NCLEX: The charge nurse on a medical-surgical unit is being evaluated for nursing care related to incident reporting. As…

Leadership and management Management of Care

Case Study

The charge nurse on a medical-surgical unit is being evaluated for nursing care related to incident reporting. Assessment data include family requests lab results by phone without verified authorization. Which error is most dangerous on the NCLEX and in practice?

Question

A. Choosing an intervention before identifying assessment cues and immediate safety risk.
B. Teaching the client after stability is confirmed.
C. Reassessing the client after an appropriate intervention.
D. Using SBAR to notify the provider about abnormal findings.

Rationale

Correct answer: A. Choosing an intervention before identifying assessment cues and immediate safety risk.

Rationale: The most dangerous NCLEX trap is treating before assessing, which can miss life-threatening deterioration.

Hint: Apply ABCs, client stability, and NCSBN clinical judgment steps before choosing an intervention.

Level: Clinical

Difficulty: Medium

Subtopic: Incident reporting