A group of nurses working in a long-term care facility fails to keep the narcotic medications in a locked secure location.
The nurses also fail to document a count of the medications before and after each shift as indicated by the institution's policies and procedures.
These failures may result in disciplinary action against the
physician's license.
pharmacist's license.
facility's license.
nurses' licenses.
The Correct Answer is D
Choice A rationale
A physician's license is primarily concerned with their medical practice, diagnosis, and treatment of patients. While medication security is important in patient care, the direct responsibility for the secure storage and accurate documentation of narcotics in a facility, according to its policies, falls on the nursing staff. Disciplinary actions related to these specific failures would typically target those directly involved in the lapse of protocol.
Choice B rationale
A pharmacist's license governs the dispensing and management of medications within a pharmacy setting. While pharmacists play a crucial role in the supply chain and providing information about medications, the day-to-day secure storage and inventory control of narcotics within a long-term care facility, as per the facility's policies, is the responsibility of the nurses on duty.
Choice C rationale
A facility's license pertains to the operational standards and overall compliance of the healthcare institution. While the failure to secure narcotics and maintain proper documentation could potentially lead to issues with the facility's licensing if it reflects systemic problems, the initial disciplinary actions for direct violations of nursing policies regarding medication handling would likely target the individual nurses involved.
Choice D rationale
Nurses are directly responsible for adhering to the policies and procedures of the healthcare facility regarding the handling and documentation of medications, especially controlled substances like narcotics. Failing to keep narcotics in a locked, secure location and neglecting to document counts before and after each shift are direct violations of these professional responsibilities and institutional guidelines, potentially leading to disciplinary actions against their nursing licenses.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Impaired Skin Integrity involves damage to the epidermal and/or dermal layers of the skin. While excessive fluid loss can indirectly affect skin turgor and increase the risk of breakdown over time, the primary and immediate physiological consequence of increased urinary output due to a diuretic is a potential reduction in overall fluid volume within the body, not a direct impairment of skin integrity.
Choice B rationale
Impaired Urinary Elimination describes difficulties in controlling or completely emptying the bladder. A diuretic, by its mechanism of action, increases urine production and thus promotes urinary elimination. While the *pattern* of elimination may change (increased frequency, urgency), the fundamental issue is not an impairment of the elimination process itself but rather an *increase* in it.
Choice C rationale
Urinary Retention is the inability to empty the bladder completely. A diuretic works to increase urine output, directly counteracting the physiological process of urinary retention. Therefore, this nursing diagnosis would be inappropriate for a client experiencing increased urinary output due to diuretic use.
Choice D rationale
Risk for Deficient Fluid Volume is a nursing diagnosis that identifies a vulnerability to a decrease in intravascular, interstitial, and/or intracellular fluid, which may compromise health. A diuretic increases urinary output, leading to a greater loss of fluid from the body. Without adequate fluid intake to compensate for this increased loss, the client is at a significant risk of developing a fluid volume deficit.
Correct Answer is D
Explanation
Choice A rationale
Anticipatory Grieving is a normal response to an expected loss, such as the impending death of oneself or a loved one. While the client is facing death, her statement "Why me, Lord" and inability to pray suggest a struggle with her spiritual beliefs and meaning in the face of this event, rather than primarily focusing on the emotional preparation for loss.
Choice B rationale
Ineffective Coping refers to an inability to manage stressors effectively. While the client's distress indicates difficulty coping with her situation, the specific mention of spiritual questioning and inability to pray points towards a disturbance in her spiritual well-being, which is more accurately described by spiritual distress.
Choice C rationale
Low Self-Esteem involves negative feelings about oneself and one's worth. While facing death can impact self-esteem, the client's direct questioning of her faith and inability to connect spiritually are the more prominent indicators in this scenario, suggesting a conflict or disruption in her spiritual domain rather than primarily a devaluation of self.
Choice D rationale
Spiritual Distress is characterized by a disruption in one's belief or value system that provides strength, hope, and meaning to life. The client's cry of "Why me, Lord" and her inability to pray indicate a struggle with her faith and a potential feeling of abandonment or questioning of her spiritual beliefs in the face of death. This aligns directly with the defining characteristics of spiritual distress.
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