A staff nurse may be exhibiting manifestations of a substance use disorder and is diverting controlled medications while at work. Which of the following actions should the nurse manager take first?
Confront the nurse regarding their behavior.
Ask the nurse to sign an action plan for behavior improvement.
Document the suspicious behavior.
Collect data on the nurse's behavior.
The Correct Answer is D
Choice A reason: Confronting the nurse immediately without objective evidence can lead to defensiveness, denial, or legal complications. Managers must avoid premature confrontation because it lacks the foundation of documented proof and may compromise the integrity of the investigation.
Choice B reason: Asking the nurse to sign an action plan assumes guilt before evidence is collected. This step is appropriate only after data has been gathered and a formal process initiated. Implementing corrective measures prematurely undermines fairness and due process.
Choice C reason: Documentation is essential but should follow systematic data collection. Recording suspicious behavior without first gathering objective evidence risks bias and incomplete reporting. Documentation becomes meaningful only when supported by collected data.
Choice D reason: Collecting data is the first and most critical step. Objective evidence ensures that any subsequent actions—documentation, confrontation, or disciplinary measures—are based on facts rather than assumptions. This protects both patient safety and the nurse’s rights, while also meeting regulatory and legal standards.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Massaging the area of a pressure ulcer is contraindicated. Massage can damage fragile capillaries and tissues, worsening the ulcer and increasing the risk of further breakdown. It may also cause pain and inflammation. Therefore, this intervention is inappropriate for a stage II ulcer.
Choice B reason: An alternating pressure mattress is an evidence-based intervention that helps redistribute pressure across the body and reduces the risk of further skin breakdown. For a comatose client who cannot reposition themselves, this intervention is especially important. It promotes circulation and prevents worsening of the ulcer, making it the most appropriate choice.
Choice C reason: A sterile, dry gauze dressing is not the recommended treatment for a stage II ulcer. Stage II ulcers involve partial-thickness skin loss and require a moist wound environment to promote healing. Dry gauze can adhere to the wound bed, cause trauma during removal, and delay healing. Moist dressings such as hydrocolloids or foam dressings are preferred.
Choice D reason: Donut-shaped cushions are not recommended because they concentrate pressure around the wound edges, worsening ischemia and tissue damage. They can increase the risk of ulcer progression rather than prevent it. This intervention is inappropriate for pressure ulcer management.
Correct Answer is B
Explanation
Choice A reason: The sterile field must always be set up at or above waist level to maintain sterility. Setting it below waist level increases the risk of contamination because the nurse cannot maintain constant visual control.
Choice B reason: Holding the bottle with the palm over the label while pouring prevents solution from running over the label, keeping it legible and dry. This is correct sterile technique and ensures safe handling of sterile solutions.
Choice C reason: Sterile items should be placed at least 2.5 cm (1 in) inside the sterile border. Placing them within 1 cm risks contamination because the edges of the sterile field are considered non-sterile.
Choice D reason: The lid of a sterile solution bottle should be placed face up on a clean surface, not within the sterile field. Placing it in the sterile field contaminates the area.
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