EXAM 2 NURS 3100

Place these methods of communicating with a​ non-English speaking client in order of their desirability and usefulness. 1. Child interprets 2. No interpretation is attempted 3. Body language and drawing is used 4. Healthcare agency interpreter 5. Adult family member interprets

1. Healthcare agency interpreter is present 2.Adult family member interprets 3. Child relative interprets 4.Nurse uses drawing and body language interprets 5.No interpretation is attempted

Place nursing activities in the correct order of the nursing process 1. Nurse documents the time and route of an administered medication 2.Nurse weighs client 3. Nurse analyzes data collected 4. Nurse changes a nursing intervention that's not working 5.Nurse writes an individualized intervention

1. Nurse weighs client 2. Nurse analyzes data collected 3. Nurse writes an individualized intervention 4. Nurse documents the time and route an administered medication 5. Nurse changes a nursing intervention that's not working ​Rationale: The order of the steps of the nursing process is​ assessment, diagnosis,​ planning, implementing, and evaluating. Weighing the client is​ assessment, analyzing data occurs in the diagnosis​ step, writing interventions occurs in the planning​ step, documentation occurs in the implementation​ step, and revising interventions occurs in the evaluation step.

The nurse preparing to transfer to a pediatric hospital would expect to administer medications to children from birth to age ? years. Record your answer rounding to the nearest whole number.

16 ​Rationale: For the purposes of medication​ administration, the pediatric patient is defined as being any age from birth to 16 years and weighing less than 50 kg.

A series of category E medication errors have occurred on a hospital unit. When discussing this trend with the nursing​ staff, the risk manager would list which characteristics of a category E​ error? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. The error contributed to the death of a client. B. A client was harmed. C. No interventions to sustain life were required as a result of the error. D. Harm to the client was permanent. E. The​ client's hospitalization was prolonged as a result of the error.

B. A client was harmed. C. No interventions to sustain life were required as a result of the error. ​Rationale: Errors that contribute to the death of a client are Category I errors. Category E errors result in temporary harm to the client. Category E errors do not result in the need for interventions to sustain​ life, and hospitalization is not prolonged.

A nurse is teaching a group of student nurses. Which of the following best indicates an ethnic characteristic that can affect​ pharmacotherapy? A. Alternative therapies B. Genetic differences C. Health beliefs D. Diet

B. Genetic differences ​Rationale: Ethnicity relates to biology and genetics.​ Diet, alternative​ therapies, and health beliefs are cultural characteristics.

A nurse is admitting a client to the emergency department who has overdosed on a benzodiazepine. The nurse should anticipate the healthcare provider will prescribe which of the following​ drugs? A. Acetaminophen B. Romazicon C. Digibind D. Acetylcysteine

B. Romazicon

A student nurse asks a nurse what items are found within the Strategic National Stockpile​ (SNS). What is the​ nurse's best​ response? A. Drinking water B. ​Two-way radios C. Antibiotics D. Prepared meals

C. Antibiotics

What is the most significant role for nurses as defined by state nurse practice acts and by regulating bodies such as The Joint​ Commission? A. Ordering lab tests B. Discharging clients C. Client teaching D. Prescribing medication

C. Client teaching Rationale: State nurse practice acts and regulating bodies such as the Joint Commission consider teaching to be a primary role for​ nurses, giving it the weight of law and key important accreditation standards.​ Assessment, planning, and evaluation are important but not the most significant roles of the nurse according to state nurse practice acts and Joint Commission.

The nurse administers potassium iodide​ (KI) tablets to a client who has been exposed to radiation from a nuclear weapon. What is the rationale for administering potassium iodide​ (KI) to this​ client? A. Prevent liver cancer B. Prevent brain cancer C. Prevent thyroid cancer D. Prevent renal cancer

C. Prevent thyroid cancer

The nurse has been teaching a client about herbal preparations and determines that additional teaching is required when the client makes which​ statement? A. ​"Herbal preparations are available in solid and liquid​ forms." B. ​"I should check with you before using an herbal​ product." C. ​"Herbal products usually contain only one active​ ingredient." D. ​"I need to be careful about where I store my herbal​ product."

C. ​"Herbal products usually contain only one active​ ingredient." ​Rationale: Herbal products contain multiple active ingredients as opposed to prescription​ drugs, which contain only one active ingredient. Herbal preparations are available in solid and liquid forms. Clients should check with the nurse before using an herbal product. Where and how an herbal product is stored can affect its potency.

A small nuclear weapon has been detonated in a nearby city. Which immediate symptoms of radiation sickness will the nurse assess in clients who have been​ exposed? A. Anorexia and fatigue. B. Dilated pupils and aggression. C. ​Nausea, vomiting, and diarrhea. D. Weight loss and fatigue.

C. ​Nausea, vomiting, and diarrhea.

A nurse is caring for a client who has been exposed to a nerve agent. Which antidote will the nurse plan to​ administer? A. Hydroxyzine​ (Vistaril) B. Apomorphine C. Acetate of ammonia D. Atropine

D. Atropine

A nurse is teaching a student nurse about common treatments for victims of bioterrorism. The nurse tells the student that atropine would be most useful for a victim of bioterrorism exposed to which of the​ following? A. Ionizing radiation B. Viral agents C. Bacterial agents D. Nerve gas

D. Nerve gas

A nursing instructor is teaching a nursing student about human DNA sequences. The student demonstrates understanding by making with of the following​ statements? A. ​"Only 2% of human DNA is different among the different​ ethnicities." B. ​"Due to enzyme​ polymorphism, Hispanics are less likely to metabolize codeine to​ morphine." C. ​"Asian Americans are the ethnic group known to be slow​ acetylators." D. ​"Even though human genetic differences are​ small, significant differences can be seen with drug​ metabolism."

D. ​"Even though human genetic differences are​ small, significant differences can be seen with drug​ metabolism." Review Only ​Rationale: Human DNA differences of only​ 0.2% can produce significant differences in the way drugs are handled within the body. Asian Americans are less likely to metabolize codeine to​ morphine, and Caucasians are known to be slow acetylators.

The nurse plans to teach clients about the difference between herbal preparations and prescription medications. Which statement describes the best plan by the​ nurse? A. ​"Herbs, like prescription​ drugs, usually only contain one active​ ingredient." B. ​"Most herbs, like prescription​ drugs, are standardized and regulated by the Food and Drug Administration​ (FDA)." C. ​"Herbs are considered to be safer than prescription medications as they are​ natural." D. ​"The active ingredients in an​ herb, unlike prescription​ drugs, may be present in just one part or many​ parts."

D. ​"The active ingredients in an​ herb, unlike prescription​ drugs, may be present in just one part or many​ parts." ​Rationale: Unlike prescription​ drugs, the active ingredients in an herb may be present in just one part or many parts. Herbs may actually contain dozens of active​ chemicals, not just one. Most herbs have not been standardized and are not regulated by the Food and Drug Administration​ (FDA). Herbs are not necessarily safer than prescription​ medications; they are medications.

The nurse recognizes that agency system checks are in place to decrease medication errors. Who commonly collaborates with the nurse on checking the accuracy of the medication prior to​ administration? A. The healthcare provider B. The nursing unit manager C. The nursing supervisor D. The pharmacist

D. The pharmacist Rationale: Pharmacists and nurses must collaborate on checking the accuracy and appropriateness of drug orders prior to client administration. The healthcare​ provider, nursing unit​ manager, and nursing supervisor do not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration.

A client with hypertension is receiving medication to lower his blood pressure. Which nursing action demonstrates the evaluation process related to medication​ administration? A. Asking the client if they have adhered to the prescribed treatment B. Determination of the​ client's baseline blood pressure C. Administration of IV antihypertensive agents D. Determining that goals were not met 3 days following medication administration

Determining that goals were not met 3 days following medication administration Rationale: Evaluation is the final step in the nursing process where goal attainment is determined. Administering medications is the intervention step. Determining the​ client's baseline blood pressure and asking him or her about compliance would be an assessment step.

Naloxone

Mechanism of action: Blocks mu and kappa receptors, used for complete or partial reversal opioid Therapeutic uses: Opioid overdose and abuse Major Precaution and Contraindications: Pregnancy category B, administer for respiratory rate of fewer than 10 breaths per minute, reversed effects of opioids can cause rapid loss of analgesia, increased blood pressure, tremors, hyperventilation, nausea, and vomiting. Do not use for respiratory depression

Which nursing intervention would take priority following administration of a new​ medication? A. Measuring​ client's weight daily B. Monitoring the​ client's respiratory status C. Administering additional medications if side effects occur D. Evaluate the results of recent labs

Monitoring the​ client's respiratory status Rationale: Any time a new medication is provided to the​ client, it is important to monitor for an allergic reaction.​ Anaphylaxis, a​ life-threatening allergic​ reaction, can impair breathing. Monitoring lab values and measuring weight might be appropriate nursing interventions with some medications but would not be the priority. Nurses do not prescribe medications.

A nurse is administering medications to a group of clients. Which situation is an example of a medication​ error? A. A client experiences unexpected hypotension as a result of medication administration. B. A medication is administered to a client with no​ allergies, yet an anaphylactic response occurs. C. The wrong dose of a medication is drawn up but is caught and corrected prior to administration. D. A medication is administered in liquid form instead of tablet form due to the​ client's difficulty swallowing.

The wrong dose of a medication is drawn up but is caught and corrected prior to administration. ​Rationale: A medication error can occur even when it does not reach the client. Unexpected reactions to medications are not preventable and would be considered adverse​ effects, not medication errors. Altering the form from a tablet to a liquid does not constitute a medication error.

The nurse is on a committee to reduce medication errors in a large healthcare facility. What is a recommendation the nurse proposes that will most likely help to reduce medication​ errors? A. Use robots to prepare all medications for administration by the nurse. B. Designate nurses whose only function is to administer medication. C. Use​ automated, computerized cabinets on all nursing units. D. Train medication technicians to administer medications.

Use​ automated, computerized cabinets on all nursing units. Rationale: To help reduce medication​ errors, many healthcare agencies are using​ automated, computerized, locked cabinets for medication storage on patient care units. Healthcare agencies are not planning to designate nurses who just do medication administration. Healthcare agencies are not planning to have medication technicians administer medications. Healthcare agencies are not planning to have robots prepare all medications for administration by the nurse.

(M6) The nurse follows the nursing process when conducting medication education about insulin. What will the nurse ask the client to evaluate the​ client's knowledge of​ insulin? A. ​"Is your abdomen the best place to inject​ insulin?" B. ​"Can you tell me four points you remember about how to take your​ insulin?" C. ​"Can you recognize when you are experiencing​ hypoglycemia?" D. ​"What questions do you have about​ insulin?"

​"Can you tell me four points you remember about how to take your​ insulin?" Rationale: The nurse is evaluating the effectiveness of medication education by asking the client for feedback from the education provided. Asking the patient what questions he or she has about insulin is an assessment question. Asking the client if his or her abdomen is the best place to inject insulin is an assessment question. Asking the client if he or she can recognize when he or she is experiencing hypoglycemia is an assessment question.

Atropine

-Mechanism of action: occupies musacrininc receptors to block parasympathetic actions of ACh and induce fight or flight response, causing increased heart rate, bronchodilation, decreased GI movement, mydriasis, and less gland secretion -Therapeutic uses: hyper-motility in the GI tract like irritable bowel syndrome, suppress secretion during surgery, increase heart rate in bradycardia, and dilation the pupils Major precautions: Oral and subcutaneous administration are not interchangeable, monitor blood pressure, heart rate, and respiration for 1 hr Contraindications: Category C pregnant women, patients with glaucoma, obstructive disorders of the GI tract, paralytic ileus, bladder neck obstruction, benign prostatic hyperplasia, cardiac insufficiency, or acute hemorrhage

Acetylcysteine

-Mechanism of action: the sulfhydryl groups hydrolyze disulfide groups with mucin, breaking down oligomers and making the mucous less viscous. Also an antioxidant, can be deacylated into cysteine, which synthesizes glutathione, another antioxidant, which decreases phosphorylation of the mucin gene. In acetaminophen overdoses, a portion of the drug is metabolized by CYP2E1 to form the toxin NAPQI, which depletes glutathione. The free NAPQI bind to free proteins, causing cellular necrosis. Therapeutic uses: Airway secretion therapies and acetaminophen overdoses Major precautions/Contraindication: Previous anaphylactoid/hypersensitive reaction to acetylcysteine, asthmatic patients, patients with bronchospasms, especially inhaling if their airways are not clear. Oral administration can exacerbate vomiting so use with caution with patients with ulcers, caution with pregnant and breastfeeding women, IV for heart patients.

The nurse uses a newly admitted​ client's armband barcode to identify the client prior to administering medications. The nurse should use at least ? other means of identifying this client. Record your answer rounding to the nearest whole number.

2 ​Rationale: Even though the barcode identification system has improved​ safety, it is not foolproof. The nurse should use two other means of identifying the client such as verifying name and birth date.

The nurse who is writing a risk nursing diagnosis will write a ? part statement. Record your answer rounding to the nearest whole number.

2 ​Rationale: Since risk diagnoses do not have evidence to support the chosen​ statement, they are written in two parts.

A nurse working in the emergency department is told that the smallpox virus was aerosolized at a parade attended by thousands of people. The nurse explains to the student nurse that the vaccine for this virus provides a high level of protection if given within ? days of exposure. Record your answer rounding to the nearest whole number.

3

A woman who wishes to become pregnant is concerned about the drugs she must take in order to treat a serious medical condition. The nurse reviewing the drug list would be most concerned about which kind of​ drug? A. A drug with a long​ half-life. B. A drug taken only when needed. C. A drug with no active metabolites. D. A drug with high​ protein-binding ability.

A. A drug with a long​ half-life. ​Rationale: Drugs with long​ half-lives or active metabolites should be avoided because they can accumulate in the​ infant's plasma. Drugs with high​ protein-binding ability are not secreted as readily to the milk. If a drug is taken on an as needed​ basis, the woman could schedule the drug to be taken immediately after breast feeding.

A nurse is caring for a client admitted to the emergency department following a drug overdose. The nurse anticipates which of the following prescriptions to enhance removal of the poison from the​ client? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Administering activated charcoal. B. Changing the pH of urine. C. Preparing the client for enemas. D. Inserting a nasogastric tube. E. Preparing corticosteroids for administration.

A. Administering activated charcoal. B. Changing the pH of urine. C. Preparing the client for enemas. D. Inserting a nasogastric tube.

When teaching the client about a new​ medication, the nurse should include which​ information? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Adverse effects that can be expected B. Which adverse effect to report to the healthcare provider C. The​ drug's therapeutic action D. Chemical composition of the drug E. Name of the drug manufacturer

A. Adverse effects that can be expected B. Which adverse effect to report to the healthcare provider C. The​ drug's therapeutic action ​Rationale: In order to help the​ client, identify and prevent adverse​ effects, the client should be taught the therapeutic​ action, adverse​ effects, and when to notify the healthcare provider of adverse effects. It is not necessary to teach the client the chemical makeup of the drug or the name of the drug manufacturer.

A nurse is preparing to administer medications to a​ school-age child. What would the nurse​ do? A. Allow the child to make decisions regarding how medications are taken. B. Provide a lengthy explanation followed by quick drug administration. C. Provide a brief explanation on why the medication is important. D. Administer drugs while holding the child down.

A. Allow the child to make decisions regarding how medications are taken. Rationale: Allowing the child to become a participant in the process of medication administration is important for this age group. At this age more detail can be included in explanations about the drug. At this age it is unlikely the child will need to be restrained. Lengthy explanations are more appropriate for adolescents.

The nurse is working hard to prevent medication errors. What interventions will assist the nurse in preventing most​ errors? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Always check the​ client's identification band prior to administration of medications. B. Open all of the medications immediately prior to administration. C. Tell healthcare providers that verbal orders will not be accepted. D. Record the medication on the medication administration record​ (MAR) immediately prior to administration. E. Validate all orders with another nurse prior to administration of medications.

A. Always check the​ client's identification band prior to administration of medications. B. Open all of the medications immediately prior to administration. C. Tell healthcare providers that verbal orders will not be accepted. Rationale: Ways to reduce medication errors include checking the​ client's identification band prior to administration of​ medications, telling healthcare providers that verbal orders will not be​ accepted, and opening all of the medications immediately prior to administration. Medications should be documented on the medication administration record​ (MAR) after they have been administered. All orders do not need to be validated with another​ nurse, only the orders that the nurse is unsure about.

