The nurse manager conducts regular audits of patient care medication records and notices that the amount of narcotic pain medications administered during the evening shift on a postsurgical unit is higher than usual. Which action should the nurse manager take first?

Conduct a closer examination of staff nurse's distribution of pain medication from evening shift.

Hold a mandatory staff meeting to discuss the findings of documentation audits from every shift.

Question clients about effectiveness of pain medication.

Discuss with healthcare provider a plan to change client analgesia.

Answer and Explanation

The Correct Answer is A

Choice A rationale: Conducting a closer examination of staff nurses' distribution of pain medication is the first step to identify any issues or patterns contributing to the higher than-usual administration of narcotic pain medications.

Choice B rationale: Holding a mandatory staff meeting may be necessary, but a focused examination should precede broader discussions.

Choice C rationale: Questioning clients about the effectiveness of pain medication is an important aspect of the investigation but should follow a thorough examination of medication distribution.

Choice D rationale: Discussing with the healthcare provider about changing client analgesia may be considered later based on the findings of the examination.

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Correct Answer is C

Explanation

Choice A rationale: The initial administration of the opioid analgesic is appropriate as long as the nurse adheres to the prescription made.

Choice B rationale: Administering naloxone via IV is an appropriate intervention to reverse the effects of opioid toxicity. It is not the focus of counseling in this scenario.

Choice C rationale: The nurse should have notified the healthcare provider as soon as the client's respiratory rate decreased to 6 breaths/minute, which is a sign of respiratory depression caused by the opioid analgesic. The nurse should not have waited until the client's respiratory rate decreased to 4 breaths/minute, which is a life-threatening condition that requires immediate intervention.

Choice D rationale: Documentation of the client's respiratory rate is essential for monitoring, and there is no indication that the documentation was inappropriate.

A. Direct UAP to delay weighing the client until later. B. Document that the client refused daily weights. C. Instruct UAP to weigh the client using a bed scale. D. Ask the client why he does not want to be weighed.

Correct Answer is D

Explanation

Choice A rationale: Directing the UAP to delay weighing the client might not address the underlying issue. Understanding the client's refusal is essential for appropriate interventions.

Choice B rationale: Documenting that the client refused daily weights is important for documentation purposes, but it doesn't address the issue or provide information on the client's fluid status.

Choice C rationale: Instructing the UAP to weigh the client using a bed scale is a good option, but understanding the client's concerns or reasons for refusal is important for effective communication and addressing potential issues.

Choice D rationale: Asking the client why he does not want to be weighed is essential for understanding and addressing the client's concerns. It allows the nurse to provide education, reassurance, or alternative solutions to ensure the client's cooperation with the prescribed care plan.

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The nurse manager conducts regular audits of patient care medication records and notices that the amount of narcotic pain medications administered during the evening shift on a postsurgical unit is higher than usual. Which action should the nurse manager take first?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

The unlicensed assistive personnel (UAP) reports to the nurse that a male client with fluid volume overload will not allow the UAP to obtain his daily weight. Which action should the nurse implement?

Correct Answer is D

Explanation

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