A nursing supervisor is about to meet with a staff nurse suspected of diverting client medications. Which of the following assessment data would lead the supervisor to suspect that the staff nurse is impaired? (Select all that apply.)
1. The staff nurse is frequently absent from work.
2. The staff nurse experiences mood swings.
3. The staff nurse makes elaborate excuses for behavior.
4. The staff nurse frequently uses the restroom.
5. The staff nurse has a flushed face.
2, 3, 4, 5
Rationale: A number of clues for recognizing substance impairment in nurses have been identified. They are not easy to detect and will vary according to the substance being used. There may be high absenteeism if the person's source is outside the work area, or the individual may rarely miss work if the substance source is at work. Some other possible signs are irritability, mood swings, tendency to isolate, elaborate excuses for behavior, unkempt appearance, impaired motor coordination, slurred speech, flushed face, inconsistent job performance, and frequent use of the restroom.
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