Two questions about safety

[neurontin]

1. The unit is preparing for a special lift that can place an obese client on a bedpan without any lifting from the staff. when the lift apparatus takes a few minutes to set up, the client urgently requests the bedpan. What does the nurse do?

a. Assist the client onto the bedpan without the lift

b. Encourage the client to try to be patient

c. Get the assistance of an aide to help lift the client

d. Encourage the client to wear an incontinence brief

2. A client is found on the floor by the nursing assistant. Once the client is safe, what should the nurse do?

a. Document the event in the client's medical record and have the nursing assistant file an incident report

b. Document in the client's medical record that an incident report was filed

c. File an incident report, but don't document the event in the client's medical record

d. Document the event in the client's medical record

Thanks in advance!

[HappyMeNow]

1. I think I would go with option B. It's the only one that supports the safety of both the client and the staff. Putting on diaper would not be good for client's skin so it's no good either.

2. I would choose D. You have to report what happened, but you never want to mention on the medical records that an "incidence report" was filed.

I hope I'm right~

[nsklors]

1. C

2. B

Those are kind of tough, im second guessing myself! haha

[HappyMeNow]

I was all kinds of wrong!!!

What source are you using? While I'm not 100% sure on question, I'm positive that kaplan says to never document in pt's medical chart that "incidence report was filed".

[LizDavRN-BSN]

1. B

2. A

I have seen these questions before but dun remember exactly where. I definitely remember getting the first one being B but I am not sure abt the second one. I am thinking since the Nursing assistant was the one that found the patient, she needs to fie the incident report.

[euphoria02]

my answer for 1 would be B- the client is obese as stated, so lifting him/her may jeopardize the RN. Getting the help of an aide won't guarantee that no one will be hurt in the process. So I think, for the safety of all just let the patient wait for few moments.

for number 2 I would answer A- I read somewhere that personnel who committed the error or who is on the event an error happened are the one to file incident report. Since the RN is not there when it happened then he/she is not responsible for IR filing but is responsible that appropriate documentation be done. Choice B is obviously wrong, Choice D is incomplete and Choice C tells that RN files IR when the situation said that it is the NA who found the client so it's wrong also.

[cloudwatcher]

I don't know about the first one, probably B

The second one has to A, because you NEVER document in the patient's notes that you filed an incident report and the person who found the patient is supposed to write the incident report.

[HappyMeNow]

Yea I change my answer to the second question to A.

I hope the original poster comes back soon to give the correct answer!

[ibelieve2011]

The answers are:

1.) b

2.) a

I remember this questions from my kaplan nclex-rn strategies, practice, and review book 2011-2012..

1.) encourage the client to wait for a little to prevent potential ergonomic injuries to nurses related to lifting and moving clients.. Even though its tempting to quickly assisting the client onto the bedpan and it might happen in real life, however it is not the best or safest option for the client or the nurse.. So its best to encourage the client for a little bit of patience.

2.) since the nursing assistant who found the patient on the floor, he/she should file the incident report. And the event should be documented in the clients medical record.

Hope that helps answer your question.. :)

[neurontin]

Like happymenow, lizdavRN-BSN, euphoria02, cloudwatcher, and ibelieve2011 said, the answers are B and A.

Here are my questions:

Q1. Why not deal with the client’s urgent need by getting a help to lift the client? What I thought when I read the question first time was UTI. If the client cannot void immediately, the risk for UTI may increase. Not sure whether nsklors had the same thought as me, but obviously we both chose C instead B.

Q2. Can we document incident report on a client’s medical record sometimes? On the page 148, the Kaplan book says, “when admin the wrong dose, the event should be filed in BOTH an incident report and in the client’s medical record.”I thought we never document incident report on the client's medical record when I did the question. Was I wrong?

[HappyMeNow]

Q1, you are reading too much into the question if you're concerned with UTI. Asking a client to hold off on using the bathroom for a few minutes is not going to cause UTI. The risk of injuring a client from a fall or breaking the nurse's back is more likely than an UTI.

Q2. I took that to mean that yes, we do both document the wrong med dose in the incidence report AND the client's medical record. However, we do not document in the medical record that we had made an incidence report. Am I making sense?

[ddunnrn]

You never EVER mention an incident report in a progress note. It considered work product, and therefore is not discoverable in a lawsuit, UNLESS YOU MENTION IT!!! That's why you also try to never mention other patients or certain staff by name in progress notes.

I'm sorta surprised some of the posters weren't aware of this.

Dave Dunn, RN