Which patient statements would the nurse evaluate as negatively affecting access to​ healthcare? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. An older adult​ says, "If I tell my doctor that I fall​ frequently, I might have to go to a nursing​ home." B. A young adult​ says, "A benefit of my new job is that it pays for my​ health, dental, and vision​ insurance." C. A client being discharged​ says, "Can you call my prescriptions in to the​ pharmacy?" D. The​ client's new insurance plan requires a​ $10 copay for office visits. E. A client asks to be discharged before noon as he has a​ 3-hour drive home.

A. An older adult​ says, "If I tell my doctor that I fall​ frequently, I might have to go to a nursing​ home." D. The​ client's new insurance plan requires a​ $10 copay for office visits. E. A client asks to be discharged before noon as he has a​ 3-hour drive home. Rationale: The older adult may not reveal a fall history out of concern for loss of independence and a change in living conditions. Even a​ low-cost copay may be difficult for some clients to afford. Living long distances from healthcare sources decreases access. Having a job that pays insurance helps ensure access. Being able to call prescriptions in to the pharmacy helps ensure access.

A nurse is planning a presentation regarding anthrax. What should the nurse​ include? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Anthrax can spread easily. B. There are three basic types of anthrax. C. Anthrax is killed by heat. D. The main area affected by inhalation anthrax is the lung periphery. E. Anthrax causes the release of multiple​ toxins, each affecting a different part of the body.

A. Anthrax can spread easily. B. There are three basic types of anthrax.

The nurse has several educational pamphlets for the client about medications the client is receiving. Prior to giving the client these​ pamphlets, what is the most important assessment by the​ nurse? A. Assess the​ client's reading level. B. Assess the​ client's ability to pay for the medication. C. Assess the​ client's cultural bias toward taking medicine. D. Assess the​ client's religious attitudes toward medicine.

A. Assess the​ client's reading level. Rationale: Educational pamphlets are ineffective if the reading level is above what the client can understand. Assessing the​ client's readiness to​ learn, cultural​ bias, and religious attitudes are important but not as important as the​ client's reading level.

Which client would be most likely to seek complementary and alternative therapies as a treatment​ modality? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. A​ 48-year-old male who wants to boost his immune system. B. A​ 22-year-old male athlete who is preparing for the Olympics. C. A​ 50-year-old female going through menopause. D. A​ 58-year-old male with prostate problems. E. None of these clients would be wise to seek these therapies.

A. A​ 48-year-old male who wants to boost his immune system. B. A​ 22-year-old male athlete who is preparing for the Olympics. C. A​ 50-year-old female going through menopause. D. A​ 58-year-old male with prostate problems. Review Only ​Rationale: The​ 58-year-old male client with prostate problems may begin treatment with alternative therapies. The​ 50-year-old female going through menopause may want to treat herself with alternative​ therapies, as menopause is not an illness. The​ 22-year-old male athlete who is preparing for the Olympics wants to be in the best possible condition and may use complementary and alternative therapies. The​ 48-year-old male can effectively boost his immune system by using complementary and alternative therapies. Complementary and alternative therapy includes such modalities as​ prayer, massage, and yoga as well as use of herbal remedies.​ Many, if not​ most, people participate in at least one form of these therapies.

The nurse is doing a holistic assessment on a client prior to starting antihypertensive medication. What should the nurse include in the​ assessment? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Blood pressure B. The biologic cause of the hypertension C. Mood D. Level of education E. Belief in a higher power

A. Blood pressure C. Mood D. Level of education E. Belief in a higher power ​Rationale: Holistic healthcare incorporates the whole client to include the biological​ (blood pressure), psychological​ (mood), sociocultural​ (level of​ education), and spiritual​ (belief in a higher​ power) dimensions. The biologic cause of the hypertension focuses on a specific​ disease, its​ cause, and​ treatment; this is a medical​ model, not a holistic model.

The client asks if there are any supplements that would help improve or preserve his memory. Which supplements would the nurse​ discuss? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. A. Carnitine B. Coenzyme Q10 C. Glucosamine D. DHEA E. Selenium

A. Carnitine D. DHEA ​Rationale: Carnitine and DHEA are used to improve memory. Coenzyme Q10 is used to prevent heart disease and to provide antioxidant therapy. Glucosamine is used to reduce symptoms of arthritis and other joint problems. Selenium is used to reduce risk of certain types of cancer.

The client has been exposed to anthrax. The nurse anticipates administering which of the following​ drugs? A. Ciprofloxacin​ (Cipro) and doxycycline​ (Vibramycin). B. Penicillin​ (Bicillin LA) and vancomycin​ (Vancocin). C. Ampicillin​ (Principen) and cefepime​ (Maxipime). D. Tetracycline​ (Sumycin) and erythromycin​ (Erythrocin).

A. Ciprofloxacin​ (Cipro) and doxycycline​ (Vibramycin).

The healthcare provider has prescribed a nitroglycerine​ (Nitrodur) patch for the client. The nurse understands that which of the following is the best outcome for this client as it relates to use of the​ medication? A. Client will demonstrate correct application of the patch prior to discharge. B. Client will be able to identify the expiration date of the medication prior to discharge. C. Client will verbalize three side effects of the medication prior to discharge. D. Client will state the reason for receiving the medication prior to discharge.

A. Client will demonstrate correct application of the patch prior to discharge. ​Rationale: The overall goal of nursing care related to pharmacotherapy is the safe and effective administration of medication. In this​ instance, the most important aspect of client teaching is that the client be able to correctly apply the patch. If the patch is not correctly​ applied, the other issues are irrelevant. The client does not need to identify side effects of the medication in order to correctly apply the patch. The client does not need to state the reason for the medication in order to correctly apply the patch. The client does not need to identify the expiration date of the medication in order to correctly apply the patch.

The nurse is preparing for medication administration to a group of clients. What is the best overall outcome for the​ clients? A. Clients will receive the best therapeutic outcome from the medications. B. Clients will take the medications after receiving medication instruction. C. Clients will state the reason they are receiving the medications. D. Clients will experience minimal side effects after taking the medications.

A. Clients will receive the best therapeutic outcome from the medications. Rationale: Outcomes should focus first on the therapeutic outcome of the medications. The fact that the client takes the medication is not the best overall outcome for the clients. The treatment of side effects is not the best overall outcome for the clients. Having the clients state the reason they are receiving the medications is the best overall outcome for the clients.

The nurse in charge of a clinical study welcomes the participants in an open forum. One client is surprised that there are men and women from several ethnic groups. The nurse explains that in the​ past, ethnic variables were largely unknown or ignored for what​ reasons? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Clinical trials failed to include ethnically diverse subjects. B. Clinical trials comprised mostly Caucasian males. C. Little attention was focused on identifying the different effects drugs had on various ethnic groups. D. Research proved there were no differences among ethnic groups. E. The large majority of clinical trials included Caucasian females.

A. Clinical trials failed to include ethnically diverse subjects. B. Clinical trials comprised mostly Caucasian males. C. Little attention was focused on identifying the different effects drugs had on various ethnic groups. Rationale: There was a lack of ethnic diversity in early clinical trials. Little attention was focused on identifying the differences in pharmacologic effects in diverse ethnic groups. Until​ recently, clinical trials comprised mostly Caucasian males.

A client is diagnosed with cancer. The healthcare provider has recommended​ chemotherapy, which would likely save the​ client's life. The client tells the​ nurse, "This is punishment from God for sins I have​ committed; some women at my church say​ so."? With permission from the​ client, what would the nurse do​ first? A. Contact the​ client's minister to discuss the​ client's perspective about cancer. B. Meet with family members to discuss the​ client's perspective about cancer. C. Involve a hospital minister to discuss the​ client's perspective about cancer. D. Plan to bring the case before the​ hospital's board of ethics.

A. Contact the​ client's minister to discuss the​ client's perspective about cancer. ​Rationale: When clients have strong religious​ beliefs, these can affect the outcome of the illness. The nurse should involve the​ client's religious leader when possible. Meeting with family might​ help; however, they may have the same perspective as the client. Bringing the case before the​ hospital's board of ethics is premature at this point. Involving a hospital minister may be an​ option, but it is best to work through the​ client's minister initially.

The nurse is teaching a class on anthrax to a group of emergency response workers. The nurse plans to include which of the​ following? A. Cutaneous anthrax is the most common​ form, but inhaled anthrax is the most lethal form. B. Anthrax most commonly affects wild rodents such as​ mice, rats,​ squirrels, and chipmunks. C. Anthrax is a deadly​ bacterium; the most common and deadly form is gastrointestinal anthrax. D. Cutaneous anthrax is serious because it quickly spreads by​ person-to-person contact.

A. Cutaneous anthrax is the most common​ form, but inhaled anthrax is the most lethal form.

A home health​ nurse's patient caseload is ethnically diverse. Which interventions show understanding of cultural​ variables? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Discussing cultural preferences for herbs and spices and possible alternatives when drug interactions are possible. B. Assessing the​ client's response to acupuncture for pain. C. Discussing the​ client's beliefs regarding treatment. D. Notifying the healthcare provider of the​ client's intentions to consult with a medicine man for spiritual guidance. E. Removing the​ client's collection of herbs to decrease the risk of an adverse effect when taken with Western medicine.

A. Discussing cultural preferences for herbs and spices and possible alternatives when drug interactions are possible. B. Assessing the​ client's response to acupuncture for pain. C. Discussing the​ client's beliefs regarding treatment. ​Rationale: It is important to assess the cultural use of herbs and spices and determine if there may be any interactions with prescribed medications. The nurse need not remove the herbs but rather should discuss possible adverse effects when the herbs are mixed with prescribed medications. The nurse can assess the​ client's response to acupuncture and interpret the effects on prescribed treatment with respect for the​ client's culture. Cultures view health and wellness in different ways. An understanding of the​ client's cultural beliefs allows the nurse to provide better support and guidance. As long as the medicine man does not​ "prescribe" any​ herbs, the nurse does not have to discuss this with the provider.

The Joint Commission documented that client education was deficient on several​ medical-surgical units of a local hospital. A nursing committee was formed to address this problem. What is the best intervention to improve client​ education? A. Discussing medications each time they are administered to clients. B. Requesting more frequent pharmacy consults for the clients. C. Providing educational pamphlets about medications to the clients. D. Asking the healthcare providers to provide medication education to the clients.

A. Discussing medications each time they are administered to clients. ​Rationale: Discussing medications each time they are administered is an effective way to increase the amount of education provided. Medication education is considered to be a responsibility of the​ nurse, not the healthcare provider or pharmacist. Educational pamphlets can be effective but are not as effective as the nurse providing education to the client.

The client takes St.​ John's wort for depression but does not tell the healthcare provider. The provider prescribes an SSRI. The nurse should monitor for which of the​ following? A. Dizziness B. Serum glucose level of 340 C. Sedation D. Serum potassium of 6.0

A. Dizziness ​Rationale: Dizziness is associated with serotonin​ syndrome, which may occur when St.​ John's wort and SSRIs are given concurrently. Combining St.​ John's wort and an SSRI does not result in hyperglycemia or hyperkalemia. It is more likely that concurrent administration of St.​ John's wort and an SSRI will result in agitation.

The nurse teaching a​ pre-conception class would tell participants that they should be most careful about exposure to drugs during which stage of​ pregnancy? A. Embryonic B. Each stage is equal in risk C. Preimplantation period D. Third trimester

A. Embryonic ​Rationale: The embryonic phase poses the greatest risk to fetal development as this is a time of rapid development of internal structures. During the preimplantation phase there is no direct link to the mother so exposure to a teratogen either causes death or has no effect. The goal should be to minimize exposure to all drugs for the length of​ pregnancy, but exposure during some time periods is more critical than exposure at other times.

The nurse understands that drug therapy is postponed until after pregnancy and lactation when possible. Which of the following acute and chronic conditions may be managed with drugs during​ pregnancy? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Epilepsy B. Serious cystic acne C. Sexually transmitted infections D. Gestational diabetes E. Hypertension

A. Epilepsy C. Sexually transmitted infections D. Gestational diabetes E. Hypertension Rationale: Epilepsy is a preexisting disease. It would not be wise to discontinue therapy during pregnancy and lactation. Sexually transmitted infections can harm the fetus. Gestational diabetes is a complication related to pregnancy that must be treated for the safety of both the mother and growing fetus. If hypertension is present prior to​ pregnancy, it would be unwise to discontinue therapy during pregnancy and lactation. Cystic acne may be treated with isotretinoin​ (Accutane). Isotretinoin is a Class X drug and can cause fetal brain damage. Other antibiotics such as tetracycline are Class D and should not be used in pregnancy.

A client with inflammatory arthritis asks about adding an​ anti-inflammatory herb to the medication regimen to decrease the use of prescription drugs. The nurse suggests the client discuss the efficacy of which herbs with the healthcare​ provider? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Evening primrose B. St.​ John's wort C. Ginger D. Ginseng E. Bilberry

A. Evening primrose B. St.​ John's wort C. Ginger ​Rationale: Evening primrose may be helpful in the relief of rheumatoid arthritis and other inflammatory symptoms. St.​ John's wort and ginger are believed to reduce inflammation. Ginseng is used to enhance the immune system. Bilberry is an antioxidant.

A​ client's genetic testing indicates the presence of a genetic polymorphism of the CYP 450 enzyme. The nurse expects this difference to be one of which​ classifications? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Extensive B. Poor C. Normal D. Ultrarapid E. Inefficient

A. Extensive B. Poor D. Ultrarapid ​Rationale: ​"Extensive," "poor," and​ "ultrarapid" are all classifications used to describe this change in drug metabolism. Since this client has a​ change, the metabolism would not be classified as​ "normal." "Inefficient" is not used to describe this change.

The nurse makes a medication​ error, but the client is not harmed. The​ client's family asks the nurse manager what is considered a medication error. How should the nurse manager​ respond? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Failure to follow healthcare​ provider's orders. B. Failure to give the right medication. C. Failure to give a medication at the ordered time. D. Failure to call the pharmacy and report that the medication has been given. E. Failure to give the right dose of the medication.

A. Failure to follow healthcare​ provider's orders. B. Failure to give the right medication. C. Failure to give a medication at the ordered time. E. Failure to give the right dose of the medication. Rationale: A medication error occurs if the client does not receive the drug as the healthcare provider intended it to be​ given, the client does not receive the drug the healthcare provider intended to be​ given, the client does not receive the drug at the time the healthcare provider intended it to be​ given, or the client does not receive the dose of the drug the healthcare provider intended to be given. The delivery of the medication is recorded on the medical administration record​ (MAR); the nurse does not report to the pharmacy each time a medication has been given.

A client with a family history of heart disease asks the nurse to recommend herbs that decrease the risk for heart disease. The nurse suggests the client discuss which herbs with the healthcare​ provider? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Flaxseed B. Green tea C. Soy D. Milk thistle E. Acai

A. Flaxseed B. Green tea C. Soy ​Rationale: Flaxseed is believed to reduce the risk of heart disease. Green tea is believed to increase LDL and​ cholesterol, which may reduce the risk for heart disease. Soy is believed to help prevent cardiovascular disease. Milk thistle is believed to be an antitoxin. Acai is an antioxidant.

A nurse is planning to teach a client about a new medication. What is the best teaching​ method? A. Give the client oral and written drug information and instructions. B. Leave written drug information and instructions at the bedside. C. Provide oral drug information and instructions as opposed to written. D. Instruct the client that their local pharmacy will teach them about this medication.

A. Give the client oral and written drug information and instructions. Rationale: Clients should be provided with oral and written drug information and instructions prior to discharge. Clients may receive these oral and written materials from their pharmacy but should be supplied initially by the hospital.

A client who is considering taking a dietary supplement recommended by the nurse asks how to determine if the supplement is safe. The nurse explains that the Dietary Supplement and Nonprescription Drug Consumer Protection Act of 2007 requires that companies marketing herbal and dietary supplements do which of the​ following? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Include their contact information on the label so consumers can report adverse effects. B. Notify the Food and Drug Administration​ (FDA) within 15 days of receiving a report of an adverse effect. C. Keep records of adverse effects for at least 6 years and make these records available for inspection by the Food and Drug Administration​ (FDA). D. Demonstrate product effectiveness prior to release of the product to the public. E. State which conditions the product is intended to cure or prevent.

A. Include their contact information on the label so consumers can report adverse effects. B. Notify the Food and Drug Administration​ (FDA) within 15 days of receiving a report of an adverse effect. C. Keep records of adverse effects for at least 6 years and make these records available for inspection by the Food and Drug Administration​ (FDA). ​Rationale: This legislation requires that the marketing​ company's contact information be listed on the label. The marketing company must notify the FDA of any reported adverse effects within 15 days. The marketing company must keep records of reported adverse effects for at least 6 years and make those records available to the FDA for inspection. This legislation does not require the marketing company to demonstrate the effectiveness of a product prior to release to the public. The marketing company cannot make the claim that a product can cure or prevent any conditions.

