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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Correct Answer is A

Explanation

A. Performance appraisals should be written in measurable terms: This principle is essential for creating objective and clear evaluations. Measurable terms allow for the assessment of specific behaviors and outcomes, making it easier to identify areas of strength and areas needing improvement. This approach helps ensure fairness and transparency in the appraisal process.

B. Appraisal objectives should be applicable to staff at every level: While having relevant objectives is important, it may not be feasible for every objective to apply equally to all staff levels. Different roles and responsibilities necessitate tailored objectives that reflect the unique contributions of various positions within the organization.

C. Performance appraisals should be based on the nurse manager's preferences: Appraisals should not be based on personal preferences. Instead, they should focus on objective criteria and measurable outcomes related to job performance, ensuring fairness and consistency across evaluations.

D. Completed appraisals should be approved by a provider: While collaboration and input from other healthcare professionals can be valuable, the nurse manager is typically responsible for conducting performance appraisals. Approval from a provider is not a standard requirement for the completion of staff performance evaluations.

A. Loud volume of the television set B. Wall-to-wall carpet in the living room C. Low chairs without armrests D. Use of indirect lighting

Correct Answer is C

Explanation

A. Loud volume of the television set. While a loud television may indicate hearing impairment, it does not pose an immediate safety risk. The nurse should assess the client’s hearing and provide recommendations if needed, but addressing environmental hazards that increase the risk of falls takes priority.

B. Wall-to-wall carpet in the living room. Unlike loose rugs, wall-to-wall carpeting reduces the risk of tripping and slipping. It provides better traction for walking, making it a safer flooring option for older adults compared to hard surfaces or throw rugs.

C. Low chairs without armrests. Low chairs make it difficult for older adults to stand up, increasing the risk of falls. The absence of armrests further reduces stability and support when rising from a seated position. Recommending higher chairs with armrests can enhance mobility and prevent injuries.

D. Use of indirect lighting. Soft, indirect lighting can help reduce glare and improve comfort, but it may not necessarily create safety concerns. However, inadequate lighting in critical areas, such as hallways or staircases, should be assessed to prevent falls.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse manager is preparing to complete staff performance appraisals. Which of the following principles should the nurse manager consider when completing the appraisals?

Correct Answer is A

Explanation

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?

Correct Answer is C

Explanation

A staff nurse is challenging a shift assignment with the charge nurse. Which of the following statements made by the charge nurse is an example of smoothing as a strategy to resolve conflict?

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 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?

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 community health nurse is reviewing primary prevention strategies for West Nile virus with a group of clients in a rural health clinic. Which of the following instructions should the nurse include?

A nurse is planning an in-service for community members living in an area with a high poverty rate. Which of the following information about health risks should the nurse include in the teaching?

A case manager is participating in the care of a client. Exhibits The case manager is planning the client's discharge. Which of the following interventions should the nurse include in the client's discharge plan?