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A nurse working in ICU has a client on a propofol (Diprivan) drip while on the mechanical ventilator. The nurse needs another bottle, which must be picked up in person in the hospital pharmacy. Which is the correct action by the nurse concerning this medication?
- A. ask the unit secretary to go to the pharmacy and pick it up
- B. send the unlicensed assistive personnel (UAP) to pick it up since the nurse is busy
- C. ask the client's health care provider to bring it when he or she rounds on the client
- D. ask another nurse to watch the clients while the nurse goes to the pharmacy to get the medication
Correct Answer: D
Rationale: The nurse must ensure continuous client monitoring, so asking another nurse to cover while retrieving the controlled medication is the safest action.
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The doctor has ordered Percocet (oxycodone) for a client following abdominal surgery. The primary objective of nursing care for the client receiving an opiate analgesic is:
- A. Preventing addiction
- B. Alleviating pain
- C. Facilitating mobility
- D. Preventing nausea
Correct Answer: B
Rationale: The primary goal of opiate analgesics like Percocet is to alleviate pain, improving comfort and recovery post-surgery.
The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with hypertension. The nurse should:
- A. Question the order
- B. Administer the medications
- C. Administer separately
- D. Contact the pharmacy
Correct Answer: B
Rationale: Lisinopril and furosemide are commonly used together for hypertension, as they have complementary effects, so administering them is appropriate.
The nurse is caring for a client with a long history of taking magnesium hydroxide for managing symptoms of peptic ulcer disease. Which finding in the client's medical history would be of concern to the nurse?
- A. asthma
- B. arthritis
- C. heart failure
- D. enlarged prostate
Correct Answer: C
Rationale: Magnesium hydroxide can cause fluid retention, worsening heart failure. Other conditions are not directly affected.
Which of the following medication orders requires clarification before the nurse can administer the order?
- A. epinephrine (EpiPen) 0.25 mg IM STAT
- B. heparin 30 units/kg/hr IV infusion for 24 hours
- C. ampicillin (Omnipen) 500 mg PO bid
- D. lorazepam (Ativan) 1.0 mg PO prn
Correct Answer: B
Rationale: Heparin dosing (30 units/kg/hr) is unusually low for anticoagulation (typically 10-20 units/kg/hr). This requires clarification to ensure safety.
The nurse is assessing the reflexes of a full-term newborn infant. Which of the following is true regarding newborn reflexes?
- A. The Babinski reflex disappears after 1 year of age.
- B. Complete fencing response disappears by 2 months.
- C. The stepping or 'walking' reflex is present until 3-4 months.
- D. The Moro reflex is present at birth and disappears by 6 months.
Correct Answer: D
Rationale: The Moro reflex, present at birth, typically disappears by 6 months. Babinski persists until ~2 years, fencing (tonic neck) until 4-6 months, and stepping until 1-2 months.