A client with frequent watery stools and a possible Clostridium difficile infection is hospitalized with dehydration. Which nursing action should the charge nurse assign to an LPN?

Performing assessments of the client's hydration status.

Administering the prescribed metronidazole 500 mg orally to the client.

Reviewing client's medical history for any risk factors for diarrhea.

Explaining the purpose of the ordered stool cultures to the client and family.

Answer and Explanation

The Correct Answer is B

A.   While LPNs can perform some assessments, the charge nurse should assign this task to an RN. Assessing hydration status requires critical thinking and a comprehensive understanding of the client's overall clinical condition, which typically falls within the RN’s scope of practice.
B.   Administering medications, including antibiotics like metronidazole, is within the scope of practice for LPNs. As long as the LPN is competent in administering medications and there are no specific contraindications for the client, this task can be appropriately assigned.
C.   This task involves critical thinking and comprehensive analysis of the client's medical history, which is typically conducted by an RN. While LPNs may review aspects of the medical history, the charge nurse should assign more complex evaluations and assessments to RNs.
D.   While LPNs can provide some patient education, explaining the rationale behind specific tests, especially in the context of complex infections, typically requires the knowledge and expertise of an RN. This task may involve more detailed clinical reasoning and the ability to address specific questions and concerns that the client or family may have.

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Correct Answer is C

Explanation

A. While low ferritin levels can indicate iron deficiency anemia, sickle cell anemia primarily involves the production of abnormal hemoglobin rather than iron deficiency. Fatigue in sickle cell anemia is more closely related to the effects of the disease itself, including chronic hemolysis and decreased red blood cell survival.
B. Sickle cell anemia is not classified as an autoimmune disease; it is a genetic disorder caused by a mutation in the hemoglobin gene. While individuals with sickle cell anemia may have increased susceptibility to infections, the fatigue they experience is not due to an autoimmune process.
C. Sickle cell anemia leads to chronic hemolytic anemia, meaning the abnormal sickle-shaped red blood cells break down more quickly than normal red blood cells. This results in a lower overall red blood cell count (anemia), which can cause fatigue and weakness due to reduced oxygen-carrying capacity in the blood.
D. While gastrointestinal bleeding can lead to fatigue due to blood loss and subsequent anemia, it is not a direct consequence of sickle cell anemia. If the client had experienced a gastrointestinal bleed, it would typically need to be evaluated independently of their sickle cell disease.

A. Have another nurse witness the disposal of the extra medication. B. Discard the extra medication in a sharps container. C. Save the extra medication for a later dosing. D. Send the waste amount to the pharmacy.

Correct Answer is A

Explanation

A. In many institutions, when a nurse administers a controlled substance and has leftover medication, it is standard practice to have another nurse witness the disposal of the excess. This is a safeguard against misuse and ensures accountability.
B. While a sharps container is appropriate for disposing of needles and other sharp objects, it is not suitable for liquid medications. Discarding liquid medications in a sharps container could lead to contamination and is not compliant with disposal protocols.
C. Medications, especially controlled substances, should never be saved for later use once they have been drawn up or prepared. This practice poses a significant risk for medication errors and misuse.
D. Generally, the waste amount is not sent to the pharmacy. Instead, it should be wasted according to the facility's policy, typically in the presence of another nurse. Sending it to the pharmacy is unnecessary and could create logistical complications.

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A client with frequent watery stools and a possible Clostridium difficile infection is hospitalized with dehydration. Which nursing action should the charge nurse assign to an LPN?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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