Nokea
The healthcare provider is preparing to administer an intravenous (IV) medication to a client. Which action should the healthcare provider take first?
- A. Verify the client's identity using two identifiers.
- B. Check the client's allergy status.
- C. Prepare the medication for administration.
- D. Administer the medication at the prescribed rate.
Correct Answer: B
Rationale: Checking the client's allergy status is the priority before administering any medication, especially intravenously. This step helps identify any potential allergic reactions and prevents harm to the client. Verifying the client's identity using two identifiers is important but not the first step in medication administration. Preparing the medication for administration and administering the medication at the prescribed rate come after ensuring the client's safety by checking for allergies.
You may also like to solve these questions
A client with a history of alcoholism is admitted with pancreatitis. Which assessment finding is most important for the nurse to report to the healthcare provider?
- A. Nausea and vomiting.
- B. Epigastric pain radiating to the back.
- C. Temperature of 102°F (38.9°C).
- D. Mild jaundice.
Correct Answer: C
Rationale: A temperature of 102°F (38.9°C) is the most important assessment finding to report to the healthcare provider in a client with pancreatitis and a history of alcoholism. Fever in this context can indicate infection, which is a serious complication requiring immediate intervention. Nausea and vomiting (choice A) are common symptoms of pancreatitis but may not require immediate intervention unless severe. Epigastric pain radiating to the back (choice B) is a classic symptom of pancreatitis and should be addressed, but a fever takes precedence. Mild jaundice (choice D) may be present in pancreatitis but is not as urgent as a high temperature signaling possible infection.
During which home visit performed by a registered nurse or a practical nurse can the home healthcare agency expect Medicare reimbursement for documenting a skilled care service provided?
- A. 13-18 years of age
- B. 11-12 years of age
- C. 18-24 months of age
- D. 4-6 years of age
Correct Answer: D
Rationale: The correct answer is D: 4-6 years of age. According to current CDC guidelines, a child receiving the measles, mumps, rubella (MMR) vaccine at 12 months of age should plan to receive the MMR booster between 4-6 years of age. Choices A, B, and C are incorrect as they do not align with the CDC's recommended age range for the MMR vaccine booster. It is crucial for healthcare providers to stay updated with current guidelines to ensure the timely administration of vaccines for optimal protection.
The school nurse is conducting an audit of incident reports for adolescent students. Which finding is the best indication that the Healthy People 2020 objectives are being addressed?
- A. the absenteeism rate has increased greatly over the past two years
- B. during the last year fewer firearms were retrieved on school property
- C. the number of requests for pregnancy testing is higher than last year
- D. decline in the number of students enrolled in school during the year
Correct Answer: B
Rationale: The correct answer is B. A decrease in firearms retrieved on school property is a positive indication that the Healthy People 2020 objectives are being addressed. This finding suggests progress in reducing violence and improving safety in schools, which aligns with the goals of promoting overall health and safety among adolescents. Choices A, C, and D do not directly relate to the Healthy People 2020 objectives. Increased absenteeism, higher requests for pregnancy testing, and a decline in student enrollment do not necessarily reflect the specific health and safety goals outlined in Healthy People 2020.
The client with liver cirrhosis needs immediate intervention for which abnormal laboratory result?
- A. Prothrombin time (PT) of 14 seconds.
- B. Bilirubin of 1.2 mg/dL.
- C. Albumin of 4 g/dL.
- D. Ammonia level of 80 mcg/dL.
Correct Answer: D
Rationale: An elevated ammonia level of 80 mcg/dL indicates hepatic encephalopathy, a serious complication of liver cirrhosis that requires immediate intervention. Ammonia is a neurotoxin that accumulates in the blood due to impaired liver function, leading to cognitive impairment and altered mental status. Monitoring and lowering ammonia levels are crucial in managing hepatic encephalopathy to prevent further neurological deterioration. Prothrombin time, bilirubin, and albumin levels are important parameters in assessing liver function and overall health status in clients with liver cirrhosis, but an elevated ammonia level poses an immediate threat to neurological function and warrants prompt attention.
A client with a history of alcohol abuse is admitted with cirrhosis. Which finding requires immediate intervention?
- A. Jaundice.
- B. Ascites.
- C. Peripheral edema.
- D. Spider angiomas.
Correct Answer: C
Rationale: Peripheral edema in a client with cirrhosis can indicate fluid overload and worsening liver function, necessitating immediate intervention to prevent further complications such as respiratory distress, cardiac issues, or renal impairment. Jaundice (choice A) is a common manifestation of cirrhosis but may not require immediate intervention unless severe. Ascites (choice B) is also a common complication of cirrhosis that may require intervention but is not as urgent as addressing peripheral edema. Spider angiomas (choice D) are typically benign skin lesions associated with cirrhosis but do not require immediate intervention unless bleeding or rupture occurs.