A nursing supervisor is conducting an in-service about performing root cause analysis for sentinel events. Which of the following situations should the nursing supervisor include as an example of a sentinel event?
A client is brought to the emergency department after a suicide attempt at home.
A client develops diarrhea following administration of sodium polystyrene sulfonate.
A client decides not to have surgery after receiving a preoperative dose of lorazepam.
A client experiences permanent lower limb paralysis following a lumbar laminectomy.
The Correct Answer is D
Rationale:
A. A client is brought to the emergency department after a suicide attempt at home: Sentinel events are defined as unexpected occurrences involving death or serious physical or psychological injury that occur in the healthcare setting. This event happened prior to admission.
B. A client develops diarrhea following administration of sodium polystyrene sulfonate: Diarrhea is a known and expected side effect of this medication. It does not represent an unexpected event or serious injury requiring root cause analysis.
C. A client decides not to have surgery after receiving a preoperative dose of lorazepam: While patient refusal of surgery under sedation may pose some ethical concerns, it does not qualify as a sentinel event. No serious or unexpected injury occurred.
D. A client experiences permanent lower limb paralysis following a lumbar laminectomy: This represents a serious, unanticipated outcome of a surgical procedure, causing significant harm and loss of function. It meets the criteria for a sentinel event and warrants root cause analysis to identify contributing system failures.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Jugular neck vein distention: Jugular venous distention is a hallmark sign of right-sided heart failure, caused by systemic venous congestion. It is not typically seen in isolated left-sided heart failure.
B. Dependent edema: Dependent or peripheral edema is another finding associated with right-sided heart failure, resulting from fluid accumulation in the lower extremities due to poor venous return.
C. Distended abdomen: A distended abdomen, often from ascites, is more indicative of right-sided heart failure due to hepatic and portal vein congestion. It is not a classic symptom of left-sided heart failure.
D. Pink-tinged sputum: Pink, frothy sputum is a key finding in left-sided heart failure, particularly when pulmonary edema develops. It results from fluid backing up into the lungs due to impaired left ventricular function, leading to pulmonary capillary pressure increases and fluid leakage into alveoli.
Correct Answer is A
Explanation
Rationale:
A. A community health clinic: This is an example of a primary care setting where individuals receive routine preventive care, health education, screenings, and management of common illnesses. It focuses on long-term health promotion and disease prevention.
B. Assisted living center: Assisted living is a residential care setting for older adults who need help with daily activities but not intensive medical care. It is not classified as a primary care setting, although residents may receive primary care services onsite.
C. Urgent care clinic: Urgent care centers provide immediate, short-term care for acute illnesses or minor injuries. While useful, they are considered a form of episodic or secondary care, not a primary care setting for ongoing health maintenance.
D. A mental health crisis center: This is a specialized, emergency-level facility that provides immediate psychiatric assessment and stabilization. It falls under tertiary or crisis intervention services, not routine primary care.
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