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. Schedule the meeting to occur in the nursing station: Conducting the meeting in the nursing station may not provide the privacy and confidentiality needed for a sensitive discussion about performance issues. A private setting is essential to encourage open communication and a constructive dialogue.

B. Arrange seating to sit across from the nurse: Sitting across from the nurse can create a confrontational atmosphere. It is more effective to arrange seating in a way that fosters collaboration and openness, such as sitting beside the nurse, which can help reduce tension during the conversation.

C. Tell the nurse they need to improve their client care delivery: Directly stating that the nurse needs to improve without first exploring their perspective may be perceived as accusatory and could lead to defensiveness. A more supportive approach is necessary to promote constructive feedback and development.

D. Ask the nurse how things have been going since the last meeting: This action is the most appropriate as it opens the conversation in a non-confrontational manner, allowing the nurse to express their thoughts and experiences. It fosters a supportive environment and encourages the nurse to reflect on their performance and any challenges they may be facing, leading to a more productive appraisal.

A. A client awaiting a screening colonoscopy later that day B. A client whose discharge was cancelled the prior day because they developed respiratory distress C. A client who is 6 hr postoperative following an open cholecystectomy D. A client who is prescribed gastric lavage treatments to treat acute aspirin toxicity

Correct Answer is A

Explanation

A. A client awaiting a screening colonoscopy later that day: This client is appropriate for early discharge. As the procedure is non-invasive and not urgent, the client can be discharged and return for the scheduled screening without compromising their health. This decision allows for the efficient use of hospital resources following a mass casualty event.

B. A client whose discharge was cancelled the prior day because they developed respiratory distress: Recommending discharge for this client is not advisable, as their recent respiratory distress indicates ongoing health issues that require monitoring and care. Early discharge could jeopardize their safety and recovery.

C. A client who is 6 hr postoperative following an open cholecystectomy: This client is not a suitable candidate for early discharge. Postoperative patients typically require observation and care to monitor for complications, such as infection or bleeding, in the hours following surgery. Early discharge could put this client's recovery at risk.

D. A client who is prescribed gastric lavage treatments to treat acute aspirin toxicity: This client should not be recommended for early discharge, as they require ongoing treatment and monitoring for aspirin toxicity. Discharging this client prematurely could lead to serious health complications and does not ensure their safety and well-being.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse manager is planning to conduct a follow-up performance appraisal with a nurse who has had reports of unsafe practice due to not completing client care tasks. Which of the following actions should the nurse manager take?

Correct Answer is D

Explanation

A nurse manager is asked to select clients for early discharge from the unit following a mass casualty event. Which of the following clients should the nurse manager recommend?

Correct Answer is A

Explanation

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 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 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 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 manager is discussing electronic medical records with a newly licensed nurse. Which of the following actions should the nurse take to maintain client confidentiality? (Select all that apply.)

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?

An occupational health nurse in a factory is planning interventions to reduce environmental stressors for employees. Which of the following interventions should the nurse use to affect physical agents in the environment? (Select all that apply.)