An assistive personnel (AP) tells the nurse manager that she observed a nurse on the unit removing a small amount of morphine from syringes prior to administering the medication to clients. Which of the following actions should the nurse manager take first?

Correct Answer: A

Rationale: The correct answer is A: Gather data about the nurse's work performance and attendance history. This is the first step because it allows the nurse manager to assess the situation comprehensively before taking any action. By gathering data, the nurse manager can determine the extent of the issue, whether it is an isolated incident or a pattern of behavior. This information will help in making an informed decision on how to proceed. Approaching the nurse (B) directly may not be appropriate without first understanding the full context of the situation. Notifying the risk manager (C) is premature without knowing the full extent of the issue. Referring the nurse to the board of nursing diversion program (D) should only be considered after gathering all relevant information about the nurse's actions.

Correct Answer: B

Rationale: The correct answer is B: Demonstrate using the device and observe the staff returning the demonstration. This teaching strategy is the most effective because it incorporates both visual and hands-on learning, allowing the nurses to see the correct way to use the device and then practice it themselves under observation. This method is more engaging and interactive, leading to better retention and understanding. A: Providing a written procedure alone may not be as effective as hands-on demonstration for learning how to use a new device. C: Reminding staff to review the procedure manual is passive and may not ensure proper understanding and competency. D: Identifying differences in a written brochure may not be as effective as a demonstration in teaching the correct usage of the device.

Correct Answer: A

Rationale: The correct answer is A because holding disaster drills on a regular basis is essential for preparedness and practice. Regular drills help ensure that staff are familiar with protocols and can respond effectively during a real disaster. Choice B is incorrect because while drills are important, they cannot fully replicate the chaos and urgency of a real disaster situation. Choice C is incorrect because typically an incident commander should be a designated leader with specific training and experience in disaster management, not just a staff nurse. Choice D is incorrect because triaging victims is usually done by trained personnel such as nurses or emergency medical technicians, not necessarily by physicians.

Correct Answer: A

Rationale: The correct answer is A: Do not adjust the oxygen flow rate. It is important not to adjust the oxygen flow rate without consulting the healthcare provider, as it can lead to inadequate oxygen delivery or oxygen toxicity. Option B is incorrect because oxygen equipment should be checked daily, not weekly, for safety. Option C is incorrect as unused oxygen tanks should be stored upright to prevent damage. Option D is incorrect as wool blankets can generate static electricity, which could be a fire hazard around oxygen. Therefore, the crucial instruction for the client is to not adjust the oxygen flow rate to ensure safe and effective oxygen therapy.

Correct Answer: D

Rationale: The correct answer is D: Check alertness. This task should be assigned first because assessing the worker's alertness ensures they are mentally capable and focused to provide assistance safely. This step is crucial in a crisis situation to prevent any potential errors or harm to the wounded workers. Incorrect Choices: A: Get temperatures - This can wait as it is not as urgent as ensuring the worker is alert. B: Take blood pressure - This is important but not as critical as checking alertness in this scenario. C: Palpate pulses - While important, checking alertness takes precedence in ensuring immediate readiness for providing care.