Author Question: Which statement by the student nurse demonstrates understanding of the appropriate way to document ... (Read 70 times)

Engineer

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Which statement by the student nurse demonstrates understanding of the appropriate way to document an error in her charting?
 
  A) If I make an error, I can draw a red circle around it.
  B) If I make an error, I have to rewrite the entire entry.
  C) If I make an error, I draw a single line through it and put my initials by it.
  D) If I make an error, I place an X through it.
  E) If I make an error, I use white-out on it.

Question 2

The client states, I hate this place. I want to go home. No one listens to me and my doctor has not been in to see me today. His arms are folded across his chest.
 
  His brow is furrowed and he refuses to allow his morning vital sign measurements. Which entry should be included in the nurse's charting? Select all that apply.
  A) Seems angry today
  B) Unhappy with his care
  C) Arms are folded across his chest and brow is furrowed
  D) States, I hate this place. I want to go home. No one listens to me and my doctor has not been in to see me today.
  E) Refuses to allow morning vital sign measurements



6ana001

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Answer to Question 1

Ans: C
Feedback:
When an error occurs, the nurse should draw a single line through the error and place her initials above it.

Answer to Question 2

Ans: C, D, E
Feedback:
When documenting observations of client behavior, the nurse must maintain objectivity by describing the actual behaviors, rather than attempting to interpret the behaviors. In this case, the nurse should chart that a client is withdrawn and answers questions with one- or two-word answers. The nurse should not describe the client as depressed or angry.



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