A nurse is preparing to complete an occurrence report for a client who fell at the facility. Which of the following actions should the nurse take?

Use objective terminology when documenting

Wait at least 12 hours to report the occurrence

Omit the name of the individuals involved

Document completion of the report in the client’s medical record

Answer and Explanation

The Correct Answer is A

Choice A reason: This statement is correct because the nurse should use objective terminology when documenting the occurrence. Objective terminology means using factual, unbiased, and verifiable information, such as the date, time, location, witnesses, and events of the occurrence. The nurse should avoid using subjective, opinionated, or judgmental language, such as blaming, criticizing, or speculating about the occurrence.
Choice B reason: This statement is incorrect because the nurse should not wait at least 12 hours to report the occurrence. The nurse should report the occurrence as soon as possible, preferably within an hour of the incident. The nurse should also notify the appropriate personnel, such as the charge nurse, the provider, and the risk manager. Delaying the report may compromise the client's safety and wellbeing, and the accuracy and completeness of the documentation.
Choice C reason: This statement is incorrect because the nurse should not omit the name of the individuals involved in the occurrence. The nurse should include the name of the client, the staff, and any other relevant parties, such as family members or visitors. The nurse should also document the role and actions of each individual, and their response to the occurrence. Omitting the name of the individuals may affect the accountability and follow-up of the occurrence.
Choice D reason: This statement is incorrect because the nurse should not document completion of the report in the client’s medical record. The nurse should document the occurrence report separately from the client’s medical record, and follow the facility's policy and procedure for filing and storing the report. The nurse should also document the occurrence in the client’s medical record, but only the facts and the nursing actions, not the details or the existence of the report. Documenting completion of the report in the client’s medical record may expose the facility to legal liability or litigation.

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Correct Answer is C

Explanation

Choice A reason: Irrigating and performing a dressing change for a client who has a pressure injury wound is not a task that the nurse should delegate to an AP. This task requires the nurse's clinical judgment, skill, and knowledge to assess the wound, select the appropriate dressing, and prevent infection. This task is also within the nurse's scope of practice, but not the AP's scope of practice.

Choice B reason: Administering oral PRN pain medication to a client who has arthritis is not a task that the nurse should delegate to an AP. This task involves the nurse's responsibility to evaluate the client's pain level, determine the need and the dosage of the medication, and monitor the client's response and side effects. This task is also within the nurse's scope of practice, but not the AP's scope of practice.

Choice C reason: Obtaining a daily weight on a client who has heart failure is a task that the nurse can delegate to an AP. This task is a routine and standardized procedure that does not require the nurse's clinical judgment, skill, or knowledge. This task is also within the AP's scope of practice, if the nurse provides clear directions and supervision.

Choice D reason: Reinforcing teaching the use of an incentive spirometer to a postoperative client is not a task that the nurse should delegate to an AP. This task involves the nurse's role to educate the client about the purpose, benefits, and technique of using the incentive spirometer, and to evaluate the client's understanding and compliance. This task is also within the nurse's scope of practice, but not the AP's scope of practice.

A. Decrease the number of visits to client by staff B. Efficiency in client care services C. Increase in length of stay for client D. Decrease number of referrals needed for client

Correct Answer is B

Explanation

Choice A reason: This statement is incorrect because an interprofessional team does not necessarily decrease the number of visits to client by staff. In fact, an interprofessional team may increase the frequency and quality of communication and interaction between the client and the staff, as each member of the team contributes their expertise and perspective to the client's care. This can enhance the client's satisfaction, engagement, and education.

Choice B reason: This statement is correct because an interprofessional team can improve the efficiency in client care services. An interprofessional team can coordinate and integrate the care delivery across different disciplines, settings, and levels of care, reducing the duplication, fragmentation, or gaps in the services. This can also lower the costs and risks of care, and improve the outcomes and quality of care.

Choice C reason: This statement is incorrect because an interprofessional team does not increase the length of stay for client. On the contrary, an interprofessional team can reduce the length of stay for client by providing timely, appropriate, and effective care that meets the client's needs and goals. This can also prevent the readmission or complication of the client, and facilitate the transition and discharge of the client.

Choice D reason: This statement is incorrect because an interprofessional team does not decrease the number of referrals needed for client. Rather, an interprofessional team can enhance the referral process by ensuring that the client receives the right service from the right provider at the right time. An interprofessional team can also collaborate and communicate with the referral sources, and follow up on the client's progress and response to the service.

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A nurse is preparing to complete an occurrence report for a client who fell at the facility. Which of the following actions should the nurse take?

Nursing Test Bank

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