the charge nurse on the third floor to start evacuation procedures. Which intervention should the charge nurse implement?

The fire alarm goes off while the charge nurse is receiving the shift report. Which action should the charge nurse implement first?

The smell of cigarette smoke is coming from a client's bathroom. Which action should the nurse implement first?

The nurse determines that an elderly client with pneumonia has a nursing problem of "altered nutrition, less than body requirements." Which instruction should the nurse give the unlicensed assistive personnel (UAP) helping with the care of this client?

The charge nurse needs to determine if an additional nurse should be called to help staff the unit for the next shift. Which information is most important for the charge nurse to consider when making this decision?