A nurse discovers an administration error on an adult unit.
Step 1
Which detail requires the nurse to act?
AA medication was given to the wrong client.✓ Correct
This is an administration error.
BThe client is awake.✗ Incorrect
Being awake does not identify the error.
CThe medication record is available.✗ Incorrect
Availability of the record is not itself an error.
DThe unit has an incident-report process.✗ Incorrect
The process supports reporting rather than identifying the event.
Rationale. The wrong-client administration is an error. It must be reported and addressed with responsible disclosure.
Step 2
How should the nurse interpret the event?
AIt is an error that requires reporting and responsible disclosure.✓ Correct
The medication reached the wrong client.
BIt is merely a near miss because a dose was given.✗ Incorrect
A dose reached the wrong client, so the event occurred.
CIt need not be reported if the client is awake.✗ Incorrect
The obligation to report is not removed by that detail.
DIt should be concealed until the client asks.✗ Incorrect
Concealment conflicts with responsible disclosure.
Rationale. The event is an actual error. Reporting and responsible disclosure are required even though the note does not describe harm.
Step 3
Which issue is the priority for the nurse’s communication about this event?
AReporting the error and arranging responsible disclosure to the client✓ Correct
Both are identified responsibilities after an error.
BProtecting the unit’s reputation by withholding the event✗ Incorrect
Concealment conflicts with disclosure.
CWaiting to see whether another nurse notices✗ Incorrect
Delay does not fulfill reporting responsibility.
DReplacing the record with a clean copy✗ Incorrect
Altering the record does not address the error.
Rationale. An error must be communicated through the appropriate channels. The client also needs responsible disclosure.
Step 4
Which responses are appropriate? Select all that apply.
AReport the error through the appropriate process.✓ Correct
The error requires reporting.
BEnsure responsible disclosure to the client.✓ Correct
The client should be told about the error responsibly.
CHide the event unless symptoms develop.✗ Incorrect
A symptom is not a condition for reporting.
DTell colleagues to avoid documenting the event.✗ Incorrect
Concealment is inconsistent with responsible handling.
EAssume reporting replaces disclosure to the client.✗ Incorrect
The source identifies both responsibilities.
Rationale. Reporting and disclosure serve different purposes. Both are part of responding responsibly to the error.
Step 5
What should the nurse do using the facility’s established process?
AReport the event and ensure responsible disclosure to the client.✓ Correct
These actions address both communication responsibilities.
BKeep the event private because the client is awake.✗ Incorrect
The client’s current appearance does not remove the duty to report.
CWait for a complaint before mentioning the event.✗ Incorrect
The error calls for reporting and disclosure.
DTell the client an error occurred only if a coworker agrees to hide it.✗ Incorrect
Concealment conflicts with responsible disclosure.
Rationale. The nurse should report the error and make sure it is responsibly disclosed. The facility’s process guides how the report is submitted.
Step 6
Which outcome best demonstrates that the communication responsibilities were met?
AThe error is reported and the client receives responsible disclosure.✓ Correct
Both responsibilities have been addressed.
BThe nurse tells no one and makes a private reminder.✗ Incorrect
A private reminder is neither reporting nor disclosure.
COnly the assistant hears about the event.✗ Incorrect
That alone does not establish reporting and client disclosure.
DThe client is told but the event is not reported.✗ Incorrect
Disclosure alone does not meet the reporting responsibility.
Rationale. The evaluation must account for both reporting and disclosure. Completing only one leaves the other responsibility unmet.
Rationale
An error requires reporting and responsible disclosure to the client.
RememberReport the error and support disclosure.
Sources
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