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Client One, prednisone 10 mg PO Daily for asthma exacerbation
Client Two, acetaminophen 500 mg PO x 1 dose for fever
Client Three, magnesium oxide 250 mg PO Daily For chronic dode 150 mg PO Daily
Client Four, glargine insulin 15 units SubQ Daily for diabetes mellitus
The nurse is performing medication administration for four clients. Which client and medication should be administered first?
- A. Client One
- B. Client Two
- C. Client Three
- D. Client Four
Correct Answer: B
Rationale: Acetaminophen for fever (B) is the priority to address an acute symptom that may indicate infection or discomfort, requiring timely intervention. Prednisone (A), magnesium oxide (C), and glargine insulin (D) are daily medications with less immediate urgency.
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The nurse manager is conducting a staff in-service and announces that the staff nurses may decide when to take meal breaks, and the assignment for new admissions may be decided upon themselves. The nurse manager is demonstrating
- A. authoritative leadership style.
- B. democratic leadership style.
- C. participative leadership style.
- D. laissez-faire leadership style.
Correct Answer: D
Rationale: Allowing staff to decide meal breaks and assignments (D) reflects a laissez-faire leadership style, characterized by minimal direction and high autonomy. Authoritative (A) is directive, democratic/participative (B, C) involve shared decision-making but with more guidance.
The nurse manager has been made aware of the following staff nurse issues. The manager should initially follow up on the staff nurse who
- A. falsified documentation on a client discharged within the last 24 hours.
- B. needs assistance completing an incident report about a medication administration error on the previous shift.
- C. was thirty minutes late and tardy to their shift and is not wearing the correct gown uniform.
- D. is suspected of alcohol impairment and is precepting a newly hired nurse.
Correct Answer: D
Rationale: Suspected alcohol impairment while precepting (C) poses an immediate safety risk to clients and staff, requiring immediate immediate manager intervention. Falsified documentation (D), incident report assistance (A), and tardiness/uniform issues (B) are serious but less urgent than impairment.
The nurse has received the following information about assigned clients. The nurse should first assess the client with
- A. chronic obstructive pulmonary disease (COPD) and has respiratory acidosis on the most recent arterial blood gas (ABG).
- B. atrial fibrillation taking prescribed warfarin and reports black, tarry stools.
- C. diabetes mellitus who refuses to eat following the administration of glargine insulin.
- D. acute pancreatitis and reports nausea with epigastric pain rated as a 3 on the Numerical Rating Scale.
Correct Answer: B
Rationale: Black, tarry stools in a client on warfarin (B) suggest gastrointestinal bleeding, a life-threatening complication requiring immediate assessment. Respiratory acidosis (A) is concerning but less acute if stable. Refusing to eat post-insulin (C) risks hypoglycemia but is less urgent. Pancreatitis pain (D) rated 3/10 is manageable.
A nurse is caring for a client who is admitted to the emergency department with suspected rhabdomyolysis. Which of the following interventions should the nurse anticipate implementing initially for this client?
- A. Administering intravenous fluids
- B. Monitoring the client’s liver enzymes
- C. Administering corticosteroids
- D. Initiating prophylactic antibiotic therapy
Correct Answer: A
Rationale: Intravenous fluids (A) are the initial intervention for rhabdomyolysis to prevent kidney damage by flushing myoglobin and maintaining urine output. Monitoring liver enzymes (B), corticosteroids (C), and antibiotics (D) are not primary interventions for this condition.
The nurse is caring for assigned clients in the behavioral health unit. The nurse should initially assess the client who
- A. has postpartum depression who appears unkempt and dejected.
- B. recently lost their family in an accident and currently states, 'I want to be with them.'
- C. has anorexia nervosa and demands that she get reweighed.
- D. refused their second dose of prescribed lithium because of a fine hand tremor.
Correct Answer: B
Rationale: The statement 'I want to be with them' (B) indicates suicidal ideation, requiring immediate assessment for safety. Postpartum depression (A), anorexia demands (C), and lithium refusal (D) are concerning but less urgent.