A nurse educator is providing an educational session on negligence. Which of the following situations is an example of nurse negligence?
A nurse omits a blood pressure assessment prior to administering Metoprolol.
A nurse finds a client who is on a diabetic diet eating a sugar-coated doughnut and immediately shouts, Stop eating that right now, and takes the doughnut out of the client's hand.
A client who is alert and oriented x 4 refuses their cardiac medications, but the nurse dissolves the medication in the client's cranberry juice.
A client alert and oriented x 2 wants to leave the hospital, and the nurse places the client in soft wrist restraints with the unlicensed assistive personnel until the provider comes to assess the situation.
The Correct Answer is A
Choice A rationale
Negligence is defined as a failure to provide the standard of care that a reasonably prudent nurse would provide in a similar situation, leading to potential harm. Metoprolol is a beta-blocker that requires monitoring of vital signs because it decreases heart rate and blood pressure. By omitting the assessment, the nurse breaches the duty of care. Normal systolic blood pressure is typically 90 to 120 mmHg, and heart rate is 60 to 100 beats per minute.
Choice B rationale
Shouting and physically snatching an object from a client represents battery or assault rather than negligence. Battery involves intentional, non-consensual physical contact, while assault involves creating an apprehension of harmful contact. While the nurse's behavior is unprofessional and violates client rights to autonomy and dignity, it is classified as an intentional tort. Negligence is usually an unintentional failure to perform a required nursing action, such as an assessment or safety check, rather than an aggressive outburst.
Choice C rationale
This action constitutes battery and a violation of the right to informed consent. Administering medications secretly after a competent client has refused is an intentional act of deception and physical violation. Ethical principles of autonomy dictate that an alert and oriented client has the absolute right to refuse any treatment. Hiding medication in food or drink is an intentional tort, which differs from negligence, where the nurse accidentally forgets a standard protocol or safety procedure.
Choice D rationale
Restraining a client against their will without a specific medical order or emergency justification constitutes false imprisonment. This is an intentional tort where a person is restricted in their personal liberty without legal authority. Negligence involves a lack of proper care or attention to detail, whereas applying restraints to a person who wants to leave is a deliberate restriction of movement. The nurse must follow strict protocols and obtain provider orders to legally apply any restrictive devices.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Directing the toddler to look downward actually positions the cornea in the path of the medication application, increasing the risk of irritation or injury. For proper administration of ophthalmic ointment, the patient should be instructed to look upward. This action exposes the lower conjunctival sac and moves the sensitive cornea away from the tip of the tube, ensuring the medication is deposited safely and effectively without causing corneal trauma.
Choice B rationale
Applying the ointment in a thin line along the lower conjunctival sac is the standard technique for ophthalmic medications. This anatomical space allows the medication to be distributed evenly across the ocular surface as the patient blinks. A thin line is sufficient to achieve therapeutic levels of the antibiotic while minimizing blurred vision. This method ensures the medication contacts the inflamed conjunctiva directly to treat the bacterial infection efficiently while avoiding excessive wastage.
Choice C rationale
Cleaning secretions from the outer to the inner canthus is incorrect because it risks pushing contaminated material and pathogens into the lacrimal duct and the opposite eye. The correct technique is to wipe from the inner canthus toward the outer canthus. This direction follows the natural flow of tears and moves bacteria away from the nasolacrimal system, thereby preventing the spread of infection and maintaining better ocular hygiene during the treatment.
Choice D rationale
Using a sterile glove and applicator is unnecessary for the application of ophthalmic ointment and may be cumbersome when treating a toddler. The nurse should instruct the caregiver to wash their hands thoroughly before and after the procedure. The tip of the ointment tube must remain sterile and should not touch the eye or any other surface. Hand hygiene and careful technique are sufficient to prevent cross-contamination without needing specialized sterile equipment.
Correct Answer is ["90"]
Explanation
Step 1 is 6 tablespoons × 15 mL ÷ 1 tablespoon.
Step 2 is 90 mL.
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