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The nurse working in an extended care facility transcribes a prescription from the health care provider for a single daily dose of 150 mg of ranitidine; this is to be taken orally at bedtime for treatment of gastroesophageal reflux disease. Of the following prescriptions, which one is transcribed correctly?
- A. Ranitidine 150 mg daily by mouth
- B. Ranitidine 150 mg per os qhs
- C. Ranitidine 150 mg po qd nightly
- D. Ranitidine 150 mg PO at bedtime
Correct Answer: D
Rationale: Ranitidine 150 mg PO at bedtime accurately specifies the dose, route, and timing (qhs = at bedtime). Other options are less precise or redundant (e.g., ‘qd nightly’).
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Which incidence should be documented on an unusual incident report?
- A. The client leaves the hospital against the doctor's advice.
- B. The client develops a fever after receiving a blood transfusion.
- C. The client reports an upset stomach after taking an antibiotic.
- D. The client falls in her bathroom.
Correct Answer: D
Rationale: A fall is an unusual incident requiring documentation due to potential injury and liability. Leaving AMA, transfusion fever, or upset stomach are notable but less likely to require an incident report.
The nurse is caring for a client who was admitted for treatment of schizoaffective disorder with visual hallucinations. He tells the nurse that he sees extraterrestrials that are coming to get him. What is the best nursing response?
- A. You know that extraterrestrials are make-believe.'
- B. Call his physician and report this visual hallucination.
- C. Ignore his comment and change the subject.
- D. You think someone is coming after you?'
Correct Answer: D
Rationale: Reflecting the client's statement validates his experience without reinforcing the hallucination, promoting therapeutic communication.
The nurse is caring for a client who performs frequent urinary self-catheterizations. Which of the following client assessments would indicate a potential for a latex allergy? Select all that apply.
- A. History of angioedema with lisinopril
- B. History of epilepsy
- C. Known allergy to avocados and bananas
- D. Known allergy to shellfish
- E. Lip swelling when blowing up balloons
Correct Answer: C,E
Rationale: Allergies to avocados, bananas, and latex (balloons) indicate a potential latex allergy due to cross-reactivity. Angioedema with lisinopril, epilepsy, and shellfish allergies are unrelated to latex sensitivity.
The nurse is talking with a client with obsessive-compulsive personality disorder who is scheduled for a colonoscopy. Due to a computer malfunction, the procedure is being postponed by 2 hours. Which of the following responses by the client would be consistent with obsessive-compulsive personality disorder?
- A. How dare they change my appointment time. I insist that the procedure be done at the scheduled time
- B. I do not understand why they would do this. It seems like they just want to make things difficult for me
- C. That is not a problem. I can come in whenever it is convenient for everyone
- D. This is unacceptable. I had my whole day planned out and I cannot change my plan
Correct Answer: D
Rationale: Obsessive-compulsive personality disorder involves rigidity and need for control, so resistance to schedule changes is typical. The other responses reflect anger, paranoia, or flexibility, less characteristic of the disorder.
When interviewing the parents of a child with asthma, it is most important to assess the child's environment for what factor?
- A. Household pets
- B. New furniture
- C. Lead based paint
- D. Plants such as cactus
Correct Answer: A
Rationale: Animal dander is a very common allergen affecting persons with asthma. Other triggers may include pollens, carpeting and household dust.