Which of the following is true about malpractice insurance for nurses?

Rationale:

A. A client who was administered glipizide for type 2 diabetes mellitus and has a blood glucose of 68 mg/dL should be assessed first because this client is hypoglycemic. Hypoglycemia is an immediate, potentially life-threatening condition that can rapidly progress to seizures, loss of consciousness, or cardiac arrhythmias if not treated promptly. Rapid assessment and intervention, such as administering a fast-acting carbohydrate or glucose, is essential.

B. A client who was administered erythromycin for acute glomerulonephritis and reports reddish-brown urinary output is important to assess but is not immediately life-threatening. The color change may indicate hematuria, which requires monitoring and reporting, but the client is hemodynamically stable.

C. A client who was administered adalimumab for Crohn's disease, has a serum calcium level of 10 mg/dL, and reports a headache is stable. A calcium of 10 mg/dL is within normal limits, and while headaches require assessment, they are not as urgent as hypoglycemia.

D. A client who was administered acyclovir for cellulitis and reports pain in the affected leg requires assessment for potential infection or complications, but this is not immediately life-threatening compared to hypoglycemia.

Rationale:

A. The physiologic status of the clients on the unit is correct because client acuity and the complexity of care needs are the primary factors in safe and effective assignment planning. The charge nurse must consider each client’s medical condition, risk for complications, required interventions, and level of monitoring to ensure appropriate nurse-to-patient ratios and patient safety. Assignments should match the skills and competency level of each nurse to the acuity of assigned clients.

B. Social relationships between nurses working the oncoming shift is incorrect because personal friendships or interpersonal dynamics should not influence assignments. Decisions based on social factors can compromise patient safety, fairness, and professional standards.

C. The most experienced nurse receives the more complex clients is partially correct but not the sole consideration. While assigning complex clients to experienced nurses is a common practice, the overall physiologic status of all clients and skill mix of the entire team must guide assignments rather than relying solely on experience.

D. Personal comfort level in making the assignments is incorrect because the charge nurse’s comfort is not a valid factor for patient assignment decisions. Assignments must be objective, patient-centered, and based on client needs and staff competencies, not personal preference.