Nokea
A nurse manager is preparing to review medication documentation with a group of newly licensed nurses. Which of the following statements should the nurse manager plan to include in the teaching?
- A. Use the complete name of the medication magnesium sulfate.
- B. Delete the space between the numerical dose and the unit of measure.
- C. Write the letter U when noting the dosage of insulin.
- D. Use the abbreviation SC when indicating an injection.
Correct Answer: A
Rationale: The correct answer is to use the complete name of the medication magnesium sulfate. This is important to prevent confusion with morphine sulfate, which is abbreviated as MSO4. Choice B is incorrect as it is essential to maintain a space between the numerical dose and the unit of measure for clarity in medication documentation. Choice C is incorrect as the standard abbreviation for units is 'U' for international units, not for the dosage of insulin. Choice D is incorrect as the appropriate abbreviation for subcutaneous injection is 'SC,' not just 'SC.' Therefore, the nurse manager should emphasize using the full name of medications to avoid errors and ensure patient safety.
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A client with a terminal illness is being educated by a healthcare provider about declining resuscitation in a living will. The client asks, "What would happen if I arrived at the ED and I had difficulty breathing?"
- A. We would give you oxygen through a tube in your nose.
- B. We would initiate full resuscitation efforts.
- C. We would consult the living will and provide comfort care.
- D. We would not provide any medical intervention.
Correct Answer: C
Rationale: In the scenario described, the client has a living will that declines resuscitation. Therefore, if the client arrives at the emergency department with difficulty breathing, healthcare providers would consult the living will to understand the client's wishes. Providing comfort care, which may include oxygen therapy to alleviate symptoms, aligns with the client's preferences. Option A incorrectly suggests an intervention that goes against the client's wishes. Option B is incorrect because full resuscitation efforts are not in line with the client's choice to decline resuscitation. Option D is also incorrect as it does not consider the client's living will and the need to provide care according to the documented preferences of the client.
A client with chronic kidney disease is receiving epoetin alfa (Epogen). Which laboratory value should the LPN/LVN monitor to determine the effectiveness of this medication?
- A. Serum potassium
- B. Hemoglobin
- C. Serum creatinine
- D. Blood urea nitrogen (BUN)
Correct Answer: B
Rationale: The correct answer is B: Hemoglobin. Monitoring hemoglobin levels is essential to assess the effectiveness of epoetin alfa in clients with chronic kidney disease. Epoetin alfa is a medication that stimulates red blood cell production, aiming to increase hemoglobin levels and improve symptoms of anemia in these patients. Monitoring serum potassium (Choice A) is important in clients with kidney disease, but it is more related to assessing electrolyte balance rather than the direct effectiveness of epoetin alfa. Serum creatinine (Choice C) and blood urea nitrogen (Choice D) are kidney function tests that help evaluate kidney health but do not specifically reflect the effectiveness of epoetin alfa therapy.
During a physical assessment, a nurse is assessing 4 adult clients. Which of the following physical assessment techniques should the nurse use?
- A. Ensure the bladder of the BP cuff surrounds 80% of their arm.
- B. Use the BP cuff on the forearm if the upper arm is not accessible.
- C. Apply the BP cuff loosely around the arm.
- D. Use a pediatric cuff for adults with small arms.
Correct Answer: A
Rationale: The correct answer is to ensure the bladder of the BP cuff surrounds 80% of the arm. This technique is crucial for obtaining accurate blood pressure readings. Choice B is incorrect because using the BP cuff on the forearm may lead to inaccurate readings. Choice C is incorrect as applying the BP cuff loosely can also result in inaccurate measurements. Choice D is incorrect because using a pediatric cuff for adults with small arms would not provide accurate blood pressure readings.
The patient is admitted to a skilled care unit for rehabilitation after the surgical procedure of fixation of a fractured left hip. The patient's nursing diagnosis is Impaired physical mobility related to musculoskeletal impairment from surgery and pain with movement. The patient is able to use a walker but needs assistance ambulating and transferring from the bed to the chair. Which nursing intervention is most appropriate for this patient?
- A. Obtain assistance and physically transfer the patient to the chair.
- B. Assist with ambulation and measure how far the patient walks.
- C. Give pain medication after ambulation so the patient will have a clear mind.
- D. Bring the patient to the cafeteria for group instruction on ambulation.
Correct Answer: B
Rationale: The most appropriate nursing intervention for this patient is to assist with ambulation and measure how far the patient walks. This intervention helps quantify the patient's progress in mobility and rehabilitation. Choice A is incorrect because physically transferring the patient does not focus on promoting independence or assessing progress. Choice C is inappropriate as pain medication should be given based on scheduled times or as needed, not specifically after ambulation. Choice D is not suitable as group instruction on ambulation is not as individualized or focused on the patient's current needs and abilities.
During a staff meeting, a nurse is discussing the purpose of regulatory agencies. Which of the following tasks should the nurse identify as the responsibility of state licensing boards?
- A. Monitoring evidence-based practice for clients with specific diagnoses.
- B. Ensuring that health care providers comply with regulations.
- C. Setting quality standards for accrediting health care facilities.
- D. Determining the safety of medications for administration to clients.
Correct Answer: B
Rationale: State licensing boards are primarily responsible for ensuring that health care providers comply with regulations. This includes overseeing licensure requirements, investigating complaints, and enforcing disciplinary actions. Monitoring evidence-based practice for clients with specific diagnoses is typically within the domain of professional organizations or healthcare institutions. Setting quality standards for accrediting health care facilities is usually the role of accrediting bodies such as The Joint Commission. Lastly, determining the safety of medications for administration to clients falls under the purview of regulatory agencies like the Food and Drug Administration (FDA).