A new nursing graduate has made an error in documentation that led to an unexpected client outcome. When aiming to avoid future errors, which action should the nurse prioritize?

Ensure charting entries are as concise as possible

Prioritize subjectivity over objectivity in documentation

Provide the greatest amount of detail possible in every charting entry

Complete documentation as soon as possible after client interactions

Answer and Explanation

The Correct Answer is D

A. While concise documentation is valuable, being overly brief can lead to omission of important information.
B. Documentation should be objective, focusing on facts and observable data rather than subjective impressions.
C. Providing excessive detail can clutter the record and make it harder to identify critical information; relevance and clarity are more important than sheer volume.
D. Completing documentation as soon as possible after client interactions helps ensure accuracy and completeness. Timely documentation reduces the risk of forgetting important details and helps maintain continuity of care.

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Correct Answer is B

Explanation

A. Reassuring the family without addressing the issue is unsafe.
B. Applying a pressure dressing helps control bleeding, and reporting findings promptly ensures timely medical intervention.
C. Simply documenting and changing the dressing without addressing bleeding risks worsening the condition.
D. Waiting to monitor without immediate intervention could allow the client’s condition to deteriorate.

A. When preparing to discharge the client home B. When documenting the care that was provided to a client whose condition recently deteriorated C. When transferring a client from the emergency department to the acute care unit D. When reporting to a client's family member or significant other

Correct Answer is C

Explanation

A. Discharge preparation involves teaching and planning, but ISBARR is not typically used.
B. Documentation uses standard medical record formats, not ISBARR.
C. ISBARR is designed for clear, structured communication between healthcare providers, especially during client handoffs like transferring from the emergency department to acute care.
D. Reporting to family uses a different communication style focused on support and explanation.

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A new nursing graduate has made an error in documentation that led to an unexpected client outcome. When aiming to avoid future errors, which action should the nurse prioritize?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing ongoing postoperative care to a client who has had knee surgery. The nurse assesses the dressing and finds it saturated with blood. The client is restless and has a rapid pulse. What should the nurse do next?

Correct Answer is B

Explanation

The nurse should utilize ISBARR communication (Introduction, Situation, Background, Assessment, Recommendation, Read Back) during which clinical situation?

Correct Answer is C

Explanation

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