The practical nurse (PN) hears an older resident of a long-term care facility shout profanities at an unlicensed assistive personnel (UAP) who shouts back at the resident. Which is the first action the PN should take?
Report the incident and the UAP for further action by the nurse manager.
Tell both of them to lower their voices in consideration of other residents.
Tell the resident and the UAP that shouting is not permitted.
Enter the room and tell the UAP to leave the room immediately.
The Correct Answer is D
When the PN witnesses a situation where a resident is shouting profanities and a staff member (UAP) responds inappropriately, the immediate priority is to ensure the safety and well-being of the resident. It is essential to address the situation promptly and prevent further escalation.
Entering the room and instructing the UAP to leave immediately serves several purposes:
1. Protecting the resident: Removing the UAP from the room ensures that the resident is not subjected to further conflict or distress.
2. Maintaining a calm and therapeutic environment: By addressing the disruptive behavior and removing the staff member involved, the PN can help restore a peaceful environment for the resident and other individuals in the facility.
3. Ensuring professional conduct: Shouting and engaging in unprofessional behavior is not acceptable in a healthcare setting. By immediately intervening and directing the UAP to leave the room, the PN reinforces the importance of maintaining a respectful and professional approach to caregiving.
After addressing the immediate concern, the PN should follow up by reporting the incident and providing a detailed account to the nurse manager or supervisor. This allows for appropriate action to be taken, such as further investigation or disciplinary measures if necessary.
The other options mentioned are not the first actions to be taken in this situation:
A. Reporting the incident and the UAP for further action by the nurse manager: While reporting the incident is important, it is not the immediate action required to address the situation in
real-time.
B. Telling both of them to lower their voices in consideration of other residents: While promoting a calm environment is important, addressing the issue of shouting and unprofessional behavior takes precedence over requesting a volume reduction.
C. Telling the resident and the UAP that shouting is not permitted: While it is essential to communicate the expectations of behavior, the immediate focus should be on removing the staff member from the situation and ensuring the resident's well-being.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This is the most important complication for the practical nurse (PN) to anticipate because it is a common and potentially life-threatening condition that can occur in clients with severe burns. Curling's ulcer, also known as stress ulcer, is a type of peptic ulcer that develops in the stomach or duodenum as a result of stress, shock, trauma, or burns. It is caused by decreased blood flow and increased acid secretion in the gastrointestinal tract, which damages the mucosal lining and leads to ulceration and bleeding.
The PN should anticipate Curling's ulcer in a client who experienced partial-thickness burns over 30% of the body surface area (BSA) 3 days ago, as this is a major risk factor for developing stress ulcers. The PN should monitor the client for signs and symptoms of Curling's ulcer, such as abdominal pain, nausea, vomiting, hematemesis, melena, and anemia. The PN should also administer prophylactic medications such as antacids, histamine-2 blockers, or proton pump inhibitors as prescribed by the health care provider.
Correct Answer is A
Explanation
Hoarseness or voice changes after thyroidectomy can be indicative of injury or irritation to the recurrent laryngeal nerve, which is responsible for controlling the vocal cords. This is a potential complication of the surgery and should be reported to the charge nurse or healthcare provider for further evaluation and management.
B. Administer humidified oxygen per nasal cannula: This option is not appropriate for addressing hoarseness in a client following a thyroidectomy. Hoarseness after a thyroidectomy is typically related to vocal cord injury or irritation, and providing humidified oxygen would not directly address this issue. It is important to notify the charge nurse or healthcare provider for further evaluation and management.
C. Obtain a cup of ice chips for the client: Providing ice chips is not the appropriate action for hoarseness following a thyroidectomy. Ice chips are typically used to provide hydration and comfort to clients, but they do not directly address the underlying cause of hoarseness, which in this case may be vocal cord injury or irritation. It is important to notify the charge nurse or healthcare provider for appropriate evaluation and management.
D. Ensure that the drainage device is compressed: While ensuring proper compression of a drainage device is important for preventing complications such as bleeding or infection, it is not directly related to the client's hoarseness. Hoarseness after a thyroidectomy is more likely related to vocal cord injury or irritation, and notifying the charge nurse or healthcare provider is necessary for further assessment and management.
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