The nurse suspects another nurse of substance use disorder while working in the long-term care facility. Which behavior(s) will the observing nurse report to the nurse manager? Select all that apply.
The narcotic count is incorrect when the nurse ends the shift.
The nurse has poor hygiene practices and has an offensive body odor.
The observing nurse finds oral narcotics blister packs torn in the back.
The clients are reporting a lack of pain control when the nurse is working.
The nurse administers narcotics and then goes to use the bathroom.
Correct Answer : A,C,D,E
Choice A: The narcotic count is incorrect when the nurse ends the shift
An incorrect narcotic count at the end of a shift is a serious issue that could indicate potential drug diversion. It's crucial for nurses to accurately count and document narcotics to ensure patient safety and maintain legal and ethical standards. Therefore, this behavior should be reported to the nurse manager.
Choice B: The nurse has poor hygiene practices and has an offensive body odor
While poor hygiene and offensive body odor can be disruptive and unpleasant in a workplace setting, they are not direct indicators of substance use disorder. However, it's important to note that changes in personal hygiene can sometimes be a sign of other health or personal issues.
Choice C: The observing nurse finds oral narcotics blister packs torn in the back
Finding torn narcotics blister packs could indicate that a nurse is diverting drugs for personal use. This is a serious violation of nursing practice and should be reported immediately.
Choice D: The clients are reporting a lack of pain control when the nurse is working
If patients consistently report a lack of pain control when a specific nurse is working, it could suggest that the nurse is not administering the prescribed pain medications properly¹?¹?¹?¹?¹?. This could be due to a variety of reasons, including potential drug diversion, and should be reported.
Choice E: The nurse administers narcotics and then goes to use the bathroom
Frequent bathroom breaks immediately after administering narcotics could be a red flag for drug diversion. While there could be other explanations, this behavior in the context of the other signs could indicate a substance use disorder and should be reported.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Gastric lavage is not indicated in this scenario as the client's lithium level is not extremely elevated. Gastric lavage is typically reserved for cases of acute lithium toxicity when levels are significantly higher than the therapeutic range.
Choice B reason: There is no need to hold the medication as the lithium level is within the normal therapeutic range, which is generally between 0.6 to 1.2 mEq/L. Early manifestations of toxicity typically occur at levels above 1.5 mEq/L.
Choice C reason: Checking the client's medication record is a standard procedure but does not take precedence over administering the medication. The lithium level indicates that the client has been compliant with the medication regimen.
Choice D reason: The nurse should administer the morning dose of lithium because the current level is within the therapeutic range, indicating that it is safe to continue the prescribed treatment.
Correct Answer is B
Explanation
Choice A reason: This statement shows that the client is willing to ground their decisions in reality, which is a key step in managing paranoid personality disorder.
Choice B reason: Trusting others is important, but it does not indicate that the client has learned to validate their ideas before acting.
Choice C reason: Differentiating true suspicions is part of managing the disorder, but it does not demonstrate an understanding of the need to validate ideas with others.
Choice D reason: Understanding the origins of paranoid thinking is insightful, but it does not show that the client has learned to validate their ideas before taking action.
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