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.

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is ["A","C","E"]

Explanation

Rationale:
A. Smoking cessation is correct because the benchmark is 75%, but compliance fell below this benchmark in Quarter 1 (70.6%) and Quarter 3 (74%). Only Quarter 2 met the benchmark (100%). Consistently failing to meet the benchmark indicates a need for improvement in preoperative patient education and intervention.

B. Postoperative normothermia is incorrect because compliance improved over the quarters, reaching 85% in Quarter 2 and 86.2% in Quarter 3, both meeting or exceeding the benchmark of 85%. This measure indicates adequate performance and does not require improvement.

C. Perioperative antibiotics is correct because the benchmark is 100%, but compliance was below this in all three quarters (Quarter 1–90.4%, Quarter 2–88.2%, Quarter 3–92.6%). Since prophylactic antibiotic administration is crucial to preventing surgical site infections, performance below the benchmark signals the need for targeted quality improvement.

D. Intraoperative vancomycin is incorrect because compliance exceeded the benchmark in Quarter 2 (80.5%) and Quarter 3 (92%), meeting or surpassing the 80.2% benchmark. This measure indicates adequate performance.

E. Glucose control is correct because the benchmark is 90%, but all three quarters fell below this target (Quarter 1–75.2%, Quarter 2–85.5%, Quarter 3–82%). Maintaining glucose within target range is critical for surgical site infection prevention, so this area requires improvement.

A. A client who has pneumonia, a WBC count of 11,500/mm3, and is prescribed piperacillin. B. A client who has anemia, hemoglobin of 11 g/dl, and is prescribed epoetin alfa C. A client who has renal failure, a serum potassium of 5.8/mEq/L, and is prescribed sodium polystyrene sulfonate D. A client who is post-coronary artery bypass graft (CABG), has total cholesterol of 318 mg/dL, and is prescribed atorvastatin

Correct Answer is C

Explanation

Rationale:
A. A client with pneumonia and WBC count of 11,500/mm³ prescribed piperacillin is incorrect as the client’s elevated WBC indicates infection, but this is not immediately life-threatening. Administering antibiotics is important, but it is not the highest priority compared to a client at risk for a life-threatening electrolyte imbalance.

B. A client with anemia, hemoglobin of 11 g/dL prescribed epoetin alfa is incorrect because a hemoglobin of 11 g/dL is mildly low but not critical. Epoetin alfa administration is important for managing anemia, but the client’s condition is stable and does not require immediate intervention.

C. A client with renal failure, serum potassium of 5.8 mEq/L prescribed sodium polystyrene sulfonate is correct because hyperkalemia is potentially life-threatening. A potassium level of 5.8 mEq/L increases the risk for cardiac arrhythmias, including ventricular fibrillation. Administering sodium polystyrene sulfonate promptly helps lower potassium and prevent acute cardiac complications.

D. A client post-CABG with total cholesterol of 318 mg/dL prescribed atorvastatin is incorrect because elevated cholesterol is a chronic risk factor, not an acute life-threatening problem. Statin therapy is important for long-term cardiovascular management but is not the priority in immediate medication administration.

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What is the appropriate action for a nurse who suspects a coworker is under the influence while on duty?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","C","E"]

Explanation

A nurse is preparing to administer medications to four clients. The nurse should administer medications to which of the following clients first?

Correct Answer is C

Explanation

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