Within the past 3 years, a major secondary care referral hospital experiences separate cases of a blood transfusion reaction due to incompatibility, 2 inpatient falls leading to significant injury, a wrong-site surgery, and a medication-dosing error causing a patient death. What is the most probable single underlying cause behind these medical errors?(2)

Correct Answer: A

Rationale: System failure often leads to multiple errors across various domains.

Correct Answer: A

Rationale: The correct answer is A: Grade 3 phlebitis at IV site. This is because the presence of a red streak along the vein path and a palpable 4-cm venous cord are classic signs of phlebitis, indicating inflammation of the vein. Grade 3 phlebitis specifically refers to visible redness, pain, and swelling along the vein. Phlebitis can be caused by mechanical irritation, chemical irritation, or infection. It is important to document this finding accurately to ensure appropriate treatment and monitoring. Summary of other choices: B: Infection at IV site - While infection can cause phlebitis, the red streak and venous cord are more indicative of inflammation rather than infection. C: Thrombosed area at IV site - Thrombosis involves the formation of a blood clot in the vein, which would present differently than the red streak and venous cord. D: Infiltration at IV site - Infiltration

Correct Answer: B

Rationale: The correct answer is B: The client is expressing a neologism. Neologism refers to the creation of new words or phrases that are not understandable to others. In this case, "Shopatoulens" is a nonsensical word created by the client. This response is appropriate as it accurately describes the client's statement. A: The client is experiencing command hallucinations - This choice is incorrect as command hallucinations involve hearing voices that command the individual to do something. The client's statement does not indicate this. C: The client is experiencing a paranoid delusion - This choice is incorrect as a paranoid delusion involves irrational beliefs of being persecuted or targeted. The client's statement does not reflect this type of delusion. D: The client is verbalizing a word salad - This choice is incorrect as word salad refers to jumbled, incoherent speech. The client's statement, while nonsensical, is not completely incoherent like word salad.

Correct Answer: C

Rationale: The correct answer is C: "Rise slowly when you change position from lying to sitting or sitting to standing." Rationale: 1. Antipsychotics and beta-blockers can both cause orthostatic hypotension, a drop in blood pressure when changing positions. 2. The combination of these medications increases the risk of orthostatic hypotension. 3. Instructing the client to rise slowly helps prevent dizziness, lightheadedness, or potential falls associated with orthostatic hypotension. Summary: A: Slow breathing techniques are not directly related to the side effects of these medications. B: While diet and exercise are important, they do not address the specific side effects of antipsychotics and beta-blockers. D: Sunscreen and sun exposure are not relevant to the side effects of these medications.

Correct Answer: B

Rationale: The correct answer is B because not using the walker poses a safety risk for the client, leading to falls or injuries. Immediate nursing intervention is needed to assess and address the client's refusal to use the walker. Choice A is incorrect because eating 80% of meals shows good appetite and does not require immediate intervention. Choice C is incorrect as watching TV with others is a social activity and not a cause for concern. Choice D is incorrect as wanting to wear own clothing is a normal preference and does not pose a risk to the client's safety.