Nokea
An RN notices an LPN in the medication room drawing up morphine. The RN asks the LPN who it is for. The LPN states that one of her clients needs pain medication. The RN offers to administer the dose, but the LPN says, 'It's ok. I can give it. I've had this client for several days and she is stable.' Which is the correct response by the nurse?
- A. Let me double-check the dose with you.
- B. OK, but let me know if you need help with anything.
- C. I am going to report this to the charge nurse immediately.
- D. You shouldn't do that. Let me chart it while you give it to save time.
Correct Answer: C
Rationale: LPNs typically cannot administer IV narcotics like morphine in most states due to scope of practice limitations. The RN should report this to the charge nurse for clarification and safety.
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A client at a psychiatric hospital tells the nurse that he does not want to join the others for dinner in the dining room because he already ate. The nurse is aware this client has been diagnosed with avoidant personality disorder. The best response from the nurse is to
- A. ask the client what would make group dinners more enjoyable so he will participate in the future.
- B. allow the client to skip the group dinner this time only.
- C. ask the client why he ate dinner so early.
- D. state clearly that the client is expected in the dining room and then walk with the client to the dining room.
Correct Answer: D
Rationale: Avoidant personality disorder involves social withdrawal due to fear of rejection. Gently encouraging participation while providing support (walking with the client) promotes socialization without confrontation.
Which of the following ethnic groups has the highest risk of developing diabetes mellitus type 2 and should be routinely screened for diabetes?
- A. Hispanics
- B. Asians
- C. Caucasians
- D. African-Americans
Correct Answer: A
Rationale: Hispanics (A) have the highest risk for type 2 diabetes due to genetic and socioeconomic factors, requiring routine screening.
A client with myasthenia gravis is admitted in a cholinergic crisis. Signs of of cholinergic crisis include:
- A. Decreased blood pressure and constricted pupils
- B. Increased heart rate and increased respirations
- C. Increased respirations and increased blood pressure
- D. Anoxia and absence of the cough reflex
Correct Answer: A
Rationale: Cholinergic crisis, due to excessive acetylcholinesterase inhibitors, causes symptoms like constricted pupils and decreased blood pressure from parasympathetic overstimulation.
A school nurse is approached by a student who says that her friend has been cutting herself on the arms. The student asks the nurse not to tell anyone. Which response by the nurse is correct?
- A. I have to notify her parents, because this affects her personal safety.
- B. I won't tell anyone, but let me know if she starts talking about suicide.
- C. I will call the hospital and let them send a psychiatrist to do an evaluation on your friend.
- D. I will make it a point to run into her in the hall and notice the cuts on her arms so I can ask about them.
Correct Answer: A
Rationale: Self-harm indicates a safety risk, requiring parental notification to ensure the student receives appropriate intervention.
A client is receiving a blood transfusion following surgery. In the event of a transfusion reaction, any unused blood should be:
- A. Sealed and discarded in a red bag
- B. Flushed down the client's commode
- C. Sealed and discarded in the sharp's container
- D. Returned to the blood bank
Correct Answer: D
Rationale: Unused blood must be returned to the blood bank for analysis in case of a transfusion reaction.