PASSNURSE QUESTIONSSafe and Effective Care Environment Management of Care Question 1 of 67/The registered nurse observes the certified nursing assistant
... [Show More] (CNA) rifle through a
clients personal belongings whilst they are away from their room undergoing
imaging. What is the most appropriate initial action to take?
Note the incident and report it if it transpires any personal items are reported
missing
Report the incident to the police
Ask the client if they wish to take any further action
Report the incident to the nurse in charge
correct 4
The actions of the CNA are inappropriate. It is not clear from the scenario if a theft
has taken place or not. It is not clear if the CNA was intending to commit a crime or if
they were being inappropriate and invading the clients privacy. Action needs to be
taken. In this instance reporting the incident to the nurse in charge is the most
appropriate. The charge nurse can then decide on appropriate escalation and
disciplinary measures.
Option 1 is not an appropriate course of action. If items have been stolen the client
may not notice or not report it which would lead to no action being taken. Regardless
of a theft taking place or not going through a clients personal belongings is
unprofessional and requires disciplinary action. Option 3 is similar in that the CNA
should be disciplined regardless of the clients wishes.
Option 2 is not appropriate at this stage as the scenario does not make it clear if a
theft has occurred or not.
Nurses have an obligation to report the following to appropriate authorities:
● Abuse
● Gun and/or knife wounds
● Murder
● Suicide
● Animal bites
● Communicable disease
● Impaired colleague
● Criminal activity
In addition to the obligatory reporting above nurses are expected to utilise incident
reporting (used to report injuries to clients, faulty equipment, medicine
administration errors etc) and to report other situations that may arise in line with
good professional standards.
Question 2 of 67
Healthcare management have advised they plan to change nurses shift duration,
staffing patterns and pay rates for working antisocial hours. They advise they are
doing this as they feel it will improve efficiency and continuity of care. The nurses
are opposed to these changes as this would result in longer shifts with more
intensive work and reduced pay. A meeting has been planned to discuss the dispute.
Which of the following actions by the nurses is most likely to achieve a satisfactory
outcome for them?
Advise management of the plan to fight these changes. Advise legal action will be
taken if these changes are introduced as they are unlawful.
Reluctantly agree to accept the changes as the economic argument is clear and the
changes can be unilaterally introduced with the appropriate notice period
Collaboration with management on potential alternatives that would be more
acceptable to both sides
Avoidance of contact with management to delay implementation of changes
Correct 3
Competing with management is unlikely to resolve this conflict as they are in a
position of power and may unilaterally enforce the decision.
Accommodating all changes will likely see resentment amongst nurses and would
be considered a loss for their 'side'. Postponement and avoidance are the same and
do not solve the conflict, this merely delays conflict and may cause prolonged
tensions between nurses and management.
Collaboration or negotiation is most likely to provide an acceptable outcome for both
sides.
Conflict
Conflict describes an active disagreement between people with differing opinions,
beliefs, principles or goals.
In the nursing environment the nurse may encounter conflict between themselves
and clients, clients representatives, other healthcare professionals, governing bodies,
management and institutional policies.
Methods of conflict resolution:
Compete or Fight
In this situation two parties compete for their own interests with little regard for the
other party. The result is usually win/loss with one party getting their own way and
the other missing out. It may be the result of one party exerting authority or power
over the other
Avoidance or postponement
In this situation one or both parties avoid or postpone the conflict. It typically results
in protracted conflict situations and delay in resolving issues.
Accommodation or acceptance of unsatisfactory terms
In accommodation one party accepts terms even though they are unhappy with the
conflict solution. Parties who accommodate do so at the expense of satisfying their
own needs or goals. This result is a loss for the accommodating party.
Negotiation or compromise
Negotiation or compromise typically sees both sides meeting some of their own
goals or needs but also accepting some unsatisfactory areas within the agreement
in exchange. This result is often satisfactory for both parties.
Collaboration
May be considered as similar to negotiation. With collaboration both parties work
towards a solution where both parties are happy with the outcome and try to avoid a
solution where either side accepts unsatisfactory terms
Question 3 of 67
The nurse is on a medication round and notices one of the clients is prescribed a
medication at three times the normal dose. The nurse suspects a prescription error.
The nurse attempts to contact the health care provider (HCP) but they are
unreachable.
What is the most appropriate next action?
Withhold the medication and attempt to contact the HCP again in 24 hours
Administer the current prescription but seek clarification of the dose at the next
review by the HCP
Clarify with the client if they are aware of the indication for the prescribed dose
Withhold the medication and contact the nurse supervisor
CORRECT 4
In cases of suspected prescription error the nurse should first contact the HCP. If the
nurse is unable to contact the HCP then the nurse should contact the nurse
supervisor
In cases of suspected prescription error the nurse should first contact the HCP. If the
nurse is unable to contact the HCP then the nurse should contact the nurse
supervisor (manager).
The nurse should not administer a prescription that they suspect is inaccurate or
inappropriate. Equally the nurse should not delay administering a medication for any
longer than is necessary as this may also result in harm to the client. Prompt
clarification of the prescription is needed. Asking a colleague if they have
administered the drug is not helpful as the colleague may have administered an
incorrect prescription without realising or questioning it. Asking the client is also
inappropriate for a number of reasons (It may even be the client has deliberately
altered their own prescription)
Prescriptions
Nurses are expected and obligated to execute the instructions of a prescription that
has been issued by a health care provider except when the nurse believes the
prescription to be in error or inappropriate.
In cases where the nurse believes a prescription to be in error or inappropriate they
should contact the health care provider immediately. If the health care provider can
not be reached then the nursing supervisor should be contacted. [Show Less]