A student nurse asks a nurse what is included in the Strategic National Stockpile​ (SNS). The nurse explains that the SNS includes which of the following​ supplies? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Intravenous administration equipment B. Antibiotics C. ​Life-support medications D. Chemical antidotes E. Hospital beds

A. Intravenous administration equipment B. Antibiotics C. ​Life-support medications D. Chemical antidotes

A nursing instructor is planning to discuss the Dietary Supplement Health and Education Act​ (DSHEA) of 1994 with a group of nursing students. The instructor plans to include which of the​ following? A. It mandates that herbal product labels state that the products are not intended to​ diagnose, treat,​ cure, or prevent disease. B. It ensures that herbal products provide proof of their intended effects. C. It requires that herbal products undergo the same rigorous testing as drugs do under the FDA. D. It mandates that herbal product labels contain accurate information.

A. It mandates that herbal product labels state that the products are not intended to​ diagnose, treat,​ cure, or prevent disease. ​Rationale: The DSHEA does not require herbal products to conform to the same standards the FDA requires of drugs or to offer proof of their intended effects. It does require that herbal product labels state that they are not intended to​ diagnose, treat,​ cure, or prevent disease. It does not mandate label accuracy.

The nurse works for the Centers for Disease Control and Prevention​ (CDC). In planning for a bioterrorist​ attack, what will the best plan of the nurse​ include? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Learn the signs and symptoms of chemical and biological agents. B. Obtain a listing of health and law enforcement contacts. C. Assist in the stockpiling of medications. D. Obtain current knowledge of emergency management. E. Assist in triage at local hospitals.

A. Learn the signs and symptoms of chemical and biological agents B. Obtain a listing of health and law enforcement contacts. D. Obtain current knowledge of emergency management.

A community health nurse is preparing a teaching plan regarding medications and their potential adverse effects for a new parent class. The nurse should encourage parents to do which of the​ following? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Maintain a list of current medications for each child. B. Be aware of each​ child's medication allergies. C. Know what the​ child's prescribed medication is​ for, how it should be​ administered, and when to expect the child to feel better. D. Be aware that any leftover medication should be appropriately disposed​ of, not saved for future use. E. Read the prescription label for any foods the child should avoid while taking the medication and for possible adverse effects to watch out for.

A. Maintain a list of current medications for each child. B. Be aware of each​ child's medication allergies. C. Know what the​ child's prescribed medication is​ for, how it should be​ administered, and when to expect the child to feel better. D. Be aware that any leftover medication should be appropriately disposed​ of, not saved for future use. Rationale: Parents should make a complete list of all prescribed​ medications, over-the-counter​ drugs, and any vitamins the child takes. It is very important that parents be aware of a​ child's allergies in order to prevent an unnecessary allergic response. Parents should know what condition the​ child's medication is prescribed​ for, and​ how, when, and how much to administer. It is also important for parents to know when to expect the child to feel better so a​ follow-up visit can be made if the child is not feeling better. Parents should be aware that it is not safe to​ self-diagnose and treat with leftover medication. Parents should be aware the label often describes food and drinks to avoid. The label will not describe possible adverse​ effects; the nurse will need to describe these to the parents.

A nurse on the​ medical-surgical unit is caring for several very ill clients. One client​ says, "I was supposed to get my medications an hour​ ago." The nurse recognizes that medication errors can have what​ impact? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Medication errors can potentially extend the​ client's length of hospital stay. B. Medication errors can result in expensive legal costs to the facility. C. Medication errors can damage the​ facility's reputation. D. Medication errors can be physically devastating to nurse and client. E. Medication errors cause preventable deaths during hospitalizations. ​

A. Medication errors can potentially extend the​ client's length of hospital stay. B. Medication errors can result in expensive legal costs to the facility. C. Medication errors can damage the​ facility's reputation. E. Medication errors cause preventable deaths during hospitalizations. Rationale: Medication errors can cause​ harm, which can extend the​ client's length of stay. If a medication error causes a client​ harm, it can result in expensive legal fees for hospital defense. If the incidence of medication errors is​ publicized, it can cause the facility to be seen as unsafe or to be delivering substandard care. Medication errors are the most common cause of morbidity and preventable death within hospitals. Medication errors can be physically devastating to clients but would be emotionally devastating to the nurse.

The nurse preparing a teaching plan for a postpartum mother. The nurse plans to include which topics regarding​ breastfeeding? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Most medications are secreted into breast milk. B. Dietary supplements should be avoided. C. Herbal products are secreted into breast milk and have the potential to cause harm to the infant. D. All tobacco products should be avoided. E. Most drugs are safe to take right after breastfeeding because they will clear the bloodstream prior to the next feeding.

A. Most medications are secreted into breast milk. B. Dietary supplements should be avoided. C. Herbal products are secreted into breast milk and have the potential to cause harm to the infant. D. All tobacco products should be avoided. ​Rationale: The majority of drugs are secreted into breast milk. The safety of these products has not been determined. OTC drugs can be secreted into breast milk and have the potential to harm the infant. All products should be approved by the provider prior to use. Tobacco products should be avoided during lactation. Drugs should only be taken during breastfeeding if the benefits to the mother outweigh the risks to the infant.

The nurse is caring for several clients. Which clients have a psychosocial history that may affect their​ outcome? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Older adult who recently suffered a​ stroke, has an unsteady​ gait, and lives in a​ two-story home B. ​Middle-aged client with Down syndrome living in a group home C. Recently divorced mother of three children with breast cancer D. ​Sixteen-year-old requesting birth control without parental consent E. ​Seven-year-old with asthma in a foster care home

A. Older adult who recently suffered a​ stroke, has an unsteady​ gait, and lives in a​ two-story home B. ​Middle-aged client with Down syndrome living in a group home C. Recently divorced mother of three children with breast cancer ​Rationale: A client who had a stroke may not be able to return to a home that requires climbing stairs. A client with Down syndrome needs additional care to ensure that treatment outcome is successful. The client with breast cancer may be the​ family's sole provider and may have financial concerns. Many teens seek contraception without their​ parents' consent. This should not have a negative impact on outcome. Residing in foster care should not have a negative impact on outcome.

The nurse provides care for elderly clients in an assisted living facility. What does the nurse assess as a primary contributing factor for drug toxicity in the​ elderly? A. Older adults are frequently dehydrated. B. Older adults are frequently constipated. C. Older adults often abuse alcohol. D. Older adults have decreased stomach acid.

A. Older adults are frequently dehydrated. Rationale: Fluid deficit is a critical factor in the older adult that can contribute to medication complications. Older adults have a tendency to decreased stomach acid which may interfere with medication absorption. Frequent constipation is not a critical factor with medication complications in older adults. Alcohol abuse could be a factor in medication complications with older adults but is not as critical as fluid volume deficit

The nurse has been hired to work in the risk management office of a hospital. What situations would the nurse expect to be included in this​ job? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Participating in the investigation of a sentinel medication event B. Using the computer to track data C. Working with staff nurses to identify work flow problems D. Meeting with the nurse executive to identify nurses who are prone to medication errors E. Participating in a committee who will recommend changes to the policy and procedures regarding medication administration.

A. Participating in the investigation of a sentinel medication event B. Using the computer to track data C. Working with staff nurses to identify work flow problems E. Participating in a committee who will recommend changes to the policy and procedures regarding medication administration. Review Only ​Rationale: The risk management department investigates​ incidents, identifies​ problems, and makes recommendations to improve policy and procedures. Data management and tracking are a big part of the risk​ manager's job. Risk management departments are not tasked with identifying and reporting on nurses.

The client uses Ginkgo biloba to enhance memory functioning but has not told the nurse about this herb. The healthcare provider orders warfarin​ (Coumadin) for this client. Which findings may the nurse find upon​ assessment? A. Petechiae and bleeding from the gums. B. A blood glucose of 56. C. An international normalized ratio​ (INR) of 3.0. D. ​Headache, dizziness,​ sweating, and agitation.

A. Petechiae and bleeding from the gums. ​Rationale: Ginkgo biloba will interact with warfarin​ (Coumadin) to promote increased bleeding potential that may lead to petechiae and bleeding from the gums. An international normalized ratio​ (INR) of 3.0 is within a normal range. Hypoglycemia​ (blood glucose of​ 56) is not the result of an interaction between Ginkgo biloba and warfarin​ (Coumadin). Headache,​ dizziness, sweating, and​ agitation, which are signs of serotonin​ syndrome, are not the result of an interaction between Ginkgo biloba and warfarin​ (Coumadin).

A pregnant client suspected of drug abuse is admitted to the emergency department. The nurse plans to teach the client about which complications associated with drug use during​ pregnancy? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Preterm birth B. Low birth weight C. Birth defects D. Allergies to narcotics E. Increased labor

A. Preterm birth B. Low birth weight C. Birth defects Rationale: Illicit drugs can cause preterm​ birth, low birth​ weight, or birth defects. No research suggests that drug use can cause allergies to narcotics or increased labor.

During​ evaluation, the​ nurse, client, and healthcare provider determine that the goals of antibiotic therapy have not been met. What actions are​ indicated? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Review the dosage of the medication B. Consider checking serum drug levels C. Discard the idea that the infection is treatable D. Consider prolonging therapy E. Consider using a different antibiotic

A. Review the dosage of the medication B. Consider checking serum drug levels D. Consider prolonging therapy E. Consider using a different antibiotic Rationale: Just because the first evaluation is that the goal is not met does not indicate that the goal is not a good one or that the therapy is not going to work. The drug may work if the dosage is altered​ (which may be indicated by serum drug​ level) or if therapy is continued for a longer time. The antibiotic may need to be changed.

A postmenopausal client with a history of stroke is told she cannot take female hormones because of the risk for future thromboembolic events. The client asks about nonpharmacologic ways to manage her symptoms. Which herbs does the nurse suggest as​ alternatives? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Soy B. Black cohosh C. Evening primrose D. Saw palmetto E. Acai

A. Soy B. Black cohosh C. Evening primrose ​Rationale: ​Soy, black​ cohosh, and evening primrose are used to alleviate postmenopausal symptoms. Saw palmetto is used to decrease prostate hyperplasia. Acai is used as an antioxidant and for weight loss.

A nurse is providing care to a client who wears bilateral hearing aids. Which nursing interventions are​ indicated? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Speak a bit slower than normal. B. Speak more loudly than normal. C. Ensure that verbal and nonverbal communication is congruent. D. Allow extra time for communication. E. Use bright lighting in the room.

A. Speak a bit slower than normal. C. Ensure that verbal and nonverbal communication is congruent. D. Allow extra time for communication. Rationale: Speaking clearly and slowly is beneficial when communicating with those with hearing impairment. Use of gestures and body language is​ important, but incongruence between verbal and nonverbal communication can be very confusing for those with impaired hearing. It is important to allow adequate time for communication and responses. It is not necessary to speak loudly. Adequate lighting is necessary in any client​ encounter, but bright lighting is not always necessary. The presence of good lighting is not made more essential because the client has a hearing impairment.

A nurse has been asked to present health promotion information at a community clinic whose clients are primarily​ non-Hispanic Black women. After review of health disparity and inequality statistics the nurse chooses to include information about which​ disorders? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Stroke B. Coronary artery disease C. Diabetes D. Illicit drug use E. Prenatal care

A. Stroke B. Coronary artery disease C. Diabetes E. Prenatal care Rationale: The rate of premature death due to stroke and coronary artery disease is higher among​ non-Hispanic Blacks than among​ non-Hispanic Whites. Diabetes is highest among​ non-Hispanic Blacks and Whites. The infant mortality rate for​ non-Hispanic Black women is more than double that for​ non-Hispanic White women. Rates for​ drug-induced death​ (from both legal and illegal​ drugs) is highest among American​ Indians, Alaskan​ Natives, and​ non-Hispanic Whites.

A nurse is preparing to administer medications to a pregnant client. Which classification of drugs would the nurse refuse to​ administer? A. Teratogenic B. Cautionary C. Category A D. Category B

A. Teratogenic Rationale​: Drugs that are known to cause birth defects are called teratogenic or classified as category D or category X. Category A and B drugs are not known to cause birth defects. Cautionary is not a term used to describe a drug that causes birth defects.

A nurse is caring for a client that was exposed to radiation. The client asks the nurse what factors increase the amount of radiation that a person is exposed to. What should the nurse include in responding to the​ client's question? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. The amount of exposure. B. The​ long-lasting effects. C. The amount of cellular death. D. The gender of the client exposed. E. The amount of naloxone​ (Narcan) ingested after exposure.

A. The amount of exposure. B. The​ long-lasting effects. C. The amount of cellular death.

For which client would the nurse expect the healthcare provider to continue prescribed medications during​ pregnancy? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. The client recently diagnosed with gonorrhea B. The client with a history of frequent asthma attacks C. The client with hypertension D. The client with frequent insomnia E. The client with a family history of stroke

A. The client recently diagnosed with gonorrhea B. The client with a history of frequent asthma attacks C. The client with hypertension Rationale: Sexually transmitted​ infections, asthma, and hypertension are treated during pregnancy. Insomnia would not be treated during pregnancy. The client would not be treated unless she has a history of stroke.

The nurse is preparing a teaching plan for an older client who is taking multiple medications. Which principles should the nurse keep in mind during the planning​ phase? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. The client should have all prescriptions filled at the same pharmacy. B. The client should keep a list of all medications for easy accessibility. C. Older clients often take multiple drugs which is a common cause of medication errors. D. Polypharmacy is unique to older clients and is the most common cause of medication errors. E. The client should be aware of each prescribed​ medication, the​ dose, and possible side effects.

A. The client should have all prescriptions filled at the same pharmacy. B. The client should keep a list of all medications for easy accessibility. C. Older clients often take multiple drugs which is a common cause of medication errors. E. The client should be aware of each prescribed​ medication, the​ dose, and possible side effects. Rationale: It is common for older clients to have medical conditions requiring the use of multiple medications that could have possible interactions. Using one pharmacy will ensure the pharmacist will discover any problematic interactions between multiple drugs. Keeping a list available is important for unexpected trips to a healthcare facility. The use of multiple drugs for multiple chronic conditions is a common cause for medication errors in older clients. Knowing the​ names, dose, and possible side effects of medications will reduce the risk for medication errors. Polypharmacy is not unique to older​ clients, although it is most often seen in this group.

The nurse is beginning medication reconciliation for a newly admitted client. What should the nurse include in this​ list? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. The client takes ibuprofen for an occasional headache. B. The client mixes a powdered form of vitamin C into his morning orange juice. C. The client applies essential oils to his forehead to help with his or her allergies. D. The client drinks milk fortified with vitamin D. E. The client takes a prescription medication for osteoporosis once a week.

A. The client takes ibuprofen for an occasional headache. B. The client mixes a powdered form of vitamin C into his morning orange juice. C. The client applies essential oils to his forehead to help with his or her allergies. E. The client takes a prescription medication for osteoporosis once a week. Rationale: ​Over-the-counter medications such as​ ibuprofen, supplements such as the powdered vitamin​ C, herbals such as the essential​ oils, and all prescription medications are included in this list. Milk is standardly fortified with vitamin D so there is no reason to list it on the medication reconciliation list.

The nursing instructor teaches the student nurses about how medication errors can occur. What information will the nursing instructor include in the​ presentation? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. The nurse miscalculates the medication dose. B. The nurse does not check the​ client's identification band. C. The nurse does not validate an order with the healthcare provider. D. The nurse misinterprets a healthcare​ provider's order. E. The nurse administers the incorrect drug.

A. The nurse miscalculates the medication dose. B. The nurse does not check the​ client's identification band. D. The nurse misinterprets a healthcare​ provider's order. E. The nurse administers the incorrect drug. Rationale: Medication errors may be related to​ misinterpretations, miscalculations, and misadministration. The nurse should always check the​ client's identification band. As long as the nurse understands the healthcare​ provider's order, there is no need to validate the order with the healthcare provider.

A nurse is planning to teach a client about the relationship of complementary and alternative therapies to pharmacology What should the nurse​ include? A. They can reduce client medication needs. B. They serve as competitors and should not be promoted. C. They are more effective than medication use. D. They have​ little-to-no value in disease prevention and treatment.

A. They can reduce client medication needs. ​Rationale: Complementary and alternative therapies can reduce client medication needs and therefore lower the risk of adverse effects. They are not generally more effective than medications but do have value in disease prevention and treatment. Both​ complementary/alternative therapies and pharmacology should be used together to provide holistic client care.

