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.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

A. Report of back pain associated with twisting at the waist. Back pain is a common musculoskeletal issue among agricultural workers due to repetitive movements and heavy lifting. While it requires intervention, it is not immediately life-threatening and does not take priority over acute symptoms that may indicate poisoning or a severe reaction.

B. Absence of a dental health provider. Lack of dental care can contribute to long-term health complications, but it does not pose an immediate risk requiring urgent intervention. Addressing acute medical conditions takes precedence over routine preventive care.

C. Lives in a home with 25 other agricultural workers. Overcrowded living conditions can increase the risk of communicable diseases and poor hygiene-related health issues. However, it is a social determinant of health rather than an urgent clinical concern that requires immediate action.

D. Report of muscle twitching and skin rash. Muscle twitching and skin rash can indicate pesticide poisoning, a common occupational hazard for agricultural workers. Pesticide exposure can lead to serious neurological and systemic effects, making this the priority for immediate assessment and intervention.

A. "Your provider will be here later today." B. "I can give you information on what that would involve." C. "I understand how you feel. I felt the same way when my sibling was terminally ill." D. "I think you should speak with social services about your request."

Correct Answer is B

Explanation

A. "Your provider will be here later today." Informing the guardian about the provider’s availability does not directly address their request or provide immediate support. While the provider plays a role in discharge planning, the nurse should offer guidance and resources to help the guardian understand the process of taking the child home.

B. "I can give you information on what that would involve." Acknowledging the guardian’s request and offering relevant information demonstrates support and facilitates informed decision-making. Providing education on home care, hospice options, and necessary resources ensures that the guardian is prepared for the transition while maintaining open communication.

C. "I understand how you feel. I felt the same way when my sibling was terminally ill." Sharing personal experiences shifts the focus away from the guardian’s concerns and may not be appropriate in a professional setting. While empathy is essential, the response should remain patient-centered and focused on providing relevant information and support.

D. "I think you should speak with social services about your request." Referring the guardian to social services may be part of the process, but immediately redirecting the conversation does not acknowledge their concerns. The nurse should first provide direct information and reassurance before involving additional support services as needed.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse working in a mobile health clinic is assessing a client who is an agricultural worker. Which of the following findings should the nurse identify as the priority?

Correct Answer is D

Explanation

The guardian of a child who has a terminally illness tells a nurse that they want to take their child home. Which of the following responses should the nurse make?

Correct Answer is B

Explanation

An occupational health nurse is preparing to teach a health promotion class for workers at a warehouse. Which of the following statements should the nurse include?

A nurse manager is teaching a group of employees about standards for Quality and Safety Education for Nurses (QSEN). Which of the following statements by an employee should the nurse manager identify as an example of the QSEN concept of quality improvement?

During an initial visit, a home health nurse is assessing a client who has cultural beliefs different than their own. Which of the following questions should the nurse ask to determine the client's beliefs about environmental control?

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?

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