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A nurse notes a provider frequently arrives to the unit with bloodshot eyes and smells like alcohol after lunch. Which of the following actions should the nurse take?
- A. Inform the state medical board for an immediate investigation.
- B. Counsel the provider to determine the cause of the substance abuse.
- C. Notify the nursing supervisor of the concerns.
- D. Encourage clients to change to a different provider.
Correct Answer: C
Rationale: The correct answer is C: Notify the nursing supervisor of the concerns. This is the most appropriate action because it allows for immediate intervention by someone in authority to address the provider's behavior. The nursing supervisor is in a position to assess the situation, determine the appropriate course of action, and provide support to the nurse in dealing with this sensitive issue. Reporting to the state medical board (choice A) may be premature and could potentially harm the provider's career without first addressing the issue internally. Counseling the provider (choice B) may not be effective if there is a serious substance abuse problem. Encouraging clients to change providers (choice D) is not the nurse's responsibility and may not address the root cause of the issue.
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A nurse is preparing a report for the quality improvement committee about medication errors. Which of the following data should the nurse include to evaluate the effectiveness of current interventions?
- A. The number of staff trained on medication safety protocols.
- B. The cost of implementing new medication scanners.
- C. The percentage of medication errors before and after interventions.
- D. The satisfaction scores from staff using new medication systems.
Correct Answer: C
Rationale: The correct answer is C, the percentage of medication errors before and after interventions. This data is crucial for evaluating the effectiveness of current interventions because it directly measures the impact of the interventions on reducing medication errors. By comparing the percentage of errors before and after the interventions, the nurse can determine if the interventions have been successful in improving medication safety.
Choice A is incorrect because while staff training is important, it does not directly measure the effectiveness of interventions on reducing errors.
Choice B is incorrect as the cost of implementing new scanners is not a direct indicator of effectiveness in reducing medication errors.
Choice D is incorrect as staff satisfaction scores do not necessarily reflect the actual impact on medication error reduction.
In summary, monitoring the percentage of medication errors before and after interventions provides a clear, objective measure of the effectiveness of current interventions in improving medication safety.
A nurse manager is reviewing incident reports from the past month. Which of the following situations should the nurse prioritize for follow-up?
- A. A client received a meal tray with the wrong diet.
- B. An assistive personnel failed to report a client's low blood glucose level.
- C. A nurse documented a medication administration 30 minutes late.
- D. A client's call light was answered after a 10-minute delay.
Correct Answer: B
Rationale: The correct answer is B. Prioritizing follow-up on the assistive personnel's failure to report a client's low blood glucose level is crucial as it directly impacts patient safety and could lead to serious consequences. Not reporting a critical health issue promptly can result in harm or even death. Addressing this issue promptly is essential to prevent recurrence and ensure the well-being of the patient. Choices A, C, and D involve errors or delays that are concerning but do not pose an immediate threat to patient safety compared to the failure to report a critical health issue.
A charge nurse hears a provider speaking to a staff nurse in anger concerning incorrect supplies that are available to perform a procedure. Which of the following statements by the charge nurse is appropriate?
- A. If you let us know ahead of time that you plan to perform a procedure, we could do better job of having the supplies available.
- B. It must be very frustrating when you don't have want you need to perform the procedure.
- C. I will help you with this procedure instead of the staff nurse.
- D. You should think about how you make others feel when you lose your temper.
Correct Answer: B
Rationale: The correct answer is B because it demonstrates empathy and understanding towards the staff nurse's frustration. By acknowledging the staff nurse's feelings and showing empathy, the charge nurse can diffuse the situation and work towards finding a solution collaboratively.
Choice A is not as appropriate because it may come across as blaming the staff nurse for the lack of supplies. Choice C is not ideal as it doesn't address the underlying issue of the incorrect supplies. Choice D shifts the focus away from the situation at hand and onto the provider's behavior.
In summary, choice B is the best response as it shows empathy, validates the staff nurse's feelings, and opens the door for constructive problem-solving.
A nurse is discussing emergency response with a newly licensed nurse. The nurse should identify which of the following as a triage officer during the time of a disaster?
- A. Nurses and other emergency medical personnel
- B. Responding law enforcement officers
- C. Members of the Federal Emergency Management Agency (FEMA)
- D. Representatives from the American Red Cross
Correct Answer: A
Rationale: The correct answer is A because nurses and other emergency medical personnel are trained to assess and prioritize patients based on their medical needs during a disaster. They have the expertise to quickly identify and categorize patients to ensure those with the most critical conditions receive immediate care. Responding law enforcement officers (B) focus on security and crowd control. Members of FEMA (C) are responsible for coordinating disaster response at a larger scale. Representatives from the American Red Cross (D) provide support services but do not typically serve as triage officers.
A nurse is caring for four postoperative clients. The nurse can delegate obtaining vital signs to an assistive personnel (AP) for which of the following clients?
- A. A client who is 3 days postoperative following a craniotomy
- B. A client who is 3 days postoperative following gastric bypass surgery
- C. A client who is 2 hr postoperative following an abdominal hysterectomy
- D. A client who is 1 hr postoperative following a thyroidectomy
Correct Answer: B
Rationale: The correct answer is B because a client who is 3 days postoperative following gastric bypass surgery is stable and unlikely to have immediate complications. Vital signs can be safely delegated to an assistive personnel (AP) for this client.
Choice A is incorrect because a client who is 3 days postoperative following a craniotomy may still be at risk for neurological complications that require close monitoring by a nurse.
Choice C is incorrect because a client who is only 2 hours postoperative following an abdominal hysterectomy is still in the immediate postoperative period and requires frequent monitoring by a nurse.
Choice D is incorrect because a client who is only 1 hour postoperative following a thyroidectomy is in the immediate postoperative period and may have potential complications that require close monitoring by a nurse.
Overall, the key factor in delegating obtaining vital signs to an AP is the stability of the client's condition postoperatively.