The nurse plans to administer medication to a preschool child. Which approach indicates the nurse has an understanding of growth and​ development? A. Use a brief​ rationale, followed by quick administration of the medication. B. There should be no need to restrain a child of this age. C. The child does better with verbal instruction than with play instruction. D. The child is often more cooperative if the parent is not in the room.

A. Use a brief​ rationale, followed by quick administration of the medication. Rationale: A brief​ rationale, followed by quick​ administration, decreases the​ child's anxiety and promotes cooperation with the medication process. It may be necessary to restrain a preschool child for medication administration. Having a parent in the room usually promotes more cooperation from the preschool child. Preschool children do better with play instruction.

A nurse is administering medications to a client. The client​ states, "I've never taken that yellow pill​ before". What should the nurse do​ first? A. Verify the order and​ double-check the label. B. Contact the health provider to verify it is the correct medication and dose. C. Reassure the client that the nurse has triple checked the drug so it is safe to take. D. Tell the client that some are made by different pharmaceutical companies and may look different.

A. Verify the order and​ double-check the label. Rationale: The same medication produced by two different pharmaceutical companies may be a different​ shape, size,​ color, etc.​ However, the nurse should always verify the medication order and medication label. Nurses should always check every medication three times before administering it to the client.​ However, when a client questions a​ medication, the nurse should always verify the medication order and medication label again before administering it to the client. The nurse does not need to contact the healthcare provider at this time.​ Instead, the nurse should always verify the medication order and medication label again before administering it to the client. When a client questions a​ medication, the nurse should always verify the medication order and medication label again before administering it to the client to prevent medication errors.

A nurse is teaching a community group about holistic medicine. Which information should the nurse include about Western​ medicine? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Western medicine focuses on the cause of disease. B. Western medicine is not compatible with holistic medicine. C. Western medicine is not compatible with holistic medicine. D. Disease is often viewed as a malfunction in a specific body system. E. Western medicine may focus on disease treatment

A. Western medicine focuses on the cause of disease. D. Disease is often viewed as a malfunction in a specific body system. E. Western medicine may focus on disease treatment. Rationale: Western medicine often focuses on determining which disease is present and what caused it. In Western medicine disease is often viewed as a specific malfunction of a body part. Western medicine often focuses on the treatment of a​ disease, not the care of the client with the disease. Western medicine is compatible with holistic​ medicine, but this requires that those providing care remain mindful of the individuality of the client. Disease and treatment are typically at the center of Western medicine.

A client experiencing occasional minor digestive problems asks the nurse about herbal therapy. What is the best response by the​ nurse? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Wheat grass B. Green tea C. Ginger D. Grape seed E. Stevia

A. Wheat grass B. Green tea C. Ginger Rationale: Wheat grass is used to improve digestion. Green tea is used to decrease nausea and vomiting. Ginger is used to decrease nausea. Grape seed is an antioxidant. Stevia is a natural sweetener.

The client​ says, "I am convinced that the​ mind-body interventions I am using are improving my​ health." The nurse would ask additional questions about which complementary and alternative therapies that belong to this​ category? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Yoga B. Massage C. Dance D. Herbal therapies E. Biofeedback

A. Yoga B. Massage C. Dance E. Biofeedback ​Rationale: ​Yoga, massage,​ dance, and biofeedback are types of​ mind-body interventions. Herbal therapies are a type of​ biologic-based therapy.

The nursing instructor is teaching student nurses about the use of viruses in a bioterrorism attack. The nurse determines that learning has occurred when the students make which​ statement? A. ​"A bioterrorist attack with viruses is a real threat to​ Americans." B. ​"Most Americans have already been vaccinated against the lethal​ viruses." C. ​"Actually, a bigger concern is a nuclear weapon exploding in a​ city." D. ​"The Centers for Disease Control and Prevention​ (CDC) has a plan to vaccinate Americans against most​ viruses."

A. ​"A bioterrorist attack with viruses is a real threat to​ Americans."

The nurse assesses the client with diabetes mellitus prior to administering medications. Which questions are important to ask the​ client? Select all that apply. A. ​"Are you allergic to any​ medications?" B. ​"Are you taking any herbal or​ over-the-counter (OTC)​ medications?" C. ​"How difficult is it for you to maintain your ideal body​ weight?" D. ​"Will you please tell me about the kind of diet you​ follow?" E. ​"What other medications are you currently​ taking?"

A. ​"Are you allergic to any​ medications?" B. ​"Are you taking any herbal or​ over-the-counter (OTC)​ medications?" D. ​"Will you please tell me about the kind of diet you​ follow?" E. ​"What other medications are you currently​ taking?" Rationale: Questions about allergies and which medications are being taken are assessment questions. Questions about normal diet help to assess health management and are pertinent to drug administration. Ideal body weight is an important question but does not refer specifically to medication administration.

The nurse teaches a class to clients about how to help prevent medication errors when in the hospital. What is the most important question for the nurse to ask the​ clients? A. ​"Do you know the names of all the medications you​ take?" B. ​"Do you trust your healthcare provider to order the correct​ medication?" C. ​"Do you know what your illness​ is, and if you will need​ surgery?" D. ​"Do you have a friend to verify that you are receiving the correct​ medication?"

A. ​"Do you know the names of all the medications you​ take?" ​Rationale: Knowing the names of all medications taken can reduce drug errors when a client is admitted to the hospital. Knowing the illness and anticipating surgery do not necessarily help prevent medication errors. Asking the clients if they trust their healthcare providers to order the correct medication is inappropriate. It is inappropriate for friends of clients to verify medications prior to administration.

A nurse who is presenting community education​ states, "Drugs are among our most powerful weapons for emergency​ preparedness." What additional​ statements, made by the​ nurse, would support this​ statement? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"Drugs help us treat the diseases that could be caused by​ bioterrorism." B. ​"We can use drugs to neutralize our​ enemies." C. ​"If we control the manufacture and distribution of​ drugs, we will control global​ politics." D. ​"Without drugs, we might be quickly overwhelmed by a bioterrorist​ attack." E. ​"Drugs can be used in chemical or nuclear​ attacks."

A. ​"Drugs help us treat the diseases that could be caused by​ bioterrorism." D. ​"Without drugs, we might be quickly overwhelmed by a bioterrorist​ attack." E. ​"Drugs can be used in chemical or nuclear​ attacks."

The older adult asks the nurse how dietary supplements will help support health. What is the best response by the​ nurse? A. ​"Fish oil will help to enhance your brain​ function." B. ​"Soy isoflavone will help prevent​ Alzheimer's disease." C. ​"Chromium will help you achieve and maintain optimum​ weight." D. ​"Dietary supplements will help support and maintain​ hydration."

A. ​"Fish oil will help to enhance your brain​ function." ​Rationale: ​Omega-3 fatty acids are neuroprotective and will enhance brain function. Dietary supplements do not support and maintain hydration. There​ isn't any evidence to support that chromium helps with weight maintenance. Soy isoflavone will help reduce the risk of certain types of cancer but will not help prevent​ Alzheimer's disease.

A client asks the nurse why a medication prescribed by the provider​ "didn't do anything at​ all." Which statement by the nurse accurately describes how genetics influence drug​ action? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"Genetic differences can result in significant differences in how each​ client's body handles the same​ medication." B. ​"Genetic differences can cause mutations in​ enzymes, changing the way they function. This can alter how the body metabolizes and excretes​ drugs." C. ​"Because of genetic​ differences, medication may accumulate to toxic levels in one client while in another client may be inactivated before it can have a therapeutic​ effect." D. ​"Genetic differences can be expressed as an alteration in the structure of an​ enzyme, which can cause a defective receptor and an allergic response to​ drugs." E. ​"Genetic differences in clients who are biracial result in an allergic response to​ medications."

A. ​"Genetic differences can result in significant differences in how each​ client's body handles the same​ medication." B. ​"Genetic differences can cause mutations in​ enzymes, changing the way they function. This can alter how the body metabolizes and excretes​ drugs." C. ​"Because of genetic​ differences, medication may accumulate to toxic levels in one client while in another client may be inactivated before it can have a therapeutic​ effect." Rationale: ​99.8% of human DNA sequences are identical. The remaining​ 0.2% can account for significant differences in​ people's ability to handle medications. The structure of an enzyme is closely related to its function. A mutation can cause a change in the structure of the​ enzyme, resulting in a change in its function. When enzymes are functionally changed by​ genetics, metabolism and excretion can be​ altered, resulting in the drug either accumulating or being inactivated. Small changes in the structure of a protein may result in a defective receptor that will not accept the drug and the drug not having any therapeutic effect. This is not an allergic response. Genetic differences can result in mutations of enzymes or​ proteins, which may result in changes in function. Being of a certain race may predispose a client to mutations​ and, therefore, uncommon responses to​ medication, but this does not mean the client will have an allergic response to medications.

The nurse is conducting a holistic assessment of a client with alcoholism. What are the important questions the nurse would​ ask? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"How is drinking alcohol viewed by your​ culture?" B. ​"Have you ever attended Alcoholics Anonymous​ meetings?" C. ​"Did you see your parents drinking alcohol when you were growing​ up?" D. ​"Have you been in alcohol rehabilitation before​ now?" E. ​"What blood relatives of yours are addicted to​ alcohol?"

A. ​"How is drinking alcohol viewed by your​ culture?" C. ​"Did you see your parents drinking alcohol when you were growing​ up?" E. ​"What blood relatives of yours are addicted to​ alcohol?" ​Rationale: ​Biological, environmental, and cultural questions are valid questions to ask during a holistic assessment. Participation in a rehabilitation program refers to treatment and does not have relevance to a holistic assessment. Participation in Alcoholics Anonymous meetings refers to treatment and does not have relevance to a holistic assessment.

The nurse is providing education about warfarin​ (Coumadin) to a patient of Asian ancestry. The nurse determines that learning has occurred when the client makes which​ statement? A. ​"I may need less medication than someone from a different ethnic​ group." B. ​"I may need more medication than someone from a different ethnic​ group." C. ​"I may need to have less frequent blood​ tests." D. ​"I may need to have more frequent blood​ tests."

A. ​"I may need less medication than someone from a different ethnic​ group." ​Rationale: A client of Asian ancestry may be a poor metabolizer of warfarin​ (Coumadin), so they will often require lower dosages. There is no need for clients of Asian ancestry to have more or less frequent blood tests than other clients.

The nurse is teaching clients in a senior center about complementary and alternative therapies. Which statement by a client indicates understanding of the information the nurse has​ presented? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"I see now that​ 'natural' doesn't really mean​ 'safe,' and I should ask my healthcare provider about any supplements I want to​ take." B. ​"I didn't realize some herbal supplements may be just as strong as a prescription drug. I will need to discuss any supplements I want to try with my​ doctor." C. ​"I understand now that when I choose to use a natural product over a prescription​ medication, I could be delaying my​ recovery." D. ​"It's good to know that herbs contain ingredients that are as powerful as a prescribed medication and are an option for safe and effective​ therapy." E. ​"It's good to know that herbs contain ingredients that are as powerful as a prescribed medication and are an option for safe and effective​ therapy."

A. ​"I see now that​ 'natural' doesn't really mean​ 'safe,' and I should ask my healthcare provider about any supplements I want to​ take." B. ​"I didn't realize some herbal supplements may be just as strong as a prescription drug. I will need to discuss any supplements I want to try with my​ doctor." C. ​"I understand now that when I choose to use a natural product over a prescription​ medication, I could be delaying my​ recovery." ​Rationale: Many herbal products are not standardized and may contain dozens of active​ chemicals, many of which have not been identified and​ studied, making these products potentially unsafe. Some herbs contain active chemicals that are just as powerful as approved prescription medications. Any time a client chooses to use an unproven alternative therapy instead of an​ established, effective medical​ treatment, healing may be delayed. Herbs may or may not be a safe option. The active ingredients can cause interactions with other prescribed drugs. It is not unusual for an herbal supplement to contain dozens of chemicals from the​ flowers, leaves, or roots of the plant. Clients who have food allergies should consult with their health provider before using any herbal product.

nurse has provided discharge medication instructions to the parents of a child being released from the emergency department. The nurse evaluates that learning has occurred when the parents make which​ statements? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"I should give this antibiotic as prescribed until the bottle is​ empty." B. ​"I should use a spoon to give this​ medication." C. ​"I will keep this medication in the refrigerator as the label​ directs." D. ​"If my child develops any adverse​ effects, I will discard the rest of the​ medicine." E. ​"This antibiotic should help to clear my​ child's infection."

A. ​"I should give this antibiotic as prescribed until the bottle is​ empty." C. ​"I will keep this medication in the refrigerator as the label​ directs." E. ​"This antibiotic should help to clear my​ child's infection." Rationale: Antibiotics should be given until the medication is gone. The label will designate storage instruction. The parents should understand the reason the medication is being prescribed. Medications should be administered with standard​ devices, not household objects. The parent should notify the​ prescriber, not just discard the medication.

The nurse in the emergency department is caring for several clients from diverse cultures. Which statement shows the​ nurse's ability to provide culturally competent​ care? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"I understand your religion prohibits blood transfusions. Would you consider nonblood​ alternatives?" B. ​"I just want to make sure you and your spouse understand the risks as you consider the​ options." C. ​"I don't really understand why you are afraid to take the medication. Do you have any questions I can answer to alleviate your​ fear?" D. ​"I really​ don't understand why you​ won't consider an abortion. Your admission papers say you are an​ atheist." E. ​"I'm not quite sure why the healthcare provider is giving you these prescriptions. You​ didn't get them filled the last time you were​ here."

A. ​"I understand your religion prohibits blood transfusions. Would you consider nonblood​ alternatives?" B. ​"I just want to make sure you and your spouse understand the risks as you consider the​ options." C. ​"I don't really understand why you are afraid to take the medication. Do you have any questions I can answer to alleviate your​ fear?" Rationale: The nurse providing culturally competent care is respectful of and sensitive to religious beliefs and open to alternate treatment. The nurse encourages client to open up about fears. There are social factors that may contribute to nonadherence to therapy.

A client returns to the clinic for​ follow-up after taking a newly prescribed medication for a month. The nurse recognizes medication teaching was successful when the client makes which​ statement? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"I've been taking my medication on an empty stomach like the prescription label said​ to." B. ​"I take my medication first thing in the​ morning, just like you​ said." C. ​"I have been able to decrease my medication to every other day and that saves me some​ money." D. ​"I switched all my medications to one pharmacy like you​ suggested." E. ​"Did you say I need to take this medication with water or​ milk?"

A. ​"I've been taking my medication on an empty stomach like the prescription label said​ to." B. ​"I take my medication first thing in the​ morning, just like you​ said." D. ​"I switched all my medications to one pharmacy like you​ suggested." ​Rationale: Statements about taking medication as directed indicate the client is adhering to instructions. Changing dosage schedule without direction indicates failure to follow instruction. If the client is unsure of​ instructions, it is less likely that the correct administration technique is being followed.

A new nurse on the orthopedic floor makes a medication error. Which statements by the nurse manager foster a safe environment in which nurses will report medication​ errors? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"Many of us have made a medication error in our careers. The most important issue is to identify why the error​ occurred." B. ​"I know you could not feel any worse than you already do. We need to discuss how this error happened and how we can prevent it from happening​ again." C. ​"It's really good that your client is OK and did not suffer any harmful effects of this error. We should discuss why this error occurred and how it can be prevented in the​ future." D. ​"Because you are a new​ nurse, we should sit down and discuss the procedure you followed to see what you could have done to prevent this​ error." E. ​"We need to sit down as soon as possible and write up an incident report describing everything you did incorrectly that caused this​ error."

A. ​"Many of us have made a medication error in our careers. The most important issue is to identify why the error​ occurred." B. ​"I know you could not feel any worse than you already do. We need to discuss how this error happened and how we can prevent it from happening​ again." C. ​"It's really good that your client is OK and did not suffer any harmful effects of this error. We should discuss why this error occurred and how it can be prevented in the​ future." D. ​"Because you are a new​ nurse, we should sit down and discuss the procedure you followed to see what you could have done to prevent this​ error." Rationale: All errors should be investigated with the goal of identifying why they occurred. This investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear of punishment. An incident report will need to be​ written, but the nurse who made the error should feel the report will identify factors contributing to the error rather than place blame.

The nurse is planning care for a pregnant client prone to substance abuse. When the client​ states, "My baby​ isn't getting my​ drugs, I​ am," how does the nurse​ respond? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"Most illicit drugs will cross the placenta and hurt the​ baby." B. ​"Drugs may work longer in your​ baby." C. ​"Some drugs result in your baby not growing​ enough." D. ​"You are correct. You are far enough along in your pregnancy that drugs will not harm your​ baby." E. ​"If you continue to take​ drugs, it will make you have a large​ infant."

