A nurse is reinforcing teaching with a group of newly licensed nurses about completing an incident report. For which of the following situations should the nurse complete an incident report?
A client decides not to have a colonoscopy after signing the consent form.
A client requests to take a shower in the evening rather than in the morning.
A client has an episode of vomiting after receiving medication for hypertension.
A client's family member becomes short of breath and reports having chest pain.
The Correct Answer is D
The correct answer is Choice D.
Choice A rationale: Withdrawing consent is a client’s legal right. No error or unexpected event occurred, so no incident report is required.
Choice B rationale: Preference for shower timing is a routine care adjustment, not an adverse or unusual event requiring documentation.
Choice C rationale: Vomiting may be a side effect, but unless it causes harm or is unexpected, it doesn’t meet incident report criteria.
Choice D rationale: A medical emergency involving a visitor is unexpected and requires documentation for liability, safety, and institutional response tracking.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The nurse is planning to use a democratic leadership style when conducting an in-service that encourages active member participation and feedback about decreasing nosocomial infections on the unit. A democratic leader values the input and opinions of team members and encourages participation and collaboration in decision-making. By encouraging active participation and feedback from team members, the nurse is demonstrating a democratic approach to leadership.
The other options are not the leadership style that the nurse plans to use in this situation. A laissez-faire leader [b] takes a hands-on approach and allows team members to make their own decisions without providing guidance or direction. An autocratic leader [c] makes decisions unilaterally without seeking input or feedback from team members. An open-door leader [d] maintains an open-door policy and is accessible to team members, but this does not necessarily involve active participation and feedback from team members.

Correct Answer is B
Explanation
If a charge nurse in an acute care facility receives a client request not to have particular assistive personnel (AP) care for her, the appropriate action for the charge nurse to take is to address the concern with the assigned nurse. This will allow the charge nurse and the assigned nurse to work together to address the client's concerns and ensure that the client receives appropriate care.
Option A is incorrect because documenting the issue on an incident report may be necessary, but it should not be the first action taken.
Option C is incorrect because explaining to the client that the AP was having a bad day does not address the client's concerns or wishes.
Option D is incorrect because notifying the human resources department may be necessary, but it should not be the first action taken.
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