The new nurse manager feels pulled between the expectations of staff, the demands of hospital administrators, and family obligations. According to Hardy (1978), unrelieved role stress and strain will lead to which condition?

Patient safety events such as falls involve risk assessment, incident reporting systems, clinical evaluation for injury, and provider notification protocols, which ensure early detection of complications like fractures, internal injuries, or neurological compromise and support quality improvement and legal documentation processes.

Rationale:

A. Documenting refusal only is incomplete and unsafe. A fall with subsequent pain requires further evaluation because it may indicate occult injury such as fracture or soft tissue trauma. Failure to escalate care violates patient safety standards.

B. Completing an incident report and notifying the provider is correct. Falls are reportable safety events requiring formal documentation and medical evaluation to rule out injury, ensure timely intervention, and support risk management and quality improvement processes.

C. Informing housekeeping to clean the area addresses environmental safety but does not address the patient’s reported pain or potential injury. Clinical evaluation and reporting take priority over environmental cleanup after a fall event.

D. Delaying reporting until the next shift is inappropriate. Fall incidents require immediate reporting and assessment to prevent missed injuries and ensure timely intervention. Delayed communication increases risk of complications and violates patient safety protocolsTop of FormBottom of Form

Medication prioritization in acute care is guided by physiologic stability, time-critical pharmacodynamics, risk of rapid deterioration, and food–drug interactions, with priority given to agents preventing acute metabolic imbalance, hypoglycemia, or life-threatening complications.

Rationale:

A. Stimulant laxatives promote intestinal peristalsis and are used for constipation management. A 3-day absence of bowel movement is not an acute emergency. This medication is not time-sensitive and does not address immediate life-threatening physiological instability.

B. IV proton-pump inhibitors suppress gastric acid secretion and are commonly administered in NPO patients to prevent stress ulcers or gastrointestinal bleeding. While important, they are not as immediately time-critical as glucose management in preventing acute hypoglycemia.

C. Rapid-acting insulin must be administered in coordination with meal intake to prevent acute hypoglycemia. Administering it when the breakfast tray is present ensures glucose availability matches insulin peak action, preventing potentially life-threatening hypoglycemic crisis and neurologic compromise.

D. Loop diuretics increase urinary excretion of sodium and potassium. A potassium level of 3.2 mEq/L indicates hypokalemia, which increases risk for dysrhythmias. Administering a loop diuretic could worsen electrolyte imbalance, making this medication inappropriate and unsafe at this time.