Nokea
The nurse is planning a staff development conference about medication safety. Which of the following medications should have a second medication check prior to administration? Select all that apply.
- A. heparin infusion
- B. regular insulin
- C. 0.9% sodium chloride (normal saline) flush
- D. patient-controlled analgesia (PCA)
- E. oxytocin infusion
- F. total parenteral nutrition
Correct Answer: A,B,D,E,F
Rationale: High-risk medications like heparin, insulin, PCA, oxytocin, and TPN require a second check to prevent errors.
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A client with angina has been taking nifedipine. The nurse should teach the client to:
- A. Monitor blood pressure monthly.
- B. Perform daily weights.
- C. Inspect gums daily.
- D. Limit intake of green leafy vegetables.
Correct Answer: C
Rationale: Nifedipine, a calcium channel blocker, can cause gingival hyperplasia. Daily gum inspection helps detect this side effect early.
A client who is to receive general anesthesia has a serum potassium level of 5.8 mEq/L. What should be the nurse's first response?
- A. Call the surgeon.
- B. Send the client to surgery.
- C. Make a note on the front of the chart.
- D. Notify the anesthesiologist.
Correct Answer: D
Rationale: A potassium level of 5.8 mEq/L indicates hyperkalemia, which can cause cardiac complications under general anesthesia. Notifying the anesthesiologist first ensures prompt evaluation and management to ensure patient safety.
The nurse is preparing a client for a bone scan to evaluate bone health. Which instruction is appropriate?
- A. Avoid caffeine 24 hours before the test.
- B. Drink plenty of water after the scan.
- C. Fast for 8 hours before the procedure.
- D. Wear tight clothing during the scan.
Correct Answer: B
Rationale: Drinking water post-scan helps flush the radioactive tracer used in a bone scan.
The nurse is assessing the urine of a client who has had an ileal conduit and notes that the urine is yellow with a moderate amount of mucus. Based on the data, the nurse should?
- A. Change the appliance bag.
- B. Notify the physician.
- C. Obtain a urine specimen for culture.
- D. Encourage a high fluid intake.
Correct Answer: D
Rationale: Yellow urine with moderate mucus is normal for an ileal conduit due to intestinal segment use. Encouraging high fluid intake prevents complications like calculi or infection.
The nurse is reviewing a care plan for a client with chronic pain receiving morphine sulfate. Which of the following aspects in the plan of care require revision?
- A. Adjust the physician's order based on the client's pain level
- B. Ensure naloxone is always available
- C. Check the client's blood pressure before administering morphine sulfate
- D. Provide a high-fiber diet
Correct Answer: A
Rationale: Nurses cannot adjust physician orders independently; this requires clarification or a new order from the provider.