Nokea
Health care provider prescription
Guaifenesin 600 mg/dextromethorphan hydrobromide 30 mg ER one tablet PO q12h PRN for thick secretions
The nurse prepares to administer an oral expectorant to a client with pneumonia. The client tells the nurse, 'That pill is too big. I won't be able to swallow it.' What is the best action by the nurse?
- A. Contact the pharmacy and request the liquid form of the medication.
- B. Crush the medication and place it in a small amount of applesauce.
- C. Instruct the client to tuck chin to chest while swallowing the tablet.
- D. Obtain a new prescription for the liquid form of the medication.
Correct Answer: A
Rationale: Contacting the pharmacy for a liquid form addresses the client's difficulty swallowing the pill, ensuring medication adherence without altering the drug inappropriately.
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The unlicensed assistive personnel notifies the charge nurse that the client is reporting feeling short of breath. What should the charge nurse do first?
- A. Activate a rapid response team
- B. Ask the unlicensed assistive personnel to take vital signs and report back
- C. Direct the client's primary nurse to examine the client
- D. Personally go and auscultate the client's lungs
Correct Answer: C
Rationale: Directing the primary nurse to assess the client ensures a timely, qualified evaluation of shortness of breath, a potentially serious symptom.
The nurse is feeding a 3-month-old client with tetralogy of Fallot. During the feeding, the client becomes cyanotic and has difficulty breathing. Which action should the nurse take first?
- A. Administer oxygen via face mask to the client
- B. Administer subcutaneous morphine to the client
- C. Obtain the client's pulse oximetry reading
- D. Place the client in the knee-chest position
Correct Answer: D
Rationale: The knee-chest position increases systemic vascular resistance and reduces right-to-left shunting in tetralogy of Fallot, immediately improving oxygenation during a tet spell.
The nurse cares for a child with bed bug bites. Which parent statement indicates that further teaching is required?
- A. I need to have the entire house treated by pest control to ensure the bed bugs are gone.
- B. I should concentrate on alleviating scratching as it can cause further complications.
- C. My other family members and pets are at risk of bed bug bites.
- D. This must have happened because I did not wash the bed sheets this week.
Correct Answer: D
Rationale: Bed bug infestations are not caused by unwashed sheets but by exposure to infested environments. This misconception indicates a need for further teaching about bed bug transmission and prevention.
The nurse is caring for assigned clients. The nurse should first check the client
- A. with hypothyroidism who is reporting constipation, weakness, and peripheral edema
- B. with chronic pancreatitis who is reporting upper abdominal pain and voluminous, foul-smelling, fatty stools
- C. who has bacterial pneumonia, is receiving IV antibiotic therapy, and is reporting a cough productive of blood-tinged sputum
- D. who has an external fixation device, a temperature of 101.8°F (38.8°C), and is reporting redness and pain around the pin sites
Correct Answer: D
Rationale: Fever, redness, and pain around pin sites suggest a possible infection at the external fixation site, which is a priority due to the risk of osteomyelitis or systemic infection.
A nurse finds a client unresponsive and is unable to palpate a pulse. Resuscitation is initiated and continued by the rapid response team. The nurse then finds a do not resuscitate (DNR) prescription in the client's chart. What is the appropriate action by the nurse?
- A. Complete resuscitation as life support measures have already been started
- B. Continue resuscitation until DNR status is verified with health care provider
- C. Immediately have the rapid response team stop resuscitation measures
- D. Verify with a family member if life-saving measures should be continued
Correct Answer: C
Rationale: A DNR order indicates the client's wish to avoid resuscitation. Once discovered, resuscitation should be stopped immediately to respect the client's directive, unless there is clear evidence the order is invalid.