A nurse manager is reviewing a group of incident reports as part of a quality improvement initiative.

Exhibits

For each incident report, click to specify if the findings in the incident report indicate a near miss or an adverse event. There must be at least 1 selection in every row. There does not need to be a selection in every column.

Incident report 1

Incident report 2

Incident report 3

Incident report 4

Incident report 5

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"}}

Near miss:

Incident Report 1: The nurse identified the client's allergy before administering azithromycin, preventing an adverse reaction. Holding the medication and notifying the provider ensured patient safety, making this a near miss rather than an adverse event.

Adverse Event:

Incident Report 2: The client did not receive prescribed prophylactic antibiotics during labor, leading to neonatal sepsis. The lack of antibiotic administration increased the risk of serious complications, making this an adverse event with potential long-term consequences.
Incident Report 3: A tenfold dosing error led to the administration of 60 units instead of 6 units of insulin, resulting in severe hypoglycemia and unresponsiveness. This critical medication error placed the client at significant risk for neurological damage or death, classifying it as an adverse event.
Incident Report 4: A critically low platelet value was reported but not communicated to the provider, delaying intervention and leading to a coma. The failure to act on critical lab results contributed to a preventable deterioration in the client’s condition, making this an adverse event.
Incident Report 5: Despite being identified as a fall risk, the client sustained a fall due to a malfunctioning call bell, leading to an injury. The failure to address the defective equipment compromised patient safety, making this an adverse event that could have been prevented.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is ["A","D","E","F"]

Explanation

A. "If I request a do-not-resuscitate (DNR) prescription, CPR will be withheld from my care.": Understanding that a DNR order means no resuscitation efforts, such as CPR, will be performed in the event of cardiac or respiratory arrest is crucial. This reflects the client’s autonomy in making end-of-life decisions and ensures their preferences are respected in critical situations.

B. "Once I choose a health care proxy, they will start making my health care decisions.": While selecting a health care proxy is an important step, they can only make decisions when the client is unable to do so. This means that the proxy’s authority to act is contingent upon the client’s capacity to communicate their wishes.

C. "I am required to complete these documents during my hospital stay.": Clients are encouraged to create advance directives, but there is no legal requirement to complete these documents while in the hospital. Clients have the right to determine the timing and circumstances under which they complete advance directives.

D. "The hospital is legally required to provide me information on these documents.": Hospitals have an obligation to inform clients about advance directives, ensuring they are aware of their rights and the options available for planning their medical care. This legal requirement promotes informed decision-making among clients.

E. "When completed, a copy of these documents will be kept in my medical record.": Storing advance directives in the medical record is essential for ensuring that healthcare providers have access to the client’s preferences regarding treatment. This practice helps to facilitate communication and adherence to the client’s wishes during their care.

F. "These documents provide instructions about my care preferences.": Advance directives outline a client’s preferences for medical treatment and interventions, ensuring that their values and wishes guide their care if they become unable to communicate those preferences. This helps healthcare providers understand and respect the client’s desires regarding their treatment.

A. Rubella B. Pertussis C. Influenza D. Varicella

Correct Answer is D

Explanation

A. Rubella: This disease is primarily spread through respiratory droplets, requiring standard precautions for management. It is important for nurses to understand that while rubella can be contagious, airborne precautions are not necessary for this condition.

B. Pertussis: Also known as whooping cough, pertussis is transmitted through respiratory droplets, which necessitates droplet precautions rather than airborne precautions. Understanding the mode of transmission helps healthcare workers implement the appropriate level of precautions to prevent the spread of infection.

C. Influenza: Influenza is primarily transmitted through respiratory droplets. Although droplet precautions are necessary when caring for patients with influenza, airborne precautions are not required. Knowledge of these distinctions is essential for nurses to ensure effective infection control measures.

D. Varicella: Varicella, or chickenpox, is classified as an airborne disease because it spreads through respiratory droplets and direct contact with the rash. Airborne precautions are necessary to prevent transmission, especially in healthcare settings where vulnerable populations may be present. Understanding the specific precautions for airborne diseases is crucial for maintaining patient and staff safety.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse manager is participating in the care of a client. Exhibits Which of the following client statements indicate an understanding of the teaching? Select all that apply.

Correct Answer is ["A","D","E","F"]

Explanation

A community health nurse is instructing a group of newly licensed nurses about diseases that require airborne precautions. Which of the following diseases should the nurse include?

Correct Answer is D

Explanation

A nurse manager is teaching a group of staff members about proper body mechanics. Which of the following statements by a staff member indicates an understanding of the teaching?

A nurse is planning a staff education program to review nursing interventions for clients who have kidney failure. Which of the following sources should the nurse identify as the best resource for obtaining evidence-based information?

A nurse is conducting a home visit with an older adult client. Which of the following observations should the nurse address to promote a safe environment?

A nurse is preparing to administer the initial dose of ceftriaxone to a client who has endometritis. Which of the following statements by the client should cause the nurse to hold the medication and consult the provider?

A nurse manager of a rural clinic is orienting a new employee. Which of the following information should the nurse include as a characteristic of rural health?

A newly licensed nurse is giving a change-of-shift report using Introductions, Situation, Background, Assessment, Recommendation (ISBAR) to an oncoming nurse. Which of the following statements by the newly licensed nurse should be included in the "Background" portion of the report?

A nurse is caring for a newborn in the nursery following a circumcision. The newborn's grandparent, who does not have an identification bracelet, requests to take the newborn to their guardian's room. Which of the following actions should the nurse take?

A school nurse is developing a teaching plan about testicular cancer for a group of clients. Which of the following information should the nurse include in the teaching?