What is the appropriate action for a nurse who suspects a coworker is under the influence while on duty?
Report the suspicion to the appropriate supervisor or manager.
Confront the coworker in front of other staff members to seek their support.
Approach the coworker directly and ask if they are under the influence.
Ignore the situation and continue with work.
The Correct Answer is A
Rationale:
A. Report the suspicion to the appropriate supervisor or manager is correct because impairment in the workplace is a serious safety risk that can lead to medication errors, delayed care, improper assessments, and patient injury or death. Nurses have a legal and ethical duty under the Nurse Practice Act, ANA Code of Ethics, and facility policy to protect clients from harm. Reporting to a supervisor ensures the situation is handled through the proper chain of command, allowing for immediate assessment of the coworker's fitness for duty, removal from patient care if necessary, and initiation of employee assistance or disciplinary procedures. This action protects clients, the impaired nurse, and the institution from liability and harm.
B. Confront the coworker in front of other staff members is incorrect because doing so may escalate the situation, cause embarrassment, and is not the nurse’s role. Public confrontation can create a hostile work environment and violates professional conduct standards. Additionally, the coworker may deny impairment or become defensive, preventing appropriate intervention.
C. Approach the coworker directly and ask if they are under the influence is incorrect because confronting a potentially impaired individual alone can be unsafe and unproductive. It also bypasses institutional policies and may place the reporting nurse at risk of retaliation or conflict. Only supervisors or designated personnel should perform an evaluation of possible impairment.
D. Ignore the situation and continue with work is incorrect because failure to act places patients at immediate risk. Ignoring the issue violates professional responsibility and mandatory reporting laws in many jurisdictions. It enables unsafe practice, jeopardizes patient safety, and can result in consequences for the nurse who failed to report.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. 32 units is incorrect because this does not reflect the sum of the prescribed doses. It may result from mistakenly adding only part of the insulin doses.
B. 14 units is incorrect because this represents only the regular insulin dose and does not include the NPH insulin dose. Administering only 14 units would under-treat the patient.
C. 42 units is correct because the nurse should prepare the total combined dose of insulin:
14 units (regular) + 28 units (NPH) = 42 units total
In practice, when drawing up regular and NPH insulin in the same syringe, the clear (regular) insulin is drawn first, followed by the cloudy (NPH) insulin to prevent contamination. Ensuring the total correct dose is administered is essential for maintaining safe and effective blood glucose control.
D. 28 units is incorrect because this represents only the NPH insulin dose. Administering only 28 units would result in insufficient coverage for the rapid-acting component (regular insulin) needed for postprandial glucose control.
Correct Answer is B
Explanation
Rationale:
A. Using electronic health records only to document the surgical procedure after completion is incorrect because retrospective documentation does not prevent errors. Documentation alone cannot ensure that the correct patient, site, and procedure are verified before surgery.
B. Implementing a surgical time-out protocol is correct because it is a proven, evidence-based safety measure designed to prevent wrong-site, wrong-procedure, and wrong-patient surgeries. During the time-out, the entire surgical team actively verifies the patient’s identity, surgical site, and planned procedure immediately before incision. This practice promotes team communication, reduces errors, and is endorsed by The Joint Commission as a mandatory safety protocol.
C. Providing additional postoperative care education is incorrect because while patient education is important for recognizing complications, it does not prevent the occurrence of the sentinel event itself, which occurs before and during surgery.
D. Increasing the number of nursing staff on the surgical team is incorrect because more staff alone does not guarantee verification of the correct site or procedure. The key preventive measure is structured communication and verification, not staffing levels.
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