A. ​"Most illicit drugs will cross the placenta and hurt the​ baby." B. ​"Drugs may work longer in your​ baby." C. ​"Some drugs result in your baby not growing​ enough." Review Only ​Rationale: Most illicit drugs cross the placenta and can cause premature​ birth, low birth​ weight, birth​ defects, and withdrawal symptoms. Because the fetus lacks mature metabolic enzymes and efficient excretion​ mechanisms, drugs will have a prolonged duration of action within the unborn child. Some drugs result in intrauterine growth retardation. The effect the drug has on the fetus will depend on the stage of fetal development. While withdrawal can cause irritability in infants born to drug​ addicts, the risk for irritability is not the reason for abstaining from drug use during pregnancy. There is a greater potential for harm during the first​ trimester, but nutrients to the fetus can be compromised by drug abuse during the latter stages of pregnancy.

A pregnant client asks the nurse about changing from her prescription antidepressant medication to St.​ John's wort because it is natural. What is the best response by the​ nurse? A. ​"St. John's wort is a​ drug, and this should be discussed with your healthcare​ provider." B. ​"Yes, you can​ change, but let your doctor know at your next​ appointment." C. ​"It should be okay because your baby has been exposed to an​ antidepressant." D. ​"No, herbal preparations are just not safe to take during​ pregnancy."

A. ​"St. John's wort is a​ drug, and this should be discussed with your healthcare​ provider." ​Rationale: All herbal preparations are​ drugs, and their use should be discussed with the healthcare provider when a client is pregnant. St.​ John's wort is not okay because the baby has not been exposed to it specifically. It is not safe to tell a pregnant woman she can change antidepressants. Some herbal preparations may be safe during pregnancy.

The nurse prepares to teach clients about the safety and efficacy of herbal preparations. Which statement would be included in the best plan by the​ nurse? A. ​"The manufacturer does not have to prove the safety or efficacy of the herbal​ preparation." B. ​"The label on the herbal preparation is required by the Dietary Supplement Health and Education Act​ (DSHEA) to be​ accurate." C. ​"Herbal preparations must be tested for safety and efficacy prior to​ marketing." D. ​"Herbal preparations have to meet the same safety and efficacy standards as prescription and​ over-the-counter (OTC)​ drugs."

A. ​"The manufacturer does not have to prove the safety or efficacy of the herbal​ preparation." ​Rationale: Herbal products are not regulated by the Food and Drug Administration​ (FDA) for safety standards. They are regulated by a far less rigorous​ law, the Dietary Supplement Health and Education Act​ (DSHEA) of​ 1994, which does not require the manufacturer to demonstrate efficacy or safety of the herbal product. The federal government does not require herbal preparations to be tested for safety and efficacy prior to marketing. The Dietary Supplement Health and Education Act​ (DSHEA) does not regulate the accuracy of the​ label; the product may or may not contain the product​ listed, in the amounts claimed. Herbal preparations do not have to meet the same safety standards as prescription and​ over-the-counter (OTC) drugs.

The client tells the nurse that she is concerned about terrorist activity and questions if everyone should be immunized against smallpox. What is the best response by the​ nurse? A. ​"The vaccine has side​ effects, which are serious and could kill many​ people." B. ​"The vaccine has some serious side​ effects, but this is probably a good​ idea." C. ​"I really do not think our country has enough vaccine to do​ this." D. ​"Don't be so​ concerned; if an attack​ comes, we will immunize people​ then."

A. ​"The vaccine has side​ effects, which are serious and could kill many​ people."

The nurse is teaching the importance of drugs for emergency preparedness to local firemen. The nurse determines that learning has occurred when the firemen make which​ statements? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"The vendor-managed inventory​ (VMI) package can reach any community within 24 to 36​ hours." B. ​"Our local hospital is supposed to be stockpiling​ antibiotics." C. ​"The push package can reach any community within 12 hours of an​ attack." D. ​"The Strategic National Stockpile is located at the Centers for Disease Control and Prevention​ (CDC) in​ Atlanta." E. ​"Our country's drug stockpile is managed by the Centers for Disease Control and Prevention​ (CDC)."

A. ​"The vendor-managed inventory​ (VMI) package can reach any community within 24 to 36​ hours." C. ​"The push package can reach any community within 12 hours of an​ attack." E. ​"Our country's drug stockpile is managed by the Centers for Disease Control and Prevention​ (CDC)."

The client confides in the nurse that he or she is drawn to complementary and alternative medicine because it promotes the​ "whole person." The client would like spirituality and prayer included in his or her plan of care. What is the best response by the​ nurse? A. ​"We will include spirituality in your plan. Would you like to say a​ prayer?" B. ​"I think your spiritual concerns are best left up to you and your​ minister." C. ​"We usually do not pray with​ clients; is there something you are worried​ about?" D. ​"What exactly do you mean by spirituality and​ prayer?"

A. ​"We will include spirituality in your plan. Would you like to say a​ prayer?" ​Rationale: Complementary and alternative medicine tends to include the​ "whole person" more than traditional medicine does. The nurse should offer to pray with the client if the client requests this. Refusing to acknowledge the​ client's spiritual​ concerns, and referring him or her to his or her​ minister, does not treat the​ "whole person." Asking the client to clarify what he or she means by spirituality and prayer could be appropriate but is not the best answer. Telling the client that the nurse does not usually pray with clients will discourage him or her from discussing spirituality.

The risk management department is using a​ root-cause analysis to improve a nursing​ unit's medication administration accuracy. What questions will be used to develop this​ tool? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"What kind of errors are​ occurring?" B. ​"What is the current medication administration accuracy​ rate?" C. ​"How do the unit nurses rank in the number of errors​ committed?" D. ​"What do the nurses think can be done to prevent errors from​ continuing?" E. ​"What is the impact of changes made to improve​ accuracy?"

A. ​"What kind of errors are​ occurring?" B. ​"What is the current medication administration accuracy​ rate?" D. ​"What do the nurses think can be done to prevent errors from​ continuing?" E. ​"What is the impact of changes made to improve​ accuracy?" Review Only ​Rationale: The current medication administration accuracy rate helps to​ determine, "What​ happened?" Asking what kind of errors are occurring helps to answer the​ question, "Why did it​ happen?" Asking nurses for suggestions helps to answer the​ question, "What can be done to prevent it from happening​ again?" The final question is​ "Has the risk of recurrence actually been​ reduced?" which can be answered by asking what the impact of interventions has been. Ranking the nurses in order of number of errors is punitive and is not part of the risk management process.

A nurse administering medications to a variety of patients on a​ medical-surgical floor recognizes that which clients may need additional education about medication​ adherence? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​Fifty-year-old recently remarried male taking antihypertensive medication B. ​Thirty-four-year-old female with family history of blood clots taking an estrogen oral contraceptive C. ​Thirty-eight-year-old male recently started on an antidepressant D. ​Twenty-eight-year-old female started on acne medication known to cause​ male-patterned hair growth E. ​Seventy-eight-year-old female being treated for shingles

A. ​Fifty-year-old recently remarried male taking antihypertensive medication B. ​Thirty-four-year-old female with family history of blood clots taking an estrogen oral contraceptive C. ​Thirty-eight-year-old male recently started on an antidepressant D. ​Twenty-eight-year-old female started on acne medication known to cause​ male-patterned hair growth Rationale: Antihypertensive medications can cause impotence. This client will need additional education about this possible side effect. Estrogen can cause an increased risk for thrombolytic​ events, especially in clients who have a positive family history. Taking an antidepressant may result in the man feeling​ weak, unhealthy, or dependent. Some acne medications cause increased hair growth in a male​ pattern, such as on the face. While controlling acne is a​ goal, the client may not want the extra hair growth. There is no indication that treatment for shingles requires education in excess of that which is generally provided.

Which information is essential for the nurse to collect when reviewing a​ client's medication​ list? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Drug names B. Drug manufacturer C. Dosage being taken D. Frequency of administration E. When last refill was obtained

A. Drug names C. Dosage being taken D. Frequency of administration Rationale- important for medication history

Which statement about the nursing process is​ accurate? A. Obtaining the outcomes is essential for goal attainment. B. After selecting the nursing​ diagnosis, interventions are completed. C. ​Generally, goals are more measurable than outcomes. D. Goals involve very specific criteria that evaluate interventions.

A. Obtaining the outcomes is essential for goal attainment. Rationale: Outcomes are​ specific, measurable criteria that are used to measure goal attainment. The planning phase​ (including outcomes and​ goals) follows nursing diagnosis. Outcomes are generally more measurable than goals as they are more specific. Goals are more general than specific.

The nurse was very busy and unfamiliar with a new​ medication, but administered it anyway. Later the nurse looked up the medication. How does the nurse manager evaluate this​ behavior? A. An error could have occurred because the nurse was unfamiliar with the medication. B. This was acceptable as long as the nurse looked up the action and side effects of the drug later. C. The nurse manager was partially at fault because the nursing unit was understaffed and the nurse was too busy. D. An error did occur because the nurse could have administered the medication via the incorrect route.

An error could have occurred because the nurse was unfamiliar with the medication. Rationale: Nurses should never administer a medication unless they are familiar with its uses and side​ effects; an error could have occurred because the nurse was unfamiliar with the medication. It is not acceptable for a nurse to administer an unfamiliar medication and then look up the action and side effects​ later; an error could occur. An error did not​ occur, but could have because the nurse was unfamiliar with the medication. There is no information in the stem of the question that the nursing unit was​ understaffed, so the nurse manager is not partially at fault.

A nurse is teaching a student nurse about the active ingredients of herbal medicines. Which of the following indicates that teaching was​ effective? A. Are found only in the stems and leaves. B. Can be found in all parts of the herb. C. Are found only in the rhizome. D. Are found only in the root system.

B. Can be found in all parts of the herb. ​Rationale: The active ingredients of herbs can be found in all of their parts. These active ingredients are not limited to the root​ system, the​ rhizome, or the stems and leaves.

A client is a vegan vegetarian and does not eat any animal products. The healthcare provider has prescribed a medication contained in a gelatin capsule. The nurse understands that a gelatin capsule is made from animal products. Which nursing actions are​ indicated? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Do not tell the client the capsule contains gelatin. B. Collaborate with the prescriber to find an alternative medication. C. Check to see if the capsule can be opened for administration. D. Work to convince the client that this application does not violate vegetarian beliefs. E. Tell the client that the gelatin is an inactive ingredient in the medication.

B. Collaborate with the prescriber to find an alternative medication. C. Check to see if the capsule can be opened for administration. ​Rationale: An alternative dosage form that does not require use of a gelatin capsule may be available. Many capsules can be opened and the contents can be placed in fluid or on soft food for administration. Withholding information regarding the medication is not ethical. If the client is a vegan vegetarian the use of a gelatin capsule is a violation of belief. The nurse should not try to influence the client otherwise. Whether the gelatin is an active ingredient or an inactive ingredient is not relevant.

A nursing student asks a nurse how pharmacotherapy in the older adult is different than a​ middle-aged adult. How would the nurse​ respond? A. ​Generally, drug doses should be increased due to prolonged drug metabolism. B. Drug absorption is slower due to increased gastric pH. C. Increased body water can lead to a higher risk of drug toxicity. D. Plasma levels are​ increased, leading to a heightened drug response.

B. Drug absorption is slower due to increased gastric pH. Rationale: Older adults have an increase in gastric​ pH, which slows absorption. Plasma levels are​ lower, causing a diminished drug response. Body water is​ reduced, leading to a higher risk of drug toxicity.​ Generally, drug doses are reduced because of prolonged drug metabolism.

A nurse is reviewing medication records of older adults living in extended care. Which concepts about the pharmacotherapy of older adults should be​ considered? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​Plasma-binding of drugs is greater in those over age 65. B. Drug distribution is slowed in the older adult. C. The​ half-life of many drugs is lessened in older adults. D. ​First-pass metabolism is reduced in the older adult. E. Changes in the kidney may result in decreased drug excretion.

B. Drug distribution is slowed in the older adult. D. ​First-pass metabolism is reduced in the older adult. E. Changes in the kidney may result in decreased drug excretion. ​Rationale: The aging cardiovascular system has decreased cardiac output and less efficient blood​ circulation, which slow drug distribution. The decline in hepatic function reduces​ first-pass metabolism. Changes in the kidney result in decreased drug excretion. The aging cardiovascular system has decreased cardiac output and less efficient blood​ circulation, which slow drug distribution. Enzyme production in the liver is decreased and the visceral blood flow is​ diminished, resulting in reduced hepatic drug metabolism and increased drug​ half-life.

The nursing instructor teaches student nurses about the Food and Drug Administration​ (FDA) Pregnancy Categories. What should the nurse​ include? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Food and Drug Administration​ (FDA) Pregnancy Category C is safe to use during pregnancy B. Food and Drug Administration​ (FDA) Pregnancy categories provide a framework for safe use of drugs in pregnant women. C. Food and Drug Administration​ (FDA) Pregnancy categories for individual drugs seldom change once they are established. D. Food and Drug Administration​ (FDA) Pregnancy categories are based on studies using clinical human research trials. E. Food and Drug Administration​ (FDA) Pregnancy Category X has been associated with teratogenic effects.

B. Food and Drug Administration​ (FDA) Pregnancy categories provide a framework for safe use of drugs in pregnant women. E. Food and Drug Administration​ (FDA) Pregnancy Category X has been associated with teratogenic effects. Rationale: Food and Drug Administration​ (FDA) Pregnancy Categories provide a framework for safe use of drugs in pregnant women. Food and Drug Administration​ (FDA) Pregnancy Category X has been associated with teratogenic effects. Food and Drug Administration​ (FDA) Pregnancy Categories are based on animal studies. Pregnancy Category C is not necessarily​ safe, it just means that animal studies have shown an adverse​ effect, but​ well-controlled studies in pregnant women have not been done. Food and Drug Administration​ (FDA) Pregnancy categories for individual drugs do change based on reported effects on fetuses.

A nurse is caring for a client being treated for seizures. The nurse would be most concerned if the client is also taking which herbal​ product? A. Goldenseal B. Ginkgo C. Feverfew D. Ginger

B. Ginkgo ​Rationale: Of the listed​ herbs, ginkgo has the greatest potential for decreasing the effects of anticonvulsants.

A nurse manager is discussing medication errors with a group of nurses. Which statement by the nurses indicates the teaching was​ effective? A. An incorrect dose​ (based on​ weight) is​ ordered, dispensed, and administered to a client. The administering nurse and ordering clinician would be the only parties held accountable. B. Handwritten orders are more frequently associated with medication errors than are typed orders. C. Nurses are always liable when a medication error occurs. D. A nurse who observes the five rights will prevent all medication errors from occurring.

B. Handwritten orders are more frequently associated with medication errors than are typed orders. ​Rationale: Handwritten orders can be​ illegible, leading to higher medication error rates. Although the nurse is a major player in medication​ safety, there are instances when medication errors occur that do not involve the​ nurse, such as when clients take medications at home. Observing the five rights is essential to avoiding medication errors but will not prevent all medication errors from occurring. The clinician ordering the​ medication, the nurse administering the​ medication, and the pharmacist dispensing the medication would be held accountable.

A nurse is caring for a client following a bioterrorism attack. The client has experienced initial nausea and vomiting followed by weight loss and eventual thyroid cancer. What was the most likely causative​ agent? A. Chemical agent B. Ionizing radiation C. Viral agent D. Bacterial agent

B. Ionizing radiation

The nurse plans to teach a safety class to parents of toddlers about household exposure to medications. What should the nurse​ include? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Keep the toddler awake and observe for side effects of the medication. B. Keep all medications locked up and stored out of reach of the toddler. C. Use syrup of ipecac immediately if the toddler has ingested medication. D. Call the Poison Control Center for guidance with any medication ingested. E. Teach the toddler that medications are for adult use only.

B. Keep all medications locked up and stored out of reach of the toddler. D. Call the Poison Control Center for guidance with any medication ingested. Rationale: Locking up medications is the safest way to childproof the home. The Poison Control Center should be contacted for any type of medication the toddler has ingested. Syrup of ipecac should only be used if recommended by the Poison Control Center. The Poison Control Center should be​ contacted, and they will advise if the child is to be kept awake. It is unrealistic to expect a toddler to understand that medications are for adult use only.

