Nokea
Which medication prescriptions should the nurse question? Select all that apply.
- A. Cephalexin for a client with severe allergy to penicillin
- B. Fexofenadine for a client with hives
- C. Ibuprofen for a client with asthma and nasal polyps
- D. Lisinopril for a client with diabetes mellitus
- E. Propranolol for a client with asthma
Correct Answer: A,C,E
Rationale: Cephalexin (A) is contraindicated in penicillin allergy due to cross-reactivity risk. Ibuprofen (C) can trigger bronchospasm in aspirin-exacerbated respiratory disease, common in asthma with nasal polyps. Propranolol (E) is contraindicated in asthma due to beta-blockade causing bronchoconstriction. Fexofenadine (B) is safe for hives, and lisinopril (D) is appropriate for diabetes to protect kidneys.
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All nursing staff on the medical unit are responsible for implementing a new interdisciplinary fall prevention protocol. Which duties are appropriate for the licensed practical nurse to delegate to unlicensed assistive personnel to promote client safety? Select all that apply.
- A. Educate newly admitted client on the importance of using the call light for assistance
- B. Place the bedside commode as close to the bed as possible
- C. Remind client to change position slowly
- D. Report observations of changes in client’s condition immediately
- E. Report whether client is using correct gait and balance while ambulating with walker
Correct Answer: B,C,D
Rationale: UAP can place commodes (B), remind about slow position changes (C), report condition changes (D), and observe gait (E). Education (A) requires nursing judgment, unsuitable for delegation.
A nurse prepared the 9:00 A.M. medications for his clients and then was called off the unit briefly before he was able to administer them. Who may administer the medications to the clients now?
- A. Any licensed nurse assigned to the unit and familiar with the clients
- B. A pharmacy technician certified to administer medications
- C. The nurse who prepared them
- D. The nurse manager of the unit
Correct Answer: C
Rationale: The nurse who prepared the medications must administer them to ensure accountability and familiarity with the preparation.
The client admitted with angina is given a prescription for nitroglycerine. The client should be instructed to:
- A. Replenish her supply every three months.
- B. Take one every 15 minutes if pain occurs.
- C. Leave the medication in the brown bottle.
- D. Crush the medication and take it with water.
Correct Answer: C
Rationale: The client should leave the medication in the brown bottle because light deteriorates the medication. The supply should be replenished every six months, so answer A is incorrect. One tablet should be taken every five minutes times three, so answer B is incorrect. If the pain does not subside, the client should report to the emergency room. The medication should be taken sublingually and should not be crushed, so answer D is incorrect.
The hospice nurse is providing end-of-life care to a client who is experiencing anorexia and cachexia. Which interventions are appropriate? Select all that apply.
- A. Allow the client to refuse food if not feeling hungry
- B. Ask if the client is experiencing any pain or nausea
- C. Involve the client in meal planning and food selection
- D. Plan for loved ones to share mealtimes with the client
- E. Provide oral care before and after meals to alleviate dry mouth
Correct Answer: A,B,D,E
Rationale: Allowing food refusal (A) respects autonomy, assessing pain/nausea (B) addresses barriers to eating, shared mealtimes (D) provide comfort, and oral care (E) improves appetite. Meal planning (C) may overwhelm a cachectic client.
The nurse is reviewing a depressed client's history from an earlier admission. Documentation of anhedonia is noted. The nurse understands that this finding refers to
- A. Reports of difficulty falling and staying asleep
- B. Expression of persistent suicidal thoughts
- C. Lack of enjoyment in usual pleasures
- D. Reduced senses of taste and smell
Correct Answer: C
Rationale: Lack of enjoyment in usual pleasures. Anhedonia, a common finding in depression, is the lack of enjoyment in usual pleasures.