Nokea
The nurse is teaching a client with a new diagnosis of hypertension about medication adherence. Which of the following statements by the client indicates a need for further teaching?
- A. I'll take my medication every morning.'
- B. I'll check my blood pressure regularly.'
- C. I'll stop my medication if I feel fine.'
- D. I'll avoid high-sodium foods.'
Correct Answer: C
Rationale: Stopping medication when feeling fine indicates a misunderstanding, as hypertension requires ongoing treatment.
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The nurse should give which medication instructions to the client prescribed quinapril hydrochloride?
- A. Take the medication with food only.
- B. Expect a therapeutic effect immediately.
- C. Discontinue the medication if nausea occurs.
- D. Rise slowly from a lying to a sitting position.
Correct Answer: D
Rationale: Quinapril hydrochloride is an angiotensin-converting enzyme (ACE) inhibitor. It is used in the treatment of hypertension. The client should be instructed to rise slowly from a lying to sitting position and to permit the legs to dangle from the bed momentarily before standing to reduce the hypotensive effect. The medication does not need to be taken with meals. It may be given without regard to food. A full therapeutic effect may be noted in 1 to 2 weeks. If nausea occurs, the client should be instructed to take a noncola carbonated beverage and salted crackers or dry toast.
The Joint Commission on the Accreditation of Healthcare Organizations mandates standardized 'hand off' change of shift reporting. Which of the following is a standardized 'hand off' change of shift reporting system that you may want to consider for implementation on your nursing care unit?
- A. The Four P's
- B. UBAR
- C. ISBAR
- D. MAUMAR
Correct Answer: C
Rationale: ISBAR is a standardized hand-off reporting system (Introduction, Situation, Background, Assessment, Recommendation) recommended by The Joint Commission for effective communication during shift changes.
Which of the following is not considered one of the 'Ten Rights of Medication Administration'?
- A. The 'right' verification
- B. The 'right' to refuse
- C. The 'right' documentation
- D. The 'right' client education
Correct Answer: A
Rationale: The Ten Rights of Medication Administration include right patient, drug, dose, route, time, documentation, reason, response, refusal, and education. 'Right verification' is not a standard right.
A primiparous client who is breast-feeding develops endometritis on the third postpartum day. Which of the following instructions should the nurse give to the mother?
- A. The neonate will need to be bottle-fed for the next few days.
- B. The condition typically is treated with I.V. antibiotic therapy.
- C. The client's uterus may become 'boggy,' requiring frequent massage and oxytocics.
- D. The client needs to remain in bed in a side-lying position as much as possible.
Correct Answer: B
Rationale: Endometritis is typically treated with I.V. antibiotics to address the infection.
A client with asthma has been prescribed beclomethasone (Beclovent) via metered-dose inhaler. To determine if the client has been rinsing the mouth after each use of the inhaler, the nurse should inspect the client's mouth for:
- A. Gingival hyperplasia.
- B. Oral candidiasis.
- C. Ulceration.
- D. Dental caries.
Correct Answer: B
Rationale: Beclomethasone, an inhaled corticosteroid, can cause oral candidiasis (thrush) if the mouth is not rinsed after use, as residual medication promotes fungal growth.