A nurse discovers an overlooked prescription for a type and crossmatch of a client who is scheduled for surgery. After notifying the laboratory, which of the following actions should the nurse take?
Prepare an incident report.
Cancel the client’s surgery.
Notify the operative team of the omission.
Give the client another blood consent form to sign.
The Correct Answer is C
Choice A Reason
Preparing an incident report is an important step in documenting the oversight and ensuring that similar errors are prevented in the future. However, it is not the immediate priority when addressing the current situation. The primary focus should be on ensuring the client’s safety and the timely completion of the necessary preoperative procedures.
Choice B Reason
Canceling the client’s surgery is a drastic measure that should only be considered if there is no other way to ensure the client’s safety. Before taking such a step, the nurse should explore all other options to rectify the situation, such as notifying the operative team and the provider. This allows for a collaborative approach to determine the best course of action.
Choice C Reason
Notifying the operative team of the omission is the most appropriate action. This ensures that all relevant healthcare providers are aware of the situation and can take the necessary steps to address it. The operative team can then decide whether to proceed with the surgery as planned or to delay it until the type and crossmatch are completed. This collaborative approach prioritizes the client’s safety and ensures that all necessary precautions are taken.
Choice D Reason
Giving the client another blood consent form to sign is not directly related to addressing the overlooked prescription for a type and crossmatch. While obtaining informed consent is crucial, it does not resolve the immediate issue of ensuring that the client has the correct blood type and crossmatch completed before surgery. The focus should be on rectifying the oversight and ensuring that all preoperative requirements are met.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Cranial nerve VII, also known as the facial nerve, is responsible for controlling the muscles of facial expression. When assessing this nerve, a nurse would expect to see symmetrical facial movements, such as a symmetrical smile. This indicates that the facial nerve is functioning properly on both sides of the face. Any asymmetry could suggest a problem with the facial nerve, such as Bell’s palsy or a stroke.
Choice B Reason:
The position of the tongue is controlled by cranial nerve XII, the hypoglossal nerve, not cranial nerve VII. The hypoglossal nerve is responsible for the movements of the tongue, and a midline position indicates normal function of this nerve. Therefore, this response is not relevant to the assessment of cranial nerve VII.
Choice C Reason:
Turning the head against resistance is a test for cranial nerve XI, the accessory nerve. This nerve controls the sternocleidomastoid and trapezius muscles, which are involved in head and shoulder movements. Assessing the ability to turn the head against resistance helps evaluate the function of the accessory nerve, not the facial nerve.
Choice D Reason:
Pupillary constriction in response to light is a function of cranial nerve III, the oculomotor nerve. This nerve controls the muscles that constrict the pupil in response to light, a reflex known as the pupillary light reflex. This response is not related to the function of cranial nerve VII.
Correct Answer is B
Explanation
Choice A Reason
Bending at the waist to pick up the box is not recommended as it can put excessive strain on the lower back. Proper lifting techniques involve bending at the knees and hips, not the waist, to use the stronger muscles of the legs and reduce the risk of back injury. This method helps maintain the natural curve of the spine and distributes the load more evenly.
Choice B Reason
When lifting the box, keeping it close to the body is the most appropriate action. This technique reduces the lever arm distance, thereby decreasing the strain on the back muscles and spine. Holding the load close to the body ensures better control and stability, making it easier to lift and carry the box safely.
Choice C Reason
Keeping the feet close together when lifting a box is not advisable. A wide stance, with feet shoulder-width apart, provides better balance and stability. This position allows for a more secure lift and reduces the risk of losing balance or straining muscles during the lifting process.
Choice D Reason
Relaxing the abdominal muscles to prevent straining the back is incorrect. Engaging the core muscles, including the abdominals, provides additional support to the spine and helps maintain proper posture during lifting. Tightening the abdominal muscles can help stabilize the torso and reduce the risk of back injury.
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