A nurse is planning a discussion of emergency preparedness with newly hired nurses. Which events would this nurse use as historical examples of​ terrorism? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. The death of a client in a Texas hospital was confirmed to be due to the Ebola virus. B. Many people died as a result of sarin gas exposure in a Tokyo subway. C. ​Twenty-two confirmed or suspected cases of anthrax infection occurred as a result of the bacillus being sent through U.S. mail. D. There is typically a marked increase in overdoses during winter holidays. E. More people are contracting H1N1 avian influenza.

B. Many people died as a result of sarin gas exposure in a Tokyo subway. C. ​Twenty-two confirmed or suspected cases of anthrax infection occurred as a result of the bacillus being sent through U.S. mail.

The client is receiving albuterol​ (Proventil) for treatment of bronchospasm related to asthma. What is the primary nursing intervention as it relates to this​ medication? A. Monitor the​ client's serum drug levels. B. Monitor the client for relief of bronchospasms. C. Monitor the client for nausea and headache. D. Provide the client with​ age-appropriate education about albuterol​ (Proventil).

B. Monitor the client for relief of bronchospasms ​ Rationale: Monitoring drug​ effects, in this​ case, the relief of​ bronchospasms, is a primary intervention that nurses perform. Nausea and headache are expected side​ effects, but monitoring for these side effects is not part of the primary intervention. Education about medication is important but is not part of the primary intervention. Monitoring of serum drug levels for albuterol​ (Proventil) is not indicated.

A​ client's genetic testing reveals a change in CYP2A6. The nurse would plan which interventions based on this​ discovery? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Teaching the client to avoid​ caffeine-containing drugs. B. Planning additional time and interventions to help the client stop smoking. C. Use of an alternative to the drug warfarin. D. Increased surveillance for the development of lung cancer. E. Frequent monitoring of blood pressure.

B. Planning additional time and interventions to help the client stop smoking. D. Increased surveillance for the development of lung cancer. ​Rationale: CYP2A6 reduction may make smoking cessation more difficult and increases risk of lung cancer. It is not associated with caffeine or blood pressure level. CYP2C9 is associated with reduced metabolism of warfarin.

The client has been exposed to a nerve agent. For which symptoms will the nurse most likely​ assess? A. Pinpoint pupils and decreased blood pressure. B. Salivation and involuntary urination. C. Dilated pupils and increased heart rate. D. Rapid Tachypnea and​ cold, clammy skin.

B. Salivation and involuntary urination.

A student nurse asks a nurse how specialty supplements differ from herbal products. What is the​ nurse's best​ response? A. Herbal products are more specific in their actions. B. Specialty supplements can come from animal sources. C. Specialty supplements are generally targeted for more general conditions. D. Specialty supplements must be prescribed.

B. Specialty supplements can come from animal sources. ​Rationale: Specialty supplements can come from animal and plant sources. They are generally more specific than herbs and targeted for a smaller number of conditions. Prescriptions are not required.

A Hispanic man has been diagnosed with​ attention-deficit/hyperactivity disorder​ (ADHD), and is taking methylphenidate​ (Ritalin). Even though the drug helps with focus and​ grades, the client will not go to the school office at noon for his medication. Which statement best describes the result of the​ nurse's evaluation? A. The adolescent is fearful that this drug may be a​ "gateway drug" and he will abuse other substances. B. The adolescent is embarrassed about having to take medicine at​ school; it is a social stigma. C. The adolescent really does not need an additional dose of methylphenidate​ (Ritalin) at school. D. The adolescent has developed alternative coping mechanisms to increase his focus during classes.

B. The adolescent is embarrassed about having to take medicine at​ school; it is a social stigma. ​Rationale: Some clients believe that having to take drugs in school will cause them to be viewed as​ weak, unhealthy, or dependent. Clients can also perceive this as a social stigma. Methylphenidate​ (Ritalin) is a​ short-acting drug and doses must be administered about 4 hours​ apart, so the client must receive a dose during school hours.​ Attention-deficit/hyperactivity disorder is a​ brain-based disorder, and the primary treatment is​ medication; alternative coping mechanisms will not usually help to increase focus during classes. Appropriate treatment of​ attention-deficit/hyperactivity disorder will result in less addiction to​ mood-altering substances, not more addiction.

A client has been admitted to the emergency department for treatment of poison ingestion. Gastric lavage and placement of activated charcoal has been prescribed. The nurse would withhold this treatment and collaborate with the prescriber if which instances​ occur? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. The client vomits. B. The client becomes unconscious. C. The client discloses that lithium was the drug taken. D. Paramedics report that it has been 2 hours since the drug was taken. E. The client begins to pass copious amounts of watery diarrhea.

B. The client becomes unconscious. C. The client discloses that lithium was the drug taken. D. Paramedics report that it has been 2 hours since the drug was taken.

The healthcare provider has prescribed quetiapine​ (Seroquel) for the client with chronic auditory hallucinations. The client has stopped taking the medication. The nurse incorrectly uses the diagnosis of​ "noncompliance." In which situation would this diagnosis be​ appropriate? A. The client reported a physical change as the reason for stopping the medication. B. The client made an informed decision not to take the medication. C. The client was unsure about how to order a refill for the prescription. D. The client did not understand why the medication was prescribed.

B. The client made an informed decision not to take the medication. Rationale: Noncompliance assumes that the client has been properly educated about the medication and has made an informed decision not to take it. A lack of understanding for the reason the medication was prescribed or being unsure of how to obtain a refill of the prescription is related to a knowledge​ deficit, not noncompliance. Reports of a physical change since taking the medication would be diagnosed as pertaining to the change.

An American Indian client has been admitted to the hospital for chemotherapy. At any given​ time, five family members are in the​ client's room. The nurse tells the client that according to hospital​ policy, only two visitors at a time are allowed. What does the best analysis by the nurse manager reveal about the​ nurse's action? A. This was the correct​ action; the nurse was following protocol by informing the client about hospital policy. B. The nurse should have assessed the​ client's preferences about how many family members she wanted to be present. C. The nurse should have called the healthcare provider and obtained an order for additional family members to be present. D. The nurse should have allowed the client to have as many family members as she wanted to be present.

B. The nurse should have assessed the​ client's preferences about how many family members she wanted to be present. Rationale: The nurse should have assessed the​ client's preference about how many visitors she wanted in her room before so strictly interpreting the hospital rules. Many hospital​ rules, such as how many visitors are​ allowed, are flexible and do not have to be strictly​ interpreted; this client is in a private room. The nurse must be realistic with regard to the number of family visitors the client wants​ present; five family members is​ acceptable; twenty would be too many. This situation could be resolved by the​ nurse; there is no need for a healthcare​ provider's order at this point.

A client asks a nurse why herbal remedies are popular now. What is the nurse best​ response? A. They are more effective for treating bacterial infections. B. They are being marketed very aggressively. C. Most insurance policies cover them. D. Their popularity is​ decreasing, not increasing.

B. They are being marketed very aggressively. ​Rationale: The popularity of herbs and alternative therapies has increased since the 1970s due to several​ factors, including aggressive marketing. They are not more effective than antibiotics for treating bacterial infections and are generally not covered under insurance policies.

The nurse is managing care for several clients at a diabetic treatment center. The nurse understands that which of the following is the priority nursing​ intervention? A. To answer any questions the client may have about the​ medicine, or any possible side effect of the medication B. To return the client to an optimum level of wellness while limiting adverse effects related to the​ client's medical diagnosis C. To administer the correct medicine to the correct client at the correct dose and the correct time via the correct route D. To include any cultural or ethnic preferences in the administration of the medication

B. To return the client to an optimum level of wellness while limiting adverse effects related to the​ client's medical diagnosis ​Rationale: Interventions are aimed at returning the client to an optimum level of wellness and limiting adverse effects related to the​ client's medical diagnosis or condition. The correct​ client, dose, and time refer to the five​ "rights" of medication administration​ and, while​ important, is not the​ best, overall nursing intervention. Answering​ questions, the client may have is an appropriate intervention but is not the best overall intervention. While important to include cultural and ethnic​ preferences, this is not the best overall intervention.

Medication reconciliation has been started for a newly admitted client. At which points would the nurses and others caring for this client check this​ list? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Each time that medications are administered to the client. B. When initial admission orders are received. C. When the client is transferred to a different unit within the hospital. D. When the client is discharged. E. If a medication error occurs.

B. When initial admission orders are received. C. When the client is transferred to a different unit within the hospital. D. When the client is discharged. Rationale: This list of medications the client takes at home should be checked against admission orders and should be checked upon any transfer or discharge. Medication reconciliation sheets are not the same as medication administration records​ (MARs). There are many situations where a medication error might occur in which it is not necessary to check this list.

A nursing student asks a nurse how gender influences pharmacology. How should the nurse​ respond? A. Heart disease has traditionally been thought of as a​ woman's disease. B. Women tend to seek medical care earlier than men do. C. Studies indicate that men and women suffer from​ Alzheimer's disease in equal numbers. D. Since the​ 1980s, the FDA has mandated that research studies include both male and female subjects.

B. Women tend to seek medical care earlier than men do. Rationale: Women are quicker to seek medical care than are men. Studies indicate that more women than men suffer from​ Alzheimer's disease. In​ 1993, the FDA mandated that research studies include both male and female subjects. Cardiac disease has traditionally been thought of as a​ men's issue.

The nurse makes a medication error and a client dies. In​ court, the attorney for the family of the deceased client asks the nurse if she followed standards of care in administering the medication. How would the attorney phrase this​ question? A. ​"Did you follow agency guidelines as in previous​ circumstances?" B. ​"Did you do what another nurse would have done under similar​ circumstances?" C. ​"Did you follow the healthcare​ provider's orders and​ double-check them before​ administration?" D. ​"Did you do the three checks and follow the five rights as taught in​ school?"

B. ​"Did you do what another nurse would have done under similar​ circumstances?" ​Rationale: Standards of care refer to the actions that a reasonable and prudent nurse with equivalent preparation would do under similar circumstances. Standards of care do not refer to following healthcare provider orders. Standards of care do not refer to following agency guidelines. Standards of care do not refer to doing three checks or five rights.

An adolescent client comes to the school nurse with complaints of vague abdominal pain. What statement by the student would help to confirm the​ nurse's suspicion that the adolescent has body image​ concerns? A. ​"I have been sexually active with my​ boyfriend." B. ​"Everyone makes a big deal about what I​ eat, so​ don't ask." C. ​"My periods are irregular. Should I see a​ physician?" D. ​"I just​ can't seem to get along with my​ parents."

B. ​"Everyone makes a big deal about what I​ eat, so​ don't ask." Rationale: The adolescent could have an eating​ disorder, which may result from altered body image. Being sexually active with her boyfriend does not necessarily indicate an altered body image. Irregular menses do not necessarily indicate an altered body image. Arguments with parents do not necessarily indicate an altered body image.

The nurse is preparing an educational plan for parents about how to protect their children if a bioterrorist attack occurs. What is the best information to​ include? A. ​"Realistically, there is nothing that can be​ done." B. ​"Follow the Centers for Disease Control and Prevention​ (CDC) guidelines for​ immunizations." C. ​"Plan to call the Centers for Disease Control and Prevention​ (CDC) if an attack​ occurs." D. ​"Don't worry, the Centers for Disease Control and Prevention​ (CDC) has everything under​ control."

B. ​"Follow the Centers for Disease Control and Prevention​ (CDC) guidelines for​ immunizations."

Clients at a senior citizen center have asked the nurse to do a presentation on herbal preparations. Which statement would be included in the best plan by the​ nurse? A. ​"As long as the herbal preparation has been tested in the clinical​ setting, it is​ safe." B. ​"Herbal preparations actually are​ drugs; you must be careful with​ them." C. ​"Herbal preparations can be dangerous if you are allergic to​ them." D. ​"Herbal preparations are safe as long as you carefully read the​ label."

B. ​"Herbal preparations actually are​ drugs; you must be careful with​ them." ​Rationale: Herbal preparations are nonprescription drugs that have side effects and can interact with many other drugs. There​ isn't any clinical evidence to support that herbal preparations have been tested in the clinical setting or that they are safe. Reading the label does not mean the herbal preparation is​ safe; clients do not commonly recognize the interactions between herbal preparations and prescription medicines. Herbal preparations can be dangerous for reasons other than an allergy to the preparation.

The nurse manager would determine that a nurse understands culturally sensitive care if which statements are​ made? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"Since all of our clients have the same​ illnesses, I sometimes get​ bored." B. ​"I have been helping my client understand how to choose foods from our diet​ menu." C. ​"I am concerned because my client needs sterile dressing changes but has no running water at​ home." D. ​"My client and I worked out a way to get her medications delivered to her at​ home." E. ​"I invited a group from my church to come and sing hymns for our​ clients."

B. ​"I have been helping my client understand how to choose foods from our diet​ menu." C. ​"I am concerned because my client needs sterile dressing changes but has no running water at​ home." D. ​"My client and I worked out a way to get her medications delivered to her at​ home." ​Rationale: Helping the client cope and navigate through the hospital​ "culture" is a culturally sensitive action. Cultural sensitivity takes environment into consideration. Helping the client cope and navigate through potential blockers to medication adherence is a culturally sensitive action. A nurse who believes that clients who have the same illness are alike is not seeing their psychosocial needs. Imposing​ one's own religious beliefs on others is not culturally sensitive.

The client is receiving an oral antibiotic as treatment for cellulitis of the lower extremity. The​ client's outcome is​ "Client will state a key point about antibiotic treatment for​ cellulitis." Which statement would the nurse evaluate as best indicating this outcome has been​ met? A. ​"I must keep my leg elevated until the swelling goes​ down." B. ​"I need to take all the pills even if my leg looks​ better." C. ​"If the swelling​ continues, I can apply an ice​ pack." D. ​"If the pain gets too​ bad, I can take my prescribed pain​ medication."

B. ​"I need to take all the pills even if my leg looks​ better." ​Rationale: Taking all the medication even if the leg looks better is a key point about antibiotic therapy and meets the​ client's outcome. Keeping the leg elevated does not address the outcome for antibiotic treatment. Applying an ice pack does not address the outcome for antibiotic treatment. Taking pain medication does not address the outcome for antibiotic treatment.

The pregnant client plans to breastfeed her baby. She asks the nurse about the use of herbal products during breastfeeding. What is the best response by the​ nurse? A. ​"This should be​ fine, as long as there is at least 12 hours between the time you use the product and when you​ breastfeed." B. ​"Most drugs can be transferred to the infant during​ breastfeeding, so this is not​ recommended." C. ​"Herbal products are considered​ natural, so it should be fine to use them during​ breastfeeding." D. ​"Be sure to check the label to see if the herbal product could be used during​ breastfeeding."

B. ​"Most drugs can be transferred to the infant during​ breastfeeding, so this is not​ recommended." Rationale: It is best to avoid as many drugs as possible during breastfeeding. The bottle may not be labeled for​ breastfeeding, so the client should check with the nurse. There is no safety time limit established between the use of the product and breastfeeding. Herbal products are drugs.

The pregnant client tells the nurse that her prescribed medication is not as effective as it was before her pregnancy. What is the best response by the​ nurse? A. ​"Maybe the medication has​ expired; check the​ label." B. ​"This is because your blood volume has​ increased." C. ​"This is because your baby is receiving part of the​ medication." D. ​"Tell me how you have been taking your​ medication."

B. ​"This is because your blood volume has​ increased." Rationale: Increased blood volume results in hemodilution and increased excretion of the medication. The medication effectiveness is not reduced because of the baby. Asking the client how she is taking the medication is a good​ idea, but in this​ case, increased blood volume is responsible for decreased drug effect. The medication has most likely not​ expired; most clients have it refilled monthly.

The client tells the nurse that he or she has been taking herbal preparations to boost his or her immune system functioning. He or she does not know the names of the preparations. What is the best assessment question for the nurse to​ ask? A. ​"Would you please ask your wife or husband to call the hospital pharmacist with the​ names?" B. ​"Would you please have your wife or husband bring the bottles to the​ hospital?" C. ​"Would you please tell your doctor about the herbs during the next​ visit?" D. ​"Would you please ask your wife or husband to discuss this with me during her next​ visit?"

B. ​"Would you please have your wife or husband bring the bottles to the​ hospital?" Rationale: The best way for the nurse to assess the kinds of herbal preparations the client is taking is to actually look at the bottles. It is preferable for the nurse to do the assessment rather than to refer to the pharmacist. It is preferable for the nurse to do the assessment rather than to refer to the healthcare provider. Discussing the herbs with the nurse is the​ second-best answer, but having objective​ data, the​ bottles, will provide the best information.

