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A client taking isotretinoin (Accutane) tells the nurse that she is pregnant. What should the nurse teach this client?
- A. Her pregnancy is threatened, and the fetus is at risk for teratogenesis.
- B. She has a reportable condition, and the pregnancy must be terminated.
- C. Accutane is a Category D drug, which means it is unsafe in pregnancy.
- D. Her pregnancy must be followed carefully by a genetic specialist.
Correct Answer: A
Rationale: Accutane is a Category X drug, which means pregnancy is contraindicated due to teratogenesis associated with the medication.
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The nurse manager overhears multiple conversations on a hospital unit. Based on the statement made, the nurse manager should initiate the process for reporting incivility with which person?
- A. Charge nurse to the nurse, "I need to discuss the medication error you made yesterday."
- B. HCP to the nurse, "Tell me again what the client's vital signs were before I collapsed."
- C. Nurse to a coworker, "You forgot to document the client's noon glucometer reading."
- D. HCP to the client, "I can't do anything more for you; you don't follow my advice anyway."
Correct Answer: D
Rationale: The HCP's statement to the client is demeaning and uncivil, warranting a report for incivility.
The nurse is caring for a 69 year-old client with a diagnosis of hyperglycemia. Which tasks could the nurse delegate to the unlicensed assistive personnel (UAP)?
- A. Test blood sugar every 2 hours by Accu-Check
- B. Review with family and client signs of hyperglycemia
- C. Monitor for mental status changes
- D. Check skin condition of lower extremities
Correct Answer: A
Rationale: The UAP can do standard, unchanging procedures. Testing blood sugar with an Accu-Check is a routine task that does not require clinical judgment, making it appropriate for delegation to a UAP.
Which of these clients is at highest risk for contracting a tuberculosis infection?
- A. A nurse who is immune-suppressed from chemotherapy
- B. A nursing student with a negative purified protein derivative (PPD) test
- C. An elderly client in a nursing home who has never been tested for TB
- D. A health care worker who has a positive PPD test but negative chest x-ray
Correct Answer: A
Rationale: The immune-suppressed nurse undergoing chemotherapy is at the highest risk for contracting tuberculosis due to a weakened immune system, which reduces the ability to fight infections like TB.
A newborn has been delivered. An Apgar score is given. What does this scoring system indicate?
- A. heart rate, respiratory effort, color, muscle tone, reflex irritability
- B. heart rate, bleeding, cyanosis, edema
- C. bleeding, reflex, edema
- D. respiratory effort, heart rate, seizures
Correct Answer: A
Rationale: The Apgar scoring system was put into place by Virginia Apgar, an anesthesiologist in New York, for the purpose of assessing newborns in the areas of heart rate, respiratory effort, color, muscle tone, and reflex irritability at 1, 5, and sometimes 10 minutes after birth.
The client with a right femoral arterial line is confused, thrashing about in bed, and picking at the tubing. The HCP prescribes wrist restraints. Based on this information, what should the nurse plan to do?
- A. Apply the wrist restraints as prescribed
- B. Request an order for a right ankle restraint also
- C. Request an order for sedation instead of restraints
- D. Question the order; restraints will increase the client's agitation
Correct Answer: B
Rationale: An ankle restraint is needed to prevent leg movement that could dislodge the femoral arterial line, which wrist restraints alone cannot address.