Pharm
Which strategy would the nurse use to convince a 3-year-old client to take medication?
"'t's time for your medication now, so would you like water or apple juice afterward?" The strategy most likely to be successful in convincing a 3-year-old client to take medication is to state that it is time to take medication and then to provide the child with a choice of water or apple juice so that the preschooler feels like he or she has some control.
Which statement by a nursing student demonstrates the difference between a nursing diagnosis and a medical diagnosis?
"A medical diagnosis relates to a health problem that can be treated with health care provider-prescribed therapies."' • I 'The nursing diagnosis identifies the client's response to illness." • I 'The nurse often uses clues in the medical diagnosis to develop the nursing diagnosis." The medical diagnosis is concerned with health problems that would be treated with a health care provider's prescription. The nursing diagnosis relates to the client's response to illness; physical, psychological, and spiritual well-being is considered in the holistic approach to client care. The nursing diagnosis can often be developed using the medical diagnosis as a basis for care.
A client with a diagnosis of dementia of the Alzheimer type has been taking donepezil 10 mg/day for 3 months. The client's partner calls the clinic and reports that the client has increasing restlessness and agitation accompanied by nausea. Which action should the nurse instruct the partner to implement?
"Bring the client to the clinic for testing and a physical examination."
Which instruction would the nurse include when educating a client about enalapril maleate?
"When standing up, change position slowly." Enalapril is an angiotensin-converting enzyme inhibitor and can cause postural hypotension. For safety purposes, the client should be instructed, when standing, to change positions slowly to avoid dizziness or fainting.
Which responsibility would the nurse identify with safe and effective psychotherapeutic drug administration?
Administer the medication to the client. • I Assess the client prior to administering the medication. vI Coordinate the client's care needs and medication schedule. • I Evaluate drug effectiveness and monitor for adverse effects. • I Monitor and evaluate the client's response to the medication. Nurses who administer psychotherapeutic medications have five responsibilities related to safe and effective medication administration. The nurse must administer the medication correctly to the client, assess the client prior to drug administration of the medication, coordinate care needs and the medication schedule, evaluate the client for drug effectiveness and monitor for adverse reactions, and monitor and evaluate the client's response to the medication.
Which medical emergency would the nurse continually monitor for in a client who sustained a transection of the spinal cord?
Autonomic hyperreflexia Autonomic hyperreflexia, an uninhibited and exaggerated response of the autonomic nervous system to stimulation, results in blood pressure greater than 200 mm Hg systolic and 100 mm Hg diastolic; it is a medical emergency.
Which device will the nurse use to administer medications to infants?
Calibrated dropper Nurses use a calibrated dropper or oral syringe to administer medication to infants.
Which symptom reported by the client is most important for the nurse to communicate to the health care provider when a client is taking varenicline?
Changes in behavior Varenicline can bring on or worsen serious mental health issues, including depression, paranoia, hallucinations, delusions, and suicidal ideation.
Which action would the nurse take after observing a client taking a monoamine oxidase inhibitor (MAOl) with coffee?
Compare current blood pressure to baseline. Foods containing vasopressors include fava beans, chocolate, coffee, tea, and colas and can cause prodromal symptoms of hypertensive crisis such as occipital headache, stiff neck, sweating, nausea, vomiting, and sharply elevated blood pressure.
The nurse is working with the parents and their 14-year-old adolescent with a new diagnosis of a conduct disorder. The parents are exhausted as the child has threatened to stab the parents, and they are not getting any sleep. Which would be the initial intervention?
Contacting the health care provider The nurse would initially contact the health care provider. The adolescent is a harm to others and would need immediate treatment.
Which action is appropriate to help promote an 11-year-old client's compliance with taking daily medications for a chronic illness, as an alternative to the parent's report of daily nagging?
Establishing a contract with the client that includes rewards The most appropriate nursing action is establishing a contract that includes rewards with the client because school-age children feel forced dependence when they are hospitalized or when they have to take daily medications, which can result in a feeling of loss of control and loss of security.
Which nursing action would be appropriate when a client with chronic arterial insufficiency of the legs refuses a prescribed dose of aspirin, stating, "My legs are not in pain"?
Explain the reason for the medication and encourage the client to take it. Aspirin is given to the client to prevent platelet aggregation and possible deep vein thrombosis.
Which information would the nurse share with a client who refuses to follow the prescribed treatment regimen and plans to leave the hospital against medical advice?
