Transcription of doctor's order is a nurse's responsibility to put the order into action. Which of the following principles of medication safety is NOT considered to belong to transcription error?
- A. Illegible handwriting of the physician.
- B. Misinterpretation of the directions ordered.
- C. Use of unapproved abbreviation in the chart.
- D. Wrong route of medication administration.
Correct Answer: D
Rationale: Transcription errors are typically associated with issues such as illegible handwriting, misinterpretation of directions, and the use of unapproved abbreviations. However, the wrong route of medication administration is not specifically related to transcription errors but rather falls under the category of medication administration errors. Administering medication via the wrong route can lead to serious consequences for the patient and is a separate issue from the act of transcribing doctor's orders.
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Sandro is taking pemoline (Cylert) for ADHD. The nurse must be aware of which of the following side effects?
- A. Decreased red blood cell count
- B. Elevated white blood cell count
- C. Decreased thyroid stimulating hormones
- D. elevated liver function test results
Correct Answer: D
Rationale: Pemoline (Cylert) is a central nervous system stimulant used in the treatment of ADHD. One of the significant potential side effects of pemoline is hepatotoxicity, which can manifest as elevated liver function test results. Therefore, the nurse must monitor the patient's liver function regularly while they are taking pemoline to monitor for any signs of liver damage or dysfunction. It is essential to educate the patient about the signs and symptoms of liver problems, such as jaundice (yellowing of the skin or eyes), abdominal pain, nausea, or dark urine, and to report any such symptoms immediately to their healthcare provider. Regular monitoring and early detection of liver function abnormalities can help prevent severe liver damage in patients taking pemoline.
A patient with a history of chronic kidney disease is prescribed a low-protein diet. Which dietary choice indicates understanding of the prescribed diet?
- A. Grilled salmon
- B. Lentil soup
- C. Beef stew
- D. Chicken Caesar salad
Correct Answer: D
Rationale: A patient with chronic kidney disease prescribed a low-protein diet should avoid high-protein foods like grilled salmon, lentil soup, and beef stew. Chicken Caesar salad, on the other hand, typically contains a smaller amount of protein compared to the other options. This choice indicates an understanding of the need to limit protein intake while still enjoying a balanced meal. However, it is important to note that the quantity and portion sizes of high-protein ingredients in the salad should also be moderate to comply with a low-protein diet.
A patient receiving palliative care for end-stage liver cancer experiences severe nausea and vomiting despite antiemetic therapy. What should the palliative nurse consider when addressing the patient's symptoms?
- A. Increase the dosage of the current antiemetic medication.
- B. Switch to a different antiemetic medication with a different mechanism of action.
- C. Discontinue antiemetic therapy and explore non-pharmacological interventions.
- D. Administer intravenous fluids to alleviate dehydration associated with vomiting.
Correct Answer: B
Rationale: When a patient receiving palliative care for end-stage cancer experiences severe nausea and vomiting despite current antiemetic therapy, the palliative nurse should consider switching to a different antiemetic medication with a different mechanism of action. This approach is based on the concept of individual variability in response to medications, as well as the potential development of tolerance to a particular drug. Switching to a different antiemetic with a new mechanism of action can provide the patient with a fresh chance at better symptom control by targeting different receptors or pathways involved in nausea and vomiting. It is important to consult the healthcare team and consider the patient's overall condition and medication history before making any changes in the treatment plan.
In order to determine the patient's ability to concentrate and focus, which would be the PRIORITY nursing action?
- A. Asked for the academic performance
- B. Conduct paper and pencil test
- C. Assess the mental status of the patient
- D. Refer the patient to the psychiatrist
Correct Answer: C
Rationale: Assessing the mental status of the patient is the PRIORITY nursing action to determine the patient's ability to concentrate and focus. This assessment includes evaluating the patient's level of alertness, orientation, memory, thought processes, and mood. By observing the patient's mental status, the nurse can gain valuable information about the patient's cognitive function, attention span, and ability to concentrate. This assessment will help guide further interventions and care planning for the patient. Asking for academic performance or conducting paper and pencil tests may be useful tools to assess concentration and focus, but they should come after a comprehensive evaluation of the patient's mental status. Referring the patient to a psychiatrist may be necessary based on the assessment findings, but it should not be the first step in determining the patient's ability to concentrate and focus.
Which of the following interventions is most appropriate for a patient with a tension pneumothorax?
- A. Needle decompression
- B. Chest tube insertion
- C. High-flow oxygen therapy
- D. Incentive spirometry
Correct Answer: A
Rationale: A tension pneumothorax is a life-threatening condition where air accumulates in the pleural space and cannot escape, causing increased pressure in the chest cavity. This can lead to compression of the lung and major blood vessels, leading to inadequate oxygenation and circulation.