A nurse is reviewing a client's medical record and discovers that the client received a double dose of a prescribed medication.
Which of the following actions should the nurse take?
Document the doubled dose in the client's medical record.
Report the incident to the manager of the pharmacy.
Place a copy of the incident report in the client's record.
Contact the nurse from the previous shift to report the doubled dose.
The Correct Answer is A
Choice A rationale
Documenting the doubled dose in the medical record ensures transparency and provides critical information for continuity of care. Accurate documentation allows the healthcare team to monitor the client for potential adverse effects, supporting accountability and preventing recurrence of medication errors.
Choice B rationale
Reporting the incident to the pharmacy manager addresses systemic issues, such as procedural errors or staff education needs, to prevent similar occurrences. However, this action does not directly prioritize client safety or care in response to the doubled dose.
Choice C rationale
Placing a copy of the incident report in the client’s record breaches confidentiality and violates facility policy. Incident reports are administrative tools to address safety concerns, not a part of the client’s medical record.
Choice D rationale
Contacting the nurse from the previous shift might provide insight into the error’s cause but does not address the immediate need to ensure client safety or document the error. This step is secondary to accurate record-keeping and reporting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Placing clipboards with client information facing down prevents unauthorized viewing, thereby adhering to confidentiality laws such as HIPAA. It reduces the likelihood of accidental breaches of sensitive information when in public or shared spaces.
Choice B rationale
Posting intake and output on message boards breaches confidentiality as it exposes personal health information to anyone in the room. This violates privacy regulations like HIPAA and compromises client trust in the healthcare system.
Choice C rationale
Faxing confidential information without a cover sheet increases the risk of unauthorized access if the fax is received by unintended parties. A cover sheet is a standard practice to safeguard client data and ensure legal compliance.
Choice D rationale
Disposing of client information in the trash without proper shredding allows potential retrieval and misuse of sensitive data. It is essential to follow facility protocols for secure disposal, like using designated shredders for healthcare documents.
Correct Answer is D
Explanation
The correct answer is Choice D
Choice A rationale: Gathering information about the conflict is important, but it should not be the first step. Addressing interpersonal disputes in a public setting can escalate tension and compromise professionalism. Conflict resolution theory emphasizes the importance of setting before engagement. The nurse must first ensure privacy to reduce environmental stressors and allow for open, non-defensive communication. Cortisol levels rise during public confrontation, impairing cognitive flexibility and emotional regulation, which are essential for constructive dialogue.
Choice B rationale: Listening to concerns is a critical component of conflict resolution, but it must occur in a controlled, private setting. Active listening activates prefrontal cortex pathways involved in empathy and problem-solving. However, in public environments, social threat perception may inhibit honest expression and escalate defensive behaviors. Neurobiologically, privacy reduces amygdala activation, promoting emotional safety. Therefore, listening should follow relocation to a private space to optimize psychological conditions for resolution.
Choice C rationale: Discussing solutions prematurely may bypass the emotional processing required for effective conflict resolution. According to the Thomas-Kilmann conflict model, resolution strategies must be tailored after understanding each party’s concerns. Initiating problem-solving before establishing psychological safety can lead to superficial or coercive outcomes. Emotional regulation and trust-building precede collaborative negotiation. Dopaminergic reward pathways are more responsive when individuals feel heard and respected, which requires a private, empathetic setting before solution-focused dialogue.
Choice D rationale: Relocating the staff nurses to a private area is the scientifically supported first step in conflict de-escalation. Privacy reduces environmental stimuli that activate the sympathetic nervous system, lowering heart rate and cortisol secretion. It also minimizes audience effects that trigger social defensiveness. In neurobehavioral terms, private settings enhance oxytocin-mediated trust and prefrontal cortex engagement, facilitating rational discourse. This foundational step sets the stage for effective listening, empathy, and resolution, aligning with best practices in workplace mediation.
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