Full responsibility for possible undesirable outcomes falls on the client. The client has the right to self-determination, which includes refusing medical treatment; however, if the client does so, he or she must accept full responsibility for any resulting illness and possible injury or undesirable outcomes.
A teenage client has a prescription for oral solution levofloxacin to treat a sinus infection, and the nurse explains when the medication should be taken. Which statement by the client leads the nurse to conclude that the teaching has been effective?
I should take the medication 1 hour before a meal." Absorption of the oral solution levofloxacin is enhanced when the stomach is empty, and it should be taken 1 hour
Which action would be best for the social worker to perform when a client with cancer reports not having money for prescribed medication?
Investigate the availability of financial resources for the client. The social worker is the best team member to find financial resources for treatment and medication for the client. The health care provider would be notified if the social worker could not find any resources for the prescribed medication; perhaps a more affordable medication can be prescribed.
Which medication formulation is safest for infants?
Liquid forms Liquid drug forms are the safest route of medication administration because they decrease the risk for choking, and absorption rates for medications are more predictable in infants.
Which priority intervention would be appropriate for the client with Parkinsonism who is taking an anticholinergic medication for morning stiffness and tremors in the right arm, and complains of some numbness in the left hand?
Make arrangements immediately for further medical evaluation by the client's primary health care provider. Numbness, a sensory deficit, is inconsistent with Parkinsonism; further medical evaluation is necessary. Numbness, even in the absence of other problems, may be indicative of an impending cerebrovascular accident (CVA).
Which statement from a client with epilepsy experiencing menopause is of most concern to the nurse when considering risk for harm to the client?
O "I have started on hormone replacement therapy (HRT)." Contraindications to HRT include seizure disorders like epilepsy. HRT can lower the level of seizure-preventing medication in the blood and increase the risk for seizures.
Which statement made by the nurse indicates an understanding of client noncompliance?
O "Noncompliance means an informed decision was made by the client not to follow a prescribed treatment."
Which side effect of antihypertensive medication would the nurse explain puts the client at risk for injury?
Orthostatic hypotension Antihypertensive medications have numerous side effects. The one that puts the client at risk for injury (from falls) is orthostatic hypotension.
The client develops lead-pipe rigidity, trismus, and tachycardia. Which intervention would the nurse anticipate for the client taking quetiapine for acute psychosis?
Perianal care • Fall precautions • I Use of a cooling blanket • _ Monitored intake and output _ Discontinuation of the medication Administration of bromocriptine as prescribed The client is demonstrating symptoms of neuroleptic malignant syndrome (NMS).
The nurse observes that a client who is on intravenous medication is experiencing an anaphylactic reaction. Which intervention is a priority to the nurse in this situation?
Stop intravenous medication and administer epinephrine. Intravenous medications can cause an anaphylactic reaction. During anaphylactic reactions, the nurse should immediately stop the intravenous medication and administer epinephrine.
The nurse is planning care for a client with myasthenia gravis who is experiencing diplopia, ptosis, and mild dysphagia. An anticholinergic medication is prescribed. Which instructions would the nurse give as a priority?
Take the medication according to a specific schedule.
Which information would the nurse include when teaching the client about potassium chloride effervescent tablets?
Take the medication with food. Eating food when taking the medication will decrease gastrointestinal irritation. Side effects of this medication include abdominal cramps, diarrhea, and ulceration of the small intestine.
Which action by the parent of a preschool client indicates a need for a nursing intervention regarding home safety?
Telling the child that medication is "candy for when you are sick" The statement by a parent that medication is "candy for when you are sick" may give a child the idea that any medication can be eaten like candy, which may lead to accidental poisoning of the child.
Which action by the parent of a preschool client indicates a need for a nursing intervention regarding home safety?
Telling the child that medication is "candy for when you are sick" The statement by a parent that medication is "candy for when you are sick" may give a child the idea that any medication can be eaten like candy, which may lead to accidental poisoning of the child. Medicine should not be referred to as candy.
Which statement is true regarding the problem, intervention, and evaluation (PIE) format of documentation?
The format can be written in several ways The PIE format can be written in several ways, so the nurse should use the format dictated by the health care facility's policy. It originated from the nursing process, whereas SOAP/SOAPIE/SOAPIER charting originated in the medical model and is included in the charting by exception (CBE) documentation.
