Nokea
What is the most effective method to prevent medication errors during administration?
- A. Relying on memory for medication dosages
- B. Using a bar-code medication administration system
- C. Administering medications as quickly as possible to avoid delays
- D. Allowing another individual to administer medications
Correct Answer: B
Rationale: Using a bar-code medication administration system is the best method to prevent medication errors during administration. This system verifies medication details electronically, ensuring that the correct medication is given to the right patient. Relying on memory for medication dosages (choice A) is not recommended as it can lead to errors. Administering medications quickly (choice C) may increase the risk of mistakes due to haste. Allowing another individual (choice D) to administer medications does not address the root cause of preventing errors during administration.
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Which statement by a mature adult client with advanced prostate cancer best indicates that he has reached a level of acceptance of his prognosis?
- A. I don't have any use for those who say the disease is going to win
- B. I've found the support I need from my faith and family
- C. I think I've had this disease for a long time, but the doctor did not find it
- D. I understand that this is a disease that occurs mostly in older men
Correct Answer: B
Rationale: The correct answer is B because finding support in faith and family is a common way for individuals to cope with serious illnesses and come to terms with their prognosis. This statement indicates that the client has found a source of strength and comfort to deal with their situation. Choice A reflects defiance rather than acceptance. Choice C suggests denial or disbelief in the diagnosis. Choice D shows factual knowledge about the disease but does not necessarily indicate acceptance of the prognosis.
A client post-coronary artery bypass graft (CABG) surgery is concerned about the risk of infection. What is the most important preventive measure the nurse should emphasize during discharge teaching?
- A. Avoid touching the incision sites with bare hands.
- B. Take all prescribed antibiotics as directed.
- C. Report any signs of infection to the healthcare provider immediately.
- D. Keep the incision sites clean and dry.
Correct Answer: D
Rationale: The correct answer is D: 'Keep the incision sites clean and dry.' After CABG surgery, maintaining the cleanliness and dryness of the incision sites is crucial to prevent infections. This practice reduces the risk of introducing harmful microorganisms to the surgical wound, promoting healing and preventing complications. Option A, while important, does not fully encompass the preventive measures necessary to avoid infections post-surgery. Option B is significant if antibiotics are prescribed, but ensuring cleanliness directly addresses infection prevention. Option C is reactive and focuses on addressing infection after it occurs, rather than proactively preventing it.
A post-operative client is recovering from a total knee replacement and is prescribed patient-controlled analgesia (PCA). What is the primary advantage of PCA for managing post-operative pain?
- A. It allows for consistent pain control without overmedication.
- B. It eliminates the need for oral pain medication.
- C. It reduces the risk of opioid addiction.
- D. It requires less monitoring by nursing staff.
Correct Answer: A
Rationale: The primary advantage of PCA for managing post-operative pain is that it allows the client to control the administration of pain medication, leading to consistent pain control without overmedication. Choice B is incorrect as PCA does not eliminate the need for oral pain medication; it supplements it. Choice C is incorrect because while PCA can help reduce opioid consumption, it does not directly reduce the risk of opioid addiction. Choice D is incorrect as PCA actually requires close monitoring by nursing staff to ensure proper use and prevent complications.
Patients are coming into the emergency room as a result of an apartment house fire. You are examining a patient who is in distress but has no visible burn marks. You suspect that she is suffering from inhalation burns. Which of the following signs would NOT be associated with inhalation burns?
- A. Singed nasal hairs
- B. Conjunctivitis
- C. Hoarseness
- D. Clear sputum
Correct Answer: D
Rationale: Clear sputum would not be associated with inhalation burns. Inhalation burns typically present with symptoms like singed nasal hairs, conjunctivitis, hoarseness, and possibly soot in sputum due to smoke inhalation. Clear sputum suggests that there is no significant inflammation or injury to the respiratory tract, which is not consistent with the typical findings in inhalation burns. The other choices are associated with inhalation burns: singed nasal hairs can occur due to exposure to hot air or gases, conjunctivitis can result from irritating substances in smoke, and hoarseness can be due to airway irritation.
The PN notes that an older female client has developed a nonproductive cough and seems more confused than the previous day. Vital signs are temperature 99.8°F, pulse 94, respirations 22, and B/P 108/54. Which intervention is most important for the PN to implement?
- A. Report the findings to the charge nurse
- B. Monitor the client's temperature hourly
- C. Offer the client fluids frequently
- D. Provide care to moisten oral mucosa
Correct Answer: A
Rationale: The change in the client's condition, especially confusion and a new cough, may indicate the onset of an infection such as pneumonia, which requires immediate attention. Reporting to the charge nurse ensures prompt evaluation and intervention. Monitoring the client's temperature hourly (Choice B) could be important but not the most critical at this point. Offering the client fluids frequently (Choice C) and providing care to moisten oral mucosa (Choice D) are not the priority interventions when facing potential signs of infection and confusion in the client.