A nurse is caring for several clients on a medical-surgical unit. Which of the following client care situations requires the nurse to complete an incident report?
The nurse disagrees with the nurse manager about inadequate staffing.
A staff member has not arrived at the facility to work an assigned shift.
A client tells the nurse that his dentures are missing.
The nurse discovers that the client does not have advanced directives.
The Correct Answer is C
An incident report should be filed whenever an unexpected event occurs. The rule of thumb is that any time a patient makes a complaint, a medication error occurs, a medical device malfunctions, or anyone— patient, staff member, or visitor—is injured or involved in a situation with the potential for injury, an incident report is required ⁴. In this case, the client's missing dentures would be considered a complaint and would require the nurse to complete an incident report.
The other options do not require an incident report. Disagreeing with the nurse manager about inadequate staffing [a], a staff member not arriving at the facility to work an assigned shift [b], and discovering that the client does not have advanced directives [d] are not situations that would require an incident report according to the information provided in my sources.
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Related Questions
Correct Answer is B
Explanation
The nurse should intervene when the AP tears a document with client information in half before disposing of it in a waste basket. This is because client information is confidential and should be disposed of properly to protect the client's privacy. Tearing a document in half is not sufficient to ensure that the information is protected.
Option A is incorrect because logging off the computer after entering a client's intake and output totals is an appropriate action.
Option C is incorrect because denying a request by another AP to use her password to enter the client's vital signs is an appropriate action to protect the client's information.
Option D is incorrect because removing a clipboard with client information from the room during visiting hours may be necessary to protect the client's privacy.
Correct Answer is ["A","B","C","E"]
Explanation
When reinforcing teaching with a client about advance directives, the nurse should include topics such as organ donation [a], disclosure of personal health care information [b], durable power of attorney for health care [c], and cardiopulmonary resuscitation [e]. Advance directives are legal documents that allow individuals to communicate their wishes about medical treatment and end-of-life care in the event that they are unable to make decisions for themselves. These topics are all important components of advance directives and should be discussed with the client.
Enteral feeding tubes [d] are not a topic that is typically included in discussions about advance directives. While enteral feeding may be a component of end-of-life care, it is not a specific topic that is addressed in advance directives.
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