The client is admitted to the hospital with sepsis following an elective abortion. The healthcare provider orders antibiotics that the client refuses​ stating, "I​ don't deserve​ them". What is the best response by the​ nurse? A. ​"It seems you think you should be punished because you had an​ abortion" B. ​"You have a serious infection and really need the​ drug." C. ​"I think you need to do what is best for​ you." D. ​"I'll call your healthcare provider and let him know about your​ decision."

B. ​"You have a serious infection and really need the​ drug." ​Rationale: Telling the client she needs the drug is providing the best care​ possible; this must be done even though the​ nurse's beliefs may be different from the​ client's beliefs. Telling the​ client, she needs to do what is best is​ inappropriate; the nurse knows she needs the drug. Calling the healthcare provider is​ inappropriate; the nurse knows the client needs the drug. Telling the client what she thinks is not appropriate.

The patient is from an Arab culture and is in labor and delivery. Her husband insists he must stay with her and will not allow her to receive any analgesia during the experience. What is the best action by the​ nurse? A. Inform the husband that he must sign a release of responsibility to avoid future litigation against the hospital B. Allow the request but inform the husband that the healthcare provider will make the final decision about analgesia C. Allow this request and be available in the event the request changes. D. Inform the husband that it is his​ wife's choice whether or not to receive analgesia.

C. Allow this request and be available in the event the request changes. ​Rationale: Nurses must allow and support cultural differences. The​ husband's decisions must be respected as long as client safety is not​ involved, and it is not involved in this situation. With some​ cultures, the husband makes the​ choices, not the wife or the healthcare provider. When cultural differences are allowed and​ supported, clients are not as likely to become involved in litigation.

The nursing supervisor tells a nurse that the medication error the nurse made yesterday has been determined to be a sentinel event. What should the nurse expect to​ occur? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Her employment will be terminated. B. Her personal malpractice insurance company will be notified. C. An immediate investigation will occur. D. Interventions to prevent the error from occurring again will quickly be put in place. E. A​ root-cause analysis will be performed.

C. An immediate investigation will occur. D. Interventions to prevent the error from occurring again will quickly be put in place. E. A​ root-cause analysis will be performed. Review Only ​Rationale: The investigation into a sentinel event is immediate with immediate initiation of interventions to prevent the error from recurring.​ Root-cause analysis is typically used to investigate sentinel events. Termination may occur but is usually unlikely. The​ hospital's malpractice insurance company may be​ notified, but the nurse is responsible for contacting personal companies.

A client asks a nurse what the common complications are due to​ drug-herbal interactions. How would the nurse​ respond? A. Vision loss B. Hair growth C. Blood coagulation D. Urine output

C. Blood coagulation ​Rationale: Many herbal products increase bleeding potential and reduce the effects of anticoagulant drugs. Hair​ growth, changes in urine​ output, and vision loss might be seen but are not common

A nursing instructor is teaching nursing students about the FDA Pregnancy Drug Categories. The instructor asks the students to what category a drug for which research has shown an adverse effect in animals but not in pregnant women would be categorized as. The instructor knows learning has occurred with which student​ response? A. Category D B. Category C C. Category B D. Category A

C. Category B Rationale: A drug that has adverse effects in animals but not in pregnant women is a Category B drug. Category A drugs have shown no adverse effects in women. Category D drugs have demonstrated risk to pregnant women. Category C drugs have had either no animal studies or adverse effects in animal studies with no adequate studies in women.

A nurse has admitted a new client to the unit. Which concepts should the nurse use when developing a nursing​ diagnosis? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Base the nursing diagnosis on the medical diagnosis B. Focus on what the nurse needs to help the client return to health C. Include the client in the identification of needs D. Consider the​ client's response to the current health problem E. Be certain the diagnosis is measurable

C. Include the client in the identification of needs D. Consider the​ client's response to the current health problem Rationale: A nursing diagnosis is a clinical judgment concerning human response to health conditions and should be client focused. Including the client in the formulation of nursing diagnoses encourages more active involvement in working toward meeting identified goals. It is not dependent on the medical diagnosis. Goals and outcomes need to be​ measurable, not nursing diagnosis.

The nurse is administering medications to an older adult. Which laboratory tests are most important for the nurse to assess prior to the administration of​ medication? A. Arterial blood gases​ (ABGs) and basic metabolic panel B. Lipid panel and thyroid function tests C. Kidney and liver function tests D. Complete blood count​ (CBC) and electrolytes

C. Kidney and liver function tests Rationale: Renal and hepatic function tests are essential for many​ clients, particularly older clients and those who are critically​ ill, as these will be used to determine the proper drug dosage. Complete blood count​ (CBC) and​ electrolytes, lipid panel and thyroid function​ tests; and ABGs and a basic metabolic panel are not likely to help in determining the proper drug dosage.

The clinic nurse will immediately alert the healthcare provider when which category X drugs are identified on the medication record of a recently diagnosed pregnant​ patient? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Tetracycline B. ACE inhibitor antihypertensive medication C. Methotrexate D. Isotretinoin​ (Accutane) E. Oral contraceptives

C. Methotrexate D. Isotretinoin​ (Accutane) E. Oral contraceptives Rationale: ​Methotrexate, isotretinoin, and oral contraceptives are in category X and should be avoided during pregnancy. Tetracycline is in category​ D, not category X. It should be avoided during​ pregnancy, and the nurse should alert the healthcare provider. ACE inhibitor antihypertensive drugs are in category C and are considered safe during pregnancy.

A client presents with hypotension and bradycardia. The client indicates that one of her healthcare providers recently prescribed three new medications to her current list of 10 medications per day. Based on this​ information, which statement would be the most​ accurate? A. The client is not in compliance with her prescribed medications. B. The client is having an allergic reaction to one of the new medications. C. The client is experiencing adverse reactions as a result of polypharmacy. D. The client is experiencing an adverse effect that will go away in time.

C. The client is experiencing adverse reactions as a result of polypharmacy. Rationale: Polypharmacy increases the risk of drug interactions and side effects. It is not appropriate to assume the side effects will go away. The information provided does not reveal anything about client compliance. Bradycardia and hypotension do not necessarily indicate an allergic reaction.

A nurse is developing a care plan for a client. Which client outcome statements are correctly​ formatted? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. The client will understand the effects of the medication administered prior to discharge. B. The nurse will administer all medications with ten minutes of their scheduled time. C. The client will identify two adverse effects of enoxaprarin​ (Lovenox) prior to​ self-administering the drug. D. The client will verbalize the storage requirements for NPH insulin prior to discharge. E. The healthcare provider will discuss the desired effects of discharge medications with the client the evening before discharge.

C. The client will identify two adverse effects of enoxaprarin​ (Lovenox) prior to​ self-administering the drug. D. The client will verbalize the storage requirements for NPH insulin prior to discharge. ​Rationale: In order to be​ complete, the client outcome measure must be client​ (not nurse or healthcare​ provider) focused, must contain a measurable​ verb, must have the specific circumstances to be​ evaluated, and must have a time line.

All of the clients listed have cancer and are receiving chemotherapy. Which client does the nurse evaluate as having the highest probability for a​ remission? A. The client who is a former healthcare provider B. The wealthy client who can afford the best medical care available C. The client with a support group of cancer survivors D. The client who is also seeing a psychiatrist for treatment of depression

C. The client with a support group of cancer survivors ​Rationale: Positive attitudes and high expectations toward therapeutic outcomes in the client may influence the success of pharmacotherapy. The support group of cancer survivors would provide the best support and the highest probability for a positive outcome. A wealthy client can afford the best medical​ care, but this client may not have good psychosocial support. Treatment for depression might help the​ outcome, but this client would not have as high a probability for remission as the client with another resource. A former healthcare provider may have a sound knowledge base about​ cancer, but this client might not have good psychosocial support.

The nurse in the emergency department administers an adult dose of an antibiotic to a​ 3-month-old baby. As a​ result, the baby suffers permanent brain damage. What best describes the effect of this error on the healthcare​ facility? A. The healthcare facility will pay a very large settlement. B. The professional license of the nurse will be lost. C. The morale of the staff involved will be decreased. D. The reputation of the healthcare facility will suffer.

C. The morale of the staff involved will be decreased. Rationale​: Medication errors that result in permanent damage increase​self-doubt and destroy the morale of all staff​involved; some may choose to leave the nursing profession. Payment of a large settlement is not the primary​concern; staff morale is the concern. The professional license of the nurse may or may not be lost depending on the circumstances of the case. The reputation of the facility will probably​suffer, but this is not as important as the staff morale.

The nurse is assessing a newly admitted​ client's current medication. Which of the following is an example of objective​ data? A. The​ client's wife tells the nurse what medications the client has been receiving. B. The client lists the medications that have been prescribed. C. The nurse checks the prescription bottles the client has brought to the hospital. D. The nurse asks the healthcare provider what medications the client was currently taking.

C. The nurse checks the prescription bottles the client has brought to the hospital. Rationale: Objective data includes information gathered through​ assessment, and not​ necessarily, what the client says or perceives. The most reliable and objective assessment by the nurse is to check the​ client's prescription medication bottles. A list of medications provided by the client and the​ client's wife is​ subjective, not objective data. Asking the healthcare provider what medication the client was receiving is subjective​ data, and the healthcare provider may not remember all the medication the client was receiving.

A nurse is preparing to administer a new drug that was just prescribed by the healthcare provider. The nurse recognizes that the wrong concentration of the drug was sent by pharmacy. What is the​ nurse's best​ response? A. The nurse does not report or document the​ error, since the error did not result in any harm to the patient. B. The nurse does not report the​ error, because the error was caught and corrected prior to drug administration. C. The nurse informs the​ client, documents the error as per hospital​ policy, and notifies the healthcare provider. D. The nurse reports the error to the healthcare provider and the charge nurse but does not document the error due to possible legal action.

C. The nurse informs the​ client, documents the error as per hospital​ policy, and notifies the healthcare provider. Rationale: The nurse should report and document all medication errors whether the client was harmed or not. It is essential to report and document medication errors to identify possible system​ failures, even when the error is caught prior to administration or has potential for legal action.

The client is receiving a​ beta-blocker medication. The nurse has done medication education and provided the client with printed information to take home. During the next​ appointment, the nurse notes that the client is not taking the medication properly. What is a therapeutic assessment question to ask this​ client? A. ​"Don't you understand how important it is to take the​ medicine?" B. ​"Do I have to inform your healthcare provider about your​ noncompliance?" C. ​"Are you able to read and comprehend the printed​ information?" D. ​"Why didn't you take your medicine as we talked​ about?"

C. ​"Are you able to read and comprehend the printed​ information?" ​Rationale: Many​ English-speaking clients do not have functional​ literacy, a basic ability to​ read, understand, and act on health information. The nurse should ask the client about the ability to read and understand printed information. Asking​ "why" questions put the client on the​ defensive, and the nurse might not receive the most accurate answer. Being confrontational with a​ "don't you​ understand" question is as demeaning as asking a​ "why" question. It is inappropriate to involve the healthcare provider before the nurse assesses the reason for​ noncompliance, and this question is threatening.

The client takes several prescription medications and asks the nurse about using complementary and alternative medicine​ (CAM). What is the best reply by the​ nurse? A. ​"CAM is a good idea that you should discuss with your healthcare​ provider." B. ​"CAM has not been demonstrated to help with your kind of​ symptoms." C. ​"CAM is an approach that might reduce your need for​ medications." D. ​"CAM might​ help, but you will still need your​ medications."

C. ​"CAM is an approach that might reduce your need for​ medications." ​Rationale: From a pharmacology​ perspective, much of the value of complementary and alternative medicine​ (CAM) therapies lies in their ability to reduce the need for medications. Complementary and alternative medicine​ (CAM) has been demonstrated to alleviate many client symptoms. Complementary and alternative medicine​ (CAM) often reduces the need for prescription medications. The nurse can answer the​ client's questions; they do not need to be referred to the healthcare provider.

The client comes to the emergency department with an anxiety attack. He or she tells the nurse he heard that there was another anthrax attack in the capitol and is concerned about running out of medications. What is the best response by the​ nurse? A. ​"Your health is in danger due to the​ anxiety; we really need to focus on reducing your anxiety​ now." B. ​"You don't need to worry about another attack at​ all; I think our government can take care of​ us." C. ​"The Centers for Disease Control and Prevention​ (CDC) maintains a large stockpile of medications for us in case that​ occurs." D. ​"I'm sure the Centers for Disease Control and Prevention​ (CDC) has contingency plans in the event of an anthrax​ attack."

C. ​"The Centers for Disease Control and Prevention​ (CDC) maintains a large stockpile of medications for us in case that​ occurs."

A healthcare provider has prescribed a chemotherapeutic drug for a client with cancer. This drug commonly causes loss of hair. The client asks the​ nurse, "Will all of my hair fall​ out?" What is the most therapeutic response by the​ nurse? A. ​"We are not really​ sure; applying an ice bag to your head may​ help." B. ​"It might. Have you discussed this with your healthcare​ provider?" C. ​"Yes, that is one of the expected side effects of this​ medication." D. ​"Don't worry, we can recommend an excellent wig company if need​ be."

C. ​"Yes, that is one of the expected side effects of this​ medication." Rationale: The nurse must always be forthright in explaining drug actions and potential side​ effects; minimizing potential adverse effects can result in a distrust of the nurse. Ice bags can minimize hair loss with some​ clients, but the nurse is not honestly answering the​ client's question. Telling a client not to worry is one of the most nontherapeutic responses a nurse can make. In this​ case, the​ nurse, not the healthcare​ provider, is responsible for answering the​ client's questions.

The nurse is reviewing the steps of the nursing process with a student. The nurse knows that the student understands the teaching when the student correctly lists which of the following as the correct order of the nursing​ process? A. Establish nursing​ diagnosis, assessment,​ intervene, collaborate, evaluation B. Establish​ goals, assessment,​ intervention, planning, communication C. ​Assessment, establish nursing​ diagnosis, planning,​ interventions, evaluation D. ​Assessment, planning, establish​ objectives, communication, evaluation

C. ​Assessment, establish nursing​ diagnosis, planning,​ interventions, evaluation Rationale: The primary steps​ (in order) include​ assessment, establish nursing​ diagnosis, planning,​ interventions, evaluation. Although some steps might not be in this precise​ order, assessment is done first. Communication is important but is not a primary step of the nursing process.

The African American client has panic​ attacks, is​ suicidal, and is on an inclient psychiatric unit. The healthcare professional prescribes sertraline​ (Zoloft) and clonazepam​ (Klonopin). The client refuses the drugs. The client also requests to have herbs and African objects in his room to​ "remove the​ curse." What is the priority action by the​ nurse? A. Allow the request without seeking further information from the client. B. Allow the request after the client signs a release of responsibility to avoid litigation. C. Allow the request after all members of the treatment team agree to it. D. Allow the request as long as the herbs and objects do not pose a safety risk for the client or other clients.

D. Allow the request as long as the herbs and objects do not pose a safety risk for the client or other clients. ​Rationale: Nurses must grant ethnic requests as long as the request does not pose a safety risk to the client or others. To allow an ethnic request without seeking further information about safety could jeopardize client safety. There is no need for the client to sign a release of responsibility to avoid​ litigation; if items pose a safety​ risk, they cannot be allowed on the unit. The treatment team does not need to agree to this​ request; the nurse can approve it as long as the items do not pose a safety risk.

The nurse is reviewing the steps of the nursing process with a student. The nurse is aware that it is most important to be accurate in which portion of the nursing​ process? A. Diagnosis B. Planning C. Evaluation D. Assessment

D. Assessment ​Rationale: Assessment is the basis for the development of the rest of the steps of the nursing process. While the nurse always strives to be​ accurate, inaccuracies in assessment will translate as inaccuracies in the remaining steps. While accuracy in​ evaluation, diagnosis, and planning is​ important, it is more important to be accurate in assessment.

A client is admitted to the emergency department with suspected exposure to anthrax. The nurse anticipates the healthcare provider will prescribe which​ medication? A. Antiviral agents. B. Atropine. C. Anthrax vaccination. D. Ciprofloxacin.

D. Ciprofloxacin.

Following a bioterrorism​ attack, the nurse finds that the victims are suffering from​ small, black lesions on their forearms. The nurse collaborates with the healthcare provider to treat exposure to which​ agent? A. Phosgene gas B. Gastrointestinal anthrax C. Hydrogen cyanide D. Cutaneous anthrax

D. Cutaneous anthrax

The African American client had a myocardial infarction and is receiving atorvastatin​ (Lipitor). The nurse assesses the​ client's diet to be very high in fat. What is the best plan by the nurse to improve the​ client's diet and reduce the risk for additional​ medications? A. Give the client information specific to African Americans about​ low-fat diets. B. Ask an African American nurse to speak to him about a​ low-fat diet. C. Obtain a consult for dietary services so a dietician can teach the client about​ low-fat diets. D. Discuss his diet with whomever prepares meals for his family.

