A nurse is recognizing errors or omissions in a plan of care for a client with chronic kidney disease who is on hemodialysis. Which of the following actions should the nurse take?

Report the errors or omissions to the quality improvement committee.

Discuss the errors or omissions with the health care team and revise the plan of care accordingly.

Ignore the errors or omissions as they are not significant enough to affect outcomes.

Document the errors or omissions in an incident report and file it in the client's chart.

Answer and Explanation

The Correct Answer is B

Choice A reason:

Reporting the errors or omissions to the quality improvement committee is not the best action to take because it does not address the immediate needs of the client or correct the plan of care. Quality improvement committees are responsible for monitoring and evaluating the quality of care and services provided by the health care organization, but they are not directly involved in the care of individual clients. Reporting the errors or omissions to the committee may be appropriate after discussing and revising the plan of care with the health care team, but it is not the first or most important action to take.

Choice B reason:

Discussing the errors or omissions with the health care team and revising the plan of care accordingly is the best action to take because it ensures that the client receives safe and effective care that meets their needs and preferences. Errors or omissions in a plan of care are failures to do the right thing that may cause harm or poor outcomes for the client Examples of errors or omissions in a plan of care include failing to order necessary tests, procedures, medications, or consultations; failing to document or communicate important information; failing to monitor or evaluate the client's condition or response to treatment; or failing to follow evidence-based guidelines or standards of care Discussing the errors or omissions with the health care team allows for identifying and correcting the causes of the errors or omissions, such as lack of knowledge, skills, resources, communication, coordination, or supervision. Revising the plan of care accordingly allows for updating and modifying the goals, interventions, and outcomes based on the client's current status and needs.

Choice C reason:

Ignoring the errors or omissions as they are not significant enough to affect outcomes is not a good action to take because it violates the ethical principles of beneficence and nonmaleficence, which require nurses to do good and avoid harm for their clients Ignoring the errors or omissions may also lead to legal consequences, such as negligence or malpractice claims, if the client suffers harm or injury as a result of the errors or omissions Furthermore, ignoring the errors or omissions does not contribute to improving the quality and safety of care or preventing future errors or omissions from occurring.

Choice D reason:

Documenting the errors or omissions in an incident report and filing it in the client's chart is not a good action to take because it does not correct the errors or omissions or revise the plan of care. Incident reports are tools for documenting and analyzing adverse events or near misses that occur in health care settings, such as medication errors, falls, infections, or equipment failures Incident reports are not part of the client's medical record and should not be filed in their chart. They are confidential documents that are used for quality improvement purposes, such as identifying system failures, implementing corrective actions,.

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Correct Answer is A

Explanation

Choice A reason:

Asking the client when they first noticed the symptoms is a relevant and appropriate question for a problem-focused assessment. It helps the nurse to determine the onset, duration, and frequency of the nausea and vomiting, which can provide clues to the possible causes and severity of the problem.

Choice B reason:

Asking the client about allergies or food intolerances is not directly related to the problem of nausea and vomiting. It might be useful to ask this question later in the assessment, but it is not the priority at this point. This question is more suitable for a comprehensive or initial assessment.

Choice C reason:

Asking the client to rate their pain on a scale of 0 to 10 is not relevant to the problem of nausea and vomiting. Pain is a different symptom that might or might not be associated with nausea and vomiting. This question is more suitable for a pain assessment.

Choice D reason:

Asking the client about their health goals is not related to the problem of nausea and vomiting. This question is more suitable for a wellness assessment or a health promotion intervention.

A. The client states that they have a burning sensation when urinating. B. The client has a temperature of 38.2°C (100.8°F) and a pulse of 110/min. C. The client appears restless and anxious during the examination. D. The client reports drinking cranberry juice to prevent UTIs.

Correct Answer is B

Explanation

Choice A reason:

This statement is not objective data because it is based on what the client states, not what the nurse observes or measures. This is an example of subjective data, which is information that depends on personal feelings.

Choice B reason:

This statement is objective data because it is based on what the nurse observes or measures using a thermometer and a pulse oximeter. This is an example of objective data, which is information that is factual and can be verified.

Choice C reason:

This statement is not objective data because it is based on the nurse's interpretation of the client's appearance and behavior, not on direct observation or measurement. This is an example of subjective data, which is information that represents the patient's perceptions, feelings, or concerns.

Choice D reason:

This statement is not objective data because it is based on what the client reports, not what the nurse observes or measures. This is an example of subjective data, which is information that the patient tells the nurse that cannot be measured or observed.

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A nurse is recognizing errors or omissions in a plan of care for a client with chronic kidney disease who is on hemodialysis. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is conducting a problem-focused assessment for a client who reports nausea and vomiting. Which of the following statements should the nurse make to gather more information about the problem?

Correct Answer is A

Explanation

A nurse is documenting the data collected from an assessment of a client who has a urinary tract infection (UTI). Which of the following statements should the nurse use to record objective data?

Correct Answer is B

Explanation

A nurse is performing an ongoing assessment for a client who has a pressure ulcer. Which of the following data should the nurse collect? (Select all that apply).

A nurse is identifying factors that contribute to success or failure of a plan of care for a client with anxiety disorder who is undergoing cognitive behavioral therapy (CBT). Which of the following factors should the nurse consider? (Select all that apply.).

Which type of intervention requires a health care provider's order?

A nurse is documenting the results of an evaluation in a client's chart. Which of the following information should the nurse include? (Select all that apply.).

A nurse is developing a care plan for a client who has impaired mobility due to a stroke. Which of the following actions should the nurse take first when formulating a diagnostic statement?

Which of these is an example of a goal rather than an outcome?

A nurse is using appropriate resources and equipment when implementing care for a client who has impaired mobility due to a stroke. Which of the following actions by the nurse demonstrates this skill?

A nurse is developing a plan of care for a client who has diabetes mellitus. Which of the following actions should the nurse take first?