A nurse is working on a unit and suspects a coworker is chemically impaired. Which of the following members of the chain of command should the nurse notify first?

Hospital supervisor

Charge nurse

Chief nursing officer

Unit director

Answer and Explanation

The Correct Answer is B

Choice A reason: The hospital supervisor is not the first person to notify, as they are not directly responsible for the unit or the staff. The hospital supervisor is usually a senior nurse who oversees the operations of the entire hospital or a specific shift. They may be involved in the later stages of the reporting process, but not as the initial contact.

Choice B reason: The charge nurse is the first person to notify, as they are the immediate supervisor of the unit and the staff. The charge nurse is usually an experienced nurse who coordinates the care and activities of the unit, assigns tasks, and provides guidance and support to the staff. They have the authority and responsibility to address the situation and take appropriate actions.

Choice C reason: The chief nursing officer is not the first person to notify, as they are not directly involved in the unit or the staff. The chief nursing officer is usually the highestranking nurse in the organization, who oversees the nursing practice, quality, and education across the entire system. They may be informed of the situation by the unit director or the hospital supervisor, but not as the initial contact.

Choice D reason: The unit director is not the first person to notify, as they are not directly available on the unit or the staff. The unit director is usually a nurse manager who oversees the administrative and financial aspects of the unit, such as budgeting, staffing, and evaluation. They may be notified of the situation by the charge nurse or the hospital supervisor, but not as the initial contact.

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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. Airway protection B. Stabilizing cardiac arrhythmias C. Preventing musculoskeletal disability D. Decreasing intracranial pressure

Correct Answer is A

Explanation

Choice A reason: This action is correct because airway protection is the first priority for a client who is unconscious and has trauma to multiple systems. The nurse should assess the client's airway patency, breathing, and oxygenation, and intervene as needed to secure and maintain the airway. The nurse should also monitor the client for signs of aspiration, bleeding, or obstruction, and suction the airway as needed.
Choice B reason: This action is incorrect because stabilizing cardiac arrhythmias is not the first priority for a client who is unconscious and has trauma to multiple systems. The nurse should assess the client's circulation, blood pressure, and pulse, and intervene as needed to treat any arrhythmias, shock, or hemorrhage. However, this is not a priority over the client's airway, which is essential for survival.
Choice C reason: This action is incorrect because preventing musculoskeletal disability is not the first priority for a client who is unconscious and has trauma to multiple systems. The nurse should assess the client's mobility, sensation, and alignment, and intervene as needed to prevent or treat any fractures, dislocations, or nerve injuries. However, this is not a priority over the client's airway, which is essential for survival.
Choice D reason: This action is incorrect because decreasing intracranial pressure is not the first priority for a client who is unconscious and has trauma to multiple systems. The nurse should assess the client's level of consciousness, pupillary response, and neurological status, and intervene as needed to prevent or treat any increased intracranial pressure, cerebral edema, or brain injury. However, this is not a priority over the client's airway, which is essential for survival.

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A nurse is working on a unit and suspects a coworker is chemically impaired. Which of the following members of the chain of command should the nurse notify first?

Nursing Test Bank

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Correct Answer is A

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