Nokea
The nurse is planning a staff development conference about medication reconciliation. Which of the following information should the nurse include?
- A. Obtain a list of the medications instead of reviewing the list with the client
- B. Medication reconciliation should occur just at discharge to prevent omissions.
- C. Prescribed medications should be obtained and omit herbs and supplements.
- D. This process should occur at admission, client transfer, and discharge.
Correct Answer: C
Rationale: Medication reconciliation at admission, transfer, and discharge ensures accuracy and continuity of care.
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A client is being admitted with a spinal cord transection at C7. Which of the following assessments take priority upon the client's arrival?
- A. Reflexes.
- B. Bladder function.
- C. Blood pressure.
- D. Temperature.
- E. Respirations.
Correct Answer: C,E
Rationale: Respirations and blood pressure are the priority assessments for a C7 spinal cord injury, as this level can impair diaphragmatic function and cause neurogenic shock, both life-threatening. Reflexes, bladder function, and temperature are important but secondary to airway and circulation stability.
A client who had a splenectomy is being discharged. Of the following discharge instructions, which is most specific to the client's surgical procedure?
- A. Do not drive.
- B. Alternate rest and activity.
- C. Make an appointment for the staples to be removed.
- D. Report early signs of infection.
Correct Answer: D
Rationale: Splenectomy increases the lifelong risk of infection due to the spleen's role in immunity. Reporting early signs of infection is the most specific instruction, as it addresses this unique risk. The other instructions are general postoperative advice.
A client who has a history of mitral valve prolapse tells the nurse that she is scheduled to get her teeth cleaned. Which of the following replies by the nurse is most appropriate?
- A. The physician will need to reevaluate the status of your heart condition before your dental appointment.'
- B. The nurse to remind your dentist that you have a heart condition.'
- C. It is important for you to care for your teeth because your heart condition makes you more susceptible to developing oral infections.'
- D. We will prescribe a prophylactic antibiotic for you to take before getting your teeth cleaned.'
Correct Answer: D
Rationale: Clients with mitral valve prolapse may require prophylactic antibiotics before dental procedures to prevent infective endocarditis, depending on current guidelines. This is the most appropriate response as it directly addresses the need for preventive measures. The other options either lack specificity or do not address the immediate clinical concern.
The nurse observes that a client's upper arm tremors disappear as he unbuttons his shirt. Which statement best guides the nurse's analysis of this observation about the client's tremors?
- A. The tremors are probably psychological and can be controlled at will.
- B. The tremors sometimes disappear with purposeful and voluntary movements.
- C. The tremors disappear when the client's attention is diverted by some activity.
- D. There is no explanation for the observation; it is probably a chance occurrence.
Correct Answer: B
Rationale: In Parkinson's disease, resting tremors often decrease or disappear during purposeful movements, such as unbuttoning a shirt. This is a characteristic feature, not psychological, distraction-related, or random.
A client who had an appendectomy for a perforated appendix returns from surgery with a drain inserted in the incisional site. The purpose of the drain is to:
- A. Provide access for wound irrigation.
- B. Promote drainage of wound exudate.
- C. Minimize development of scar tissue.
- D. Decrease postoperative discomfort.
Correct Answer: B
Rationale: The drain in the incisional site of a perforated appendix promotes drainage of wound exudate to prevent infection and abscess formation. It is not for irrigation, scar prevention, or direct pain relief. CN: Physiological adaptation; CL: Apply