A nurse admits an older patient to the emergency room with reports of shortness of breath on exertion and a productive cough.
The nurse reviews the patient's current medications and the patient says, “I take one pink pill every morning.”. The nurse asks the name of the drug and the patient says she doesn’t know.
The patient cannot supply the name of the drug or the purpose of taking it either.
This happens with four other medications the patient says she takes.
What is an appropriate nursing diagnosis for this patient?
Ineffective health maintenance.
Noncompliance.
Acute confusion.
Risk-prone health behavior.
The Correct Answer is A
Choice A rationale
Ineffective health maintenance is appropriate due to the patient's inability to provide names and purposes of medications, indicating insufficient knowledge of their regimen.
Choice B rationale
Noncompliance implies intentional refusal of medication, which is not evident here as the patient is unaware rather than refusing.
Choice C rationale
Acute confusion is not indicated as the patient appears oriented and not disoriented.
Choice D rationale
Risk-prone health behavior is not appropriate as it suggests engagement in harmful activities, which is not described.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Maintaining narcan (naloxone) on standby is not directly related to anticoagulant therapy. Narcan is used to reverse opioid overdoses, not to manage the effects of anticoagulants.
Choice B rationale
Notifying the healthcare provider of any patient receiving this drug is a general action but not an appropriate nursing diagnosis. Nursing diagnoses focus on identifying specific patient needs and planning care to address those needs.
Choice C rationale
Evaluating the patient for PT (prothrombin time) for 2.5 is an action, not a nursing diagnosis. Nursing diagnoses identify patient needs and risks, guiding the planning and implementation of care.
Choice D rationale
Establishing safety precautions is an appropriate nursing diagnosis for a patient on anticoagulant therapy. Anticoagulants increase the risk of bleeding, so ensuring patient safety and preventing injury is crucial to minimize this risk. .
Correct Answer is B
Explanation
Choice A rationale
Generic medications are equivalents to brand name drugs and are not typically a priority query unless there's an issue of consistency in medication use.
Choice B rationale
Over-the-counter (OTC) medications can interact with prescription medications or have side effects, so it’s crucial to know if a patient is taking any.
Choice C rationale
This question is important for women who are pregnant but is not the primary concern when assessing general medication use.
Choice D rationale
Orphan drugs are used to treat rare conditions and are less likely to be encountered in a general assessment.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.