Nokea
You are precepting a new graduate nurse who will be administering an intramuscular injection to an adult client. The new graduate nurse identifies the gluteus maximus muscle by palpating it. What would you do?
- A. Allow the nurse to administer the injection.
- B. Ask the nurse to use the vastus lateralis muscle instead.
- C. Ask the nurse to verify the doctor's order again.
- D. Stop the nurse from administering the injection.
Correct Answer: B
Rationale: The vastus lateralis is preferred over the gluteus maximus for IM injections in adults due to lower risk of sciatic nerve injury.
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When a client states that he is allergic to amoxicillin (Ampicillin) even though his medication administration record and armband do not indicate medication allergies, the nurse should:
- A. Administer the prescribed medication.
- B. Withhold the amoxicillin (Ampicillin).
- C. Administer another, similarly acting antibiotic.
- D. Call the family to verify the client's statement.
Correct Answer: B
Rationale: Withholding the medication is the safest action until the allergy can be verified to prevent an allergic reaction.
A client with a history of chronic lymphocytic leukemia is admitted with fatigue and pallor. Which laboratory value should the nurse monitor?
- A. Hemoglobin
- B. White blood cell count
- C. Platelet count
- D. All of the above
Correct Answer: D
Rationale: Chronic lymphocytic leukemia can cause anemia (low hemoglobin), infection risk (abnormal WBCs), and bleeding risk (low platelets), requiring monitoring of all values.
The nurse is caring for a client with a history of deep vein thrombosis who is prescribed enoxaparin (Lovenox). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild bruising.
- B. Bleeding gums.
- C. Headache.
- D. Nausea.
Correct Answer: B
Rationale: Bleeding gums indicate a potential bleeding complication with enoxaparin, requiring immediate reporting.
The nurse is teaching a client with hypertension about dietary modifications. Which statement by the client indicates understanding of the teaching?
- A. I should increase my intake of processed foods.'
- B. I will limit my sodium intake to 2,300 mg per day.'
- C. I can drink coffee as much as I want.'
- D. I should avoid fruits like bananas.'
Correct Answer: B
Rationale: Limiting sodium to 2,300 mg per day or less helps manage hypertension by reducing fluid retention and blood pressure.
A client with a history of depression is prescribed citalopram (Celexa). The nurse should instruct the client to:
- A. Report signs of serotonin syndrome.
- B. Take the medication at bedtime.
- C. Avoid high-fiber foods.
- D. Stop the medication if mood improves.
Correct Answer: A
Rationale: Citalopram can cause serotonin syndrome, requiring monitoring for agitation and tremors.