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A nurse is caring for a client who has a prescription for acetaminophen 300 mg with codeine 30 mg, 1 tablet every 3 to 4 hr. PRN for pain. The nurse inadvertently administers 2 tablets to the client. In which of the following locations should the nurse document this client care incident?
- A. Nursing care plan
- B. Controlled substance inventory record
- C. Incident report
- D. Provider's progress notes
Correct Answer: C
Rationale: Completing an incident report is correct. An incident report is used to document medication errors, allowing for review and quality improvement measures to prevent future occurrences.
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A nurse is reinforcing teaching with a client who is scheduled for a parathyroid scan. Which of the following instructions should the nurse include?
- A. Avoid iodine-rich foods for 1 week before the scan.
- B. Fast for 12 hours before the scan.
- C. Expect to receive sedation.
- D. Remove all jewelry before the scan.
Correct Answer: D
Rationale: Removing all jewelry before a parathyroid scan prevents interference with the imaging process.
A nurse is caring for a client who has a new diagnosis of diverticulitis. Which of the following dietary recommendations should the nurse make?
- A. Increase fiber intake.
- B. Limit fluid intake.
- C. Avoid whole grains.
- D. Reduce protein intake.
Correct Answer: A
Rationale: Increasing fiber intake helps prevent constipation and promotes bowel regularity, reducing diverticulitis flare-ups.
A nurse is caring for a client who has a new prescription for fluoxetine. Which of the following adverse effects should the nurse monitor for?
- A. Weight loss
- B. Bradycardia
- C. Hypotension
- D. Insomnia
Correct Answer: D
Rationale: Fluoxetine, an SSRI, can cause insomnia due to its stimulatory effect on the central nervous system.
A nurse is caring for a client who has Clostridium difficile. When applying a cover gown, which of the following techniques should the nurse use?
- A. Tie the gown with the gloves on.
- B. Tuck the glove cuffs under the gown sleeves.
- C. Apply the gown before the gloves.
- D. Push the gown sleeves up to the elbows.
Correct Answer: C
Rationale: Applying the gown before the gloves is correct. According to infection control guidelines, the gown should be worn first, followed by gloves. This technique ensures that the gown covers the sleeves properly and that the gloves are overlapping the gown cuffs, reducing the risk of contamination.
A nurse is caring for a client who has a new prescription for varenicline. Which of the following adverse effects should the nurse monitor for?
- A. Mood changes
- B. Weight loss
- C. Bradycardia
- D. Hypoglycemia
Correct Answer: A
Rationale: Varenicline, used for smoking cessation, can cause mood changes, including depression or agitation, requiring monitoring.