During change-of-shift report, a nurse discovers they overlooked a prescription for a type and cross-match of a client who is to have surgery the next day. Which of the following actions should the nurse take first?

Obtain the client's type and cross-match.

Inform the provider of the delay in obtaining the type and cross-match.

Document the incident in the client's medical record.

Prepare an incident report for risk management.

Answer and Explanation

The Correct Answer is A

A.   Obtaining the client's type and cross-match is the first action the nurse should take because it ensures that the client will have compatible blood available for transfusion if needed during surgery.
B.   This is important but should only be done after obtaining the client’s type and cross-match.
C.   This should be done after obtaining the client’s type and cross-match.

D. While an incident report may be necessary, the immediate priority is to address the oversight and ensure patient safety.

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Correct Answer is A

Explanation

A. Using a straw can increase the risk of aspiration for clients with dysphagia; thickened liquids should be consumed from a cup.
B. Taking breaks during meals can aid in swallowing and reduce the risk of aspiration.
C. Elevating the head of the bed to 90° helps prevent aspiration during swallowing.

D. Tucking the chin can help close off the airway during swallowing, reducing the risk of aspiration.

A. The newly licensed nurse uses a paper towel to turn off the faucet after washing their hands. B. The newly licensed nurse uses an alcohol-based hand rub and begins patient care before their hands dry. C. The newly licensed nurse uses soap and cold water to wash their hands. D. The newly licensed nurse uses an alcohol-based hand rub to clean visibly soiled hands.

Correct Answer is A

Explanation

A. This action prevents recontamination of the hands after handwashing, which is an essential component of maintaining medical asepsis.
B. It is recommended to allow alcohol-based hand rub to dry completely before engaging in patient care to ensure effectiveness.

C. While handwashing with soap and water is appropriate, cold water may not be as effective as warm water for removing contaminants.
D. Alcohol-based hand rubs are not sufficient for cleaning visibly soiled hands; soap and water are required in such cases.

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During change-of-shift report, a nurse discovers they overlooked a prescription for a type and cross-match of a client who is to have surgery the next day. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is A

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