A nurse suspects that another nurse on the unit is removing a small amount of morphine from the syringe before administering the medication to the client. Which of the following actions should the nurse take?

Choice A rationale Asking the assistive personnel (AP) to observe the other nurse is inappropriate as the AP is not authorized or trained to monitor for controlled substance diversion, which is a serious ethical, legal, and professional matter. This action delegates a complex nursing responsibility to unlicensed personnel, violating professional standards and potentially compromising client safety and confidentiality. Reporting to the charge nurse is the appropriate chain of command. Choice B rationale Informing the charge nurse is the mandatory and appropriate first step according to professional and institutional policies. The charge nurse is the immediate supervisor, responsible for unit operations, and is trained to initiate the formal process for investigating suspected diversion of controlled substances, ensuring client safety and adherence to legal and ethical requirements. This follows the chain of command. Choice C rationale Reporting directly to hospital security bypasses the immediate supervisory chain of command (charge nurse/nurse manager). While security may become involved later in the investigation, the initial concern about a breach of professional conduct and potential client safety issue should first be reported to the unit's nursing leadership for immediate action and formal documentation. Choice D rationale Approaching the nurse directly is not the recommended procedure due to the serious nature of drug diversion. This action could escalate the situation, potentially put the reporting nurse at risk, and fail to initiate the formal, confidential, and unbiased investigation required to protect clients, staff, and the integrity of medication administration processes.