A client is ordered ampicillin 400mg IM every 6 hours. The vial is 500mg per vial.For IM use reconstitute using 1.8mL of diluent for a final concentration of 250mg per mL. How many milliliters would be drawn up for the injection? (Round to the nearest tenth. Use leading zero if it applies .Do not use a trailing zero.)

A. Require staff nurses to demonstrate competency by passing a medication administration examination is incorrect. While testing competency may be part of the solution later, it is not the first step. The CQI process should begin by understanding why errors occurred, not by immediately requiring examinations without understanding the root causes.
B. Review the events leading up to each medication administration error is correct. The first step in a Continuous Quality Improvement (CQI) program should be to gather data and analyze the root causes of the medication errors. By reviewing the events that led to the errors, the committee can identify systemic problems, whether related to processes, communication, or individual actions. This approach helps to focus the improvement efforts on addressing the actual causes of the errors rather than just treating the symptoms.
C. Develop a quality improvement program for nurses involved in medication administration errors is incorrect. Developing a quality improvement program is an important step, but the first step in CQI is to gather and analyze data to identify why errors are occurring. The program should be based on findings from the error reviews.
D. Provide an in-service on medication administration to all the nurses is incorrect. While education and in-service training are useful for improving practice, the first step in CQI is to identify the problem. The committee needs to understand the reasons behind the medication errors before implementing training programs.

A. Discuss the behavior with other colleagues to gain support may provide emotional relief, but it doesn’t formally address the issue or ensure appropriate intervention. It can also risk spreading gossip rather than resolving the conflict.
B. Report the bullying to a supervisor or manager is the most appropriate action. Bullying should be addressed through proper channels to protect the nurse and maintain a safe, professional work environment. Leaders are responsible for enforcing a zero-tolerance policy and can take corrective steps.
C. Ignore the behavior and focus on your work is not a healthy or effective strategy. Ignoring bullying can lead to increased stress, burnout, and decreased job satisfaction, and it allows the behavior to continue unchecked.
D. Confront the experienced nurse directly and demand respect may escalate the situation or lead to further conflict. While direct communication can be part of conflict resolution, it should be done professionally and often with support or guidance from a manager or HR.