D. Discuss his diet with whomever prepares meals for his family. Rationale: Every culture has​ culture-specific diets; the nurse must include the person in the family who does the meal preparation if a different diet is to be successful. Asking the client about having an African American nurse speak to him is racist and implies that a Caucasian nurse cannot understand the dietary needs of an African American client. At this​ point, a consult by dietary services is premature. Providing information is a good​ idea, but the nurse must also teach the client.

The nurse assesses an adverse effect of a medication that has been administered. Who should the nurse report this adverse effect​ to? A. Food and Drug​ Administration's (FDA) Med MARX Website. B. Food and Drug​ Administration's (FDA) Safe Medicine Website. C. Food and Drug​ Administration's (FDA) Adverse Event Website. D. Food and Drug​ Administration's (FDA) MedWatch Website.

D. Food and Drug​ Administration's (FDA) MedWatch Website.

A nurse is reviewing safe medication administration with a student nurse. What should the nurse plan to include in the​ teaching? A. Discontinue a medication at the request of a client B. Use abbreviations while charting to save time C. Administer medications intramuscularly when a client refuses to take it orally D. Give medications within the time frame specified by hospital policy

D. Give medications within the time frame specified by hospital policy Rationale: Administering medications as specified by agency policy is meeting the standard of care. Discontinuing medications is outside the scope of nursing. Changing the route of medication administration requires an​ order, and would not be​ appropriate, since the client is refusing it. Using abbreviations might save time but is not generally considered meeting a standard of care.

A nurse working in an obstetric practice should consider which fact when discussing medication use with pregnant​ clients? A. Drug excretion rates are lowered. B. Oral drug absorption rate is lowered. C. Drugs should not be used during pregnancy. D. Inhaled drugs may be absorbed to a greater extent.

D. Inhaled drugs may be absorbed to a greater extent. Rationale: Increase in tidal volume and pulmonary vasodilation during pregnancy may lead to inhaled drugs being absorbed to a greater extent. Gastric emptying is​ delayed, leading to prolonged oral drug absorption rates. Renal blood flow is​ increased, leading to higher excretion rates. Some circumstances call for drug administration during pregnancy.

The nurse will administer medication to a​ school-age child. What is the best action by the​ nurse? A. Tell the child he will not be allowed to go to recess if the medication is not taken. B. Teach the child the action and expected side effects of the medication. C. Offer to play with the child prior to medication administration. D. Offer the child a choice of beverage with which to take the medication.

D. Offer the child a choice of beverage with which to take the medication. Rationale: Offering the child a choice fosters cooperation and compliance. Playing with the child is a preschool child activity. Teaching child the action and expected side effects of the medication is too advanced for the​ school-age child. Threatening a​ school-age child will antagonize​ him; he will most likely not take the medication.

The client was exposed to cutaneous anthrax 2 weeks ago. What will the nurse see when assessing the​ client's skin? A. ​Small, fluid-filled​ vesicles, and​ later, small skin erosions B. Large pustules and​ later, reddish scabs C. Ulcerated areas and​ later, keloids D. Small skin lesions and​ later, black scabs

D. Small skin lesions and​ later, black scabs

The adolescent is supposed to go to the school nurse at​ 12:00 to receive his medication for​ attention-deficit/ hyperactivity disorder​ (ADHD). He often does not go for the medication. What best describes the​ nurse's understanding of this​ situation? A. The adolescent forgets that he is supposed to take the medication. B. The adolescent has made a conscious decision not to take the medication. C. The adolescent does not understand the need for the medication. D. The adolescent is embarrassed in front of his peers.

D. The adolescent is embarrassed in front of his peers. Rationale: Adolescents relate strongly to peers and are easily​ embarrassed; the adolescent does not want to be made fun of. The adolescent is most likely not forgetting the medication. Most adolescents receiving​ attention-deficit/hyperactivity disorder​ (ADHD) medication recognize that it helps them. Most adolescents know why they are receiving medication.

The client is being treated for a cardiac dysrhythmia with amiodarone​ (Cordarone). The client has elevated liver function tests​ (LFTs). Which assessment finding would the nurse suspect as contributing to the elevated​ LFTs? A. The client was taking St.​ John's wort for depression. B. The client was taking gingko biloba for memory problems. C. The client was taking​ Kava-Kava for anxiety. D. The client was taking Echinacea to treat cold symptoms.

D. The client was taking Echinacea to treat cold symptoms. ​Rationale: Echinacea and amiodarone​ (Cordarone) can lead to hepatotoxicity. There​ isn't any interaction between St.​ John's wort and amiodarone​ (Cordarone). There​ isn't any interaction between Kava and amiodarone​ (Cordarone). There​ isn't any interaction between gingko biloba and amiodarone​ (Cordarone).

The nurse commits a medication error. The nurse documents the error in the​ client's record and completes the incident report. What does the nurse recognize as the primary reason for doing​ this? A. To protect the client from further harm B. To protect the nurse from liability C. To protect the healthcare facility from litigation D. To verify that the​ client's safety was protected

D. To verify that the​ client's safety was protected Rationale: Documentation in the​ client's medical record and completion of an incident report verify that the​ client's safety was protected. Documentation of an error does not necessarily protect the healthcare facility from litigation. The client has already been​ harmed; the documentation will not protect the client from future harm. Documentation of an error does not necessarily protect the nurse from liability.

The public health nurse notices that several clients in the hypertension clinic have poorly controlled​ hypertension, even though they have been prescribed appropriate antihypertensive drugs. Which question will best enable the nurse to assess these​ clients? A. ​"Does your culture use herbs to treat high blood​ pressure?" B. ​"Does your religion allow the use of high blood pressure​ medication?" C. ​"Do you think your high blood pressure is a​ problem?" D. ​"Can you afford the high blood pressure​ medication?"

D. ​"Can you afford the high blood pressure​ medication?" Rationale: Once treatment is​ rendered, the cost of prescription drugs may be far too high for clients on limited incomes. The use of herbs may be important in the​ client's culture, but the cost of the medication is more likely the problem. To ask a client if they think hypertension is a problem should not be​ necessary; the nurse could eliminate this by appropriate medication education when the medication is prescribed for the client. Religious beliefs could result in the client not taking the​ medication, but the cost of the medication is more likely the problem.

The toddler refuses to take his oral medication. What is the best suggestion to the mother from the nurse for ensuring the toddler receives his​ medication? A. ​"Tell him you will buy him a toy if he takes the​ medication." B. ​"Crush the tablet and mix it with​ milk." C. ​"Tell him he will be punished if he does not take the​ medicine." D. ​"Crush the tablet and mix it with a small amount of​ jam."

D. ​"Crush the tablet and mix it with a small amount of​ jam." Review Only ​Rationale: Mixing the medication in jam will disguise the taste. The parent should not buy the​ child's compliance with a toy. Punishment will alienate the child and decrease compliance. Parents should avoid placing medication in milk as this may cause the toddler to avoid healthy foods.

The nurse conducts a seminar in a local community center on how citizens can be affected by radiation from a nuclear attack. The nurse determines that the education is effective when the clients make which​ statement? A. ​"I can protect myself from cancers by taking potassium iodide​ (KI)." B. ​"I need to stay inside my house for at least 2 days after the attack to be​ safe." C. ​"I need to take at least four showers every day or I will develop skin​ ulcers." D. ​"I am at risk to develop leukemia as a result of radiation​ exposure."

D. ​"I am at risk to develop leukemia as a result of radiation​ exposure."

The client tells the nurse that he or she plans to take St.​ John's wort to treat his or her depression. What is the best response by the​ nurse? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"That should be fine as long as you are not​ suicidal." B. ​"St. John's wort is successfully used in Europe for minor​ depression." C. ​"It would be a good idea to try this before paying for a prescription​ medication." D. ​"It would be better to have a psychiatric assessment​ first." E. ​"Herbal preparations can interact with many other​ medications."

D. ​"It would be better to have a psychiatric assessment​ first." E. ​"Herbal preparations can interact with many other​ medications." Rationale: Anyone who is depressed should have a psychiatric assessment prior to starting on any type of medication.​ Often, there is a physiological cause for the depression that must also be treated. Herbal preparations do interact with many other medications and can have serious adverse side effects. The suicidality of the client should not be a determining factor with using St.​ John's wort. Even though St.​ John's wort is successfully used in​ Europe, this does not mean it is appropriate for this client. The client should have a psychiatric assessment prior to trying St.​ John's wort; the cost of the prescription medication should not be a determining factor.

The nurse is teaching a class on dietary supplements. The nurse determines that learning has occurred when the patients make which​ statement? A. ​"The manufacturer of the dietary supplement has the burden of proof for the safety of the​ supplement." B. ​"Dietary supplements must go through rigorous testing prior to being marketed by the​ manufacturer." C. ​"The Food and Drug Administration​ (FDA) is not involved with the approval of the dietary supplement and cannot remove it from the​ market." D. ​"Products can make claims based on body structure and function like​ 'promotes healthy urinary​ tract.'"

D. ​"Products can make claims based on body structure and function like​ 'promotes healthy urinary​ tract." Rationale: The Dietary Supplement Health and Education Act​ (DSHEA) of 1994 states that the supplement label may make claims about the​ product's effect on body structure and function such as​ "promotes healthy urinary​ tract." The Dietary Supplement Health and Education Act​ (DSHEA) of 1994 states that the government has the responsibility to prove that the dietary supplement is unsafe. The Dietary Supplement Health and Education Act​ (DSHEA) of 1994 states that dietary supplements do not have to be tested prior to marketing. The Dietary Supplement Health and Education Act​ (DSHEA) of 1994 states that the Food and Drug Administration​ (FDA) has the power to remove from the market any product that poses a​ "significant or​ unreasonable" risk to the public.

The nurse teaches a class about medication used during pregnancy to pregnant women. The nurse determines that additional instruction is required when a class participant makes which​ response? A. ​"It is important to not take​ over-the-counter (OTC) drugs during my​ pregnancy." B. ​"Exposure to teratogens can result in my​ baby's death or in​ malformations." C. ​"If I breastfeed my​ baby, drugs can come through my breast​ milk." D. ​"The baby can only be harmed by medications during the first​ trimester."

D. ​"The baby can only be harmed by medications during the first​ trimester." Rationale: A baby can be harmed by medication used throughout the period of gestation.​ Over-the-counter (OTC) drugs should be avoided during pregnancy. Many drugs are transferred through breast milk. Teratogens can cause fetal demise and congenital malformations.

The nurse is teaching a support group for caretakers of older adult clients. The focus is medication compliance. The nurse determines that learning has occurred when the caregivers make which​ response? A. ​"We should give them more education about the medicine so they will take​ it." B. ​"We should crush their medicine and put it in applesauce so they will swallow​ it." C. ​"We should ask the doctor if all the medication is really​ necessary." D. ​"We should use a medication management box so they​ won't forget to take​ it."

D. ​"We should use a medication management box so they​ won't forget to take​ it." ​Rationale: Most older adult clients will be medication compliant if they have a way to remember to take the​ medication; a medication management box is an excellent idea. Many older adults can swallow pills just​ fine, and many medications cannot be crushed. The problem is not the​ education; it is that older adults often forget what medication to take at what time. Asking the healthcare provider about medications is​ fine, but this will not help the older adult client to remember when to take it.

A client was exposed to ionizing radiation. The nurse plans to administer which of the following​ medications? A. Antibiotics. B. Salt tablets. C. Calcium tablets. D. ​Potassium-iodine tablets.

D. ​Potassium-iodine tablets.

Vitamin K

Mechanism of action: Cofactor of gamma-carboxylase, which attach carboxylic acid groups to glutamate, allowing precursors to bind to calcium ions, which convert clotting factors into active forms, which are secreted from hepatocytes into the blood stream to restore blood factors. Carboxylates matrix proteins in chondrocytes, inhibiting calcification and increasing collagen. Therapeutic Uses: Vitamin Supplementations Major Precautions and Contraindications: IV, IM, and subcutaneous administration

Potassium Iodide

Mechanism of action: It works by shrinking the size of the thyroid gland and decreasing the amount of thyroid hormones produced.In a radiation emergency, potassium iodide blocks only the thyroid from absorbing radioactive iodine, protecting it from damage and reducing the risk of thyroid cancer. Therapeutic Uses: radioactive iodine toxicity, lung problems in asthma, chronic bronchitis, and emphysema, hyperthyroidism, Major Precautions and Contraindications: bronchitis, dermatitis, herpeteformis, hypocomplementemic vasculitis, nodular thyroid disease with heart disease, hyperthyroidism, pregnant and breastfeeding women, kidney disease, high potassium levels

Calcium EDTA

Mechanism of action: a chelating agent for divalent and trivalent ions, which displace the calcium component of Calcium EDTA, which form stable, soluble complexes that are excreted by kidneys Therapeutic uses: treatment of lead toxicity Major Precautions and Contraindications: Children, encephalopathy, increased intracranial pressure, intravenous administration (IM is preferred),Anuria, oliguria, renal disease

A nurse is preparing care for a newly admitted client with diabetes. Which information would be critical for the nurse to​ assess? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Medical history B. Current lab results C. Medication allergies D. Use of dietary supplements E. Number of previous hospitalizations

Medical history B. Current lab results C. Medication allergies D. Use of dietary supplements ​Rationale: Medical history may reveal conditions that contraindicate the use of certain drugs. Current lab results may reveal important information about the health of​ organs, such as the kidneys and​ liver, which would be important to metabolism and excretion of drugs. Allergies to one drug may cross over to another drug and would need to be avoided. Some dietary supplements can interact with drugs. While knowledge about number of previous hospitalizations is good to know it is not critical to this admission.

The nurse administers an evening medication to the client in the morning. What is the​ nurse's best initial course of action at this​ time? A. Tell the evening nurse to hold the evening dose just for tonight. B. Notify the healthcare provider about the error. C. Document the incident in the​ client's health record. D. Change the medication administration time to the morning.

Notify the healthcare provider about the error. ​Rationale: Even though the medication went to the correct​ client, this is still considered a medication error. The​ nurse's first priority is to assess the client and contact the healthcare provider. The time of the medication cannot be changed without an order from the healthcare provider. Telling the evening nurse to hold the evening dose is​ unethical; an error has been committed. Completing an incident report and documenting the facts of the situation in the​ client's medical record are a lower priority.

The nurse is preparing medications for a group of clients. Another nurse begins telling the nurse about her recent engagement. What is the best action by the first​ nurse? A. Continue to prepare the medications for administration and pretend to listen to the first nurse. B. Tell the second nurse that the conversation is distracting and she must stop talking while medications are being prepared. C. Ask the second nurse to help with administering medications so they can have more time to talk. D. Stop preparing medications until the second nurse has finished talking about her engagement.

Tell the second nurse that the conversation is distracting and she must stop talking while medications are being prepared. ​Rationale: When preparing​ medications, the nurse must focus entirely on the task at hand and instruct others who are talking to stop. It is inappropriate to ask another nurse to assist with medications so there is more time for the nurses to talk. The nurse cannot stop preparing​ medications; the clients must receive them on time. Pretending to listen to the second​ nurse's conversation will also be distracting.

A nurse is assessing a client recently admitted to the unit. The nurse understands that which assessment identifies the collection of objective​ data? A. The client has a wound measured at 5 cm in length. B. The client rates his or her pain a 5 on a 0-10 pain scale. C. The client states he or she is anxious. D. The client informs the nurse that he or she weighs 150 pounds.

The client has a wound measured at 5 cm in length. ​Rationale: Objective data are gathered through physical​ assessment, laboratory​ tests, and other diagnostic sources. Subjective data consist of what the client says or perceives.

A student nurse asks a nursing instructor which federal agency responsible for reviewing all medication errors reports. What is the nursing​ instructor's best​ response? A. ​FDA's Division of Medication Error Prevention and Analysis​ (DMEPA) B. Risk Management department at the healthcare facility in which it occurred C. Centers for Disease Control​ (CDC) D. Medication errors are never acceptable. National Coordinating Council for Medication Error Reporting and Prevention​ (NCC MERP)

​FDA's Division of Medication Error Prevention and Analysis​ (DMEPA) ​Rationale: Medication errors are not reported to the CDC. If the facility has a risk management​ department, they will review all medication errors in that facility.​ However, this​ isn't a federal agency. Healthcare professional are encouraged to report medication errors to NCC​ MERP, although it is not a requirement. The federal agency responsible for reviewing all medication error reports is DMEPA.