During an evening shift on a medical unit, the only nurse on the unit is busy with an unstable client. The unit clerk, who is also both a certified medication aide and an unlicensed assistive personnel (UAP), reports to the nurse that a healthcare provider is on the telephone and wishes to prescribe an as needed (PRN) dose of an oral over-the-counter laxative for a client who is constipated. Which instruction should the nurse provide the unit clerk?

Choice A Reason: This intervention is the most appropriate and effective for the nurse-manager to employ, as it provides clear and objective feedback to the staff nurse based on professional criteria, and encourages a positive and constructive approach to enhance the nurse's performance and development.

Choice B Reason: This intervention is not advisable, as it may create a false impression of the staff nurse's performance and fail to address the underlying issues or problems. Documenting the nurse's negative behaviors is important for accountability and improvement purposes, and avoiding it may expose the nurse manager to legal or ethical risks.

Choice C Reason: This intervention is not optimal, as it may demoralize or discourage the staff nurse and create a negative or hostile work environment. Focusing only on the areas of weakness may overlook the strengths and potential of the staff nurse, and may not foster a supportive and collaborative relationship between the nurse- manager and the staff nurse.

Choice D Reason: This intervention is not relevant, as it may divert the attention from the staff nurse's performance and shift the blame to external factors. Discussing how the inconsistency in the staff nurse's performance disrupts the routine of all of the staff members on the unit may not help the staff nurse identify and address their own areas of improvement, and may cause resentment or conflict among the team.

Choice A Reason: Contacting the healthcare provider is not the priority action because restraints should only be used as a last resort and not for staff convenience. The nurse manager should first ensure that the client's safety and dignity are respected.

Choice B Reason: This is the correct answer because restraints are not indicated for this situation and violate the client's rights. The nurse manager should educate the staff nurse about the ethical and legal implications of using restraints without proper justification and documentation.

Choice C Reason: Closing the door to the room is not a priority action because it does not address the issue of restraints. It also may isolate the client and increase her anxiety and distress.

Choice D Reason: Determining if the client has a PRN prescription for an antianxiety agent is not a priority action because it does not address the issue of restraints. It also may not be appropriate to medicate the client without assessing her condition and obtaining her consent.