The plan of care for a patient is not completed within 24 hours of the patient’s admission due to the unit being short-staffed. Which action should the nurse prioritize?
Administer an as-needed dose of an antipsychotic drug
Complete the plan of care as soon as possible
Transfer the patient to another unit
Document the staffing issue in the patient’s chart
The Correct Answer is B
Choice A reason: Administering an antipsychotic without a completed care plan risks inappropriate treatment, as the plan outlines specific needs and interventions. This could lead to adverse effects or mismanagement of the patient’s condition, violating evidence-based practice in psychiatric care, making this choice incorrect.
Choice B reason: Completing the care plan promptly ensures individualized, evidence-based interventions, critical for effective psychiatric treatment. It addresses the patient’s specific needs, guides therapy, and ensures safety, aligning with nursing standards and patient-centered care principles, making this the correct choice for prioritization.
Choice C reason: Transferring the patient to another unit does not address the immediate need for a care plan and may disrupt continuity of care. Staffing issues should be managed locally, and transfer is not a primary solution for incomplete planning, making this choice incorrect.
Choice D reason: Documenting staffing issues, while important for administrative purposes, does not directly address the patient’s immediate care needs. A completed care plan is critical for guiding treatment and ensuring safety, making this choice a lower priority compared to completing the plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: A provider giving a telephone order is a standard practice in healthcare, not inherently requiring reporting unless the order is unsafe. It does not indicate negligence or ethical violations, unlike impaired practice or boundary issues, making it incorrect for mandatory intervention and reporting.
Choice B reason: A peer under the influence of alcohol compromises patient safety due to impaired judgment and coordination, a serious ethical and professional violation. Nurses are obligated to report such behavior to protect patients, aligning with nursing ethics and safety protocols, making this a correct choice.
Choice C reason: Violating relationship boundaries with a patient, such as inappropriate personal interactions, breaches ethical standards and risks patient harm. Nurses must report this to ensure patient safety and maintain professional integrity, aligning with mental health care ethics, making this a correct choice.
Choice D reason: A licensed provider prescribing medication is a routine clinical action, not requiring reporting unless the prescription is unsafe or inappropriate. This choice does not inherently indicate a need for intervention, unlike impaired practice or boundary violations, making it incorrect.
Correct Answer is B
Explanation
Choice A reason: Asking if the client felt this way before hospitalization focuses on past feelings, which may not address the current emotional state or therapeutic needs. While it gathers history, it lacks empathy and does not encourage the client to elaborate on their current concerns, making it less therapeutic.
Choice B reason: Reflecting the client’s statement by asking if they feel the setting is wrong demonstrates active listening and empathy, key components of therapeutic communication. It encourages the client to express feelings, fostering trust and exploration of their concerns, aligning with psychiatric nursing principles, making this the correct choice.
Choice C reason: Suggesting the client discuss concerns later with a doctor dismisses their current emotional state, potentially undermining trust in the nurse-client relationship. It avoids immediate engagement and fails to address the client’s feelings, which is critical in psychiatric care, making this response non-therapeutic and incorrect.
Choice D reason: Labeling the client’s statement as inappropriate is judgmental and dismissive, hindering therapeutic communication. It may increase the client’s sense of alienation or shame, contrary to psychiatric nursing goals of building trust and validating feelings. This response is non-therapeutic and does not support the client’s emotional needs.
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