A nurse and assistive personnel (AP) are caring for a client who requests a PRN pain medication. After the nurse administers the medication, which of the following tasks should the nurse assign to the AP?
Document the client's respiratory rate in 1 hr.
Monitor the client for an allergic reaction for 30 min.
Check the client's response to the medication in 1 hr.
Evaluate the client for therapeutic effects in 30 min.
The Correct Answer is A
After the nurse administers a PRN pain medication to a client, the nurse can assign the assistive personnel (AP) to document the client's respiratory rate in 1 hour. This is within the scope of practice of an AP.
The other tasks are not appropriate for an AP to perform.
Monitoring the client for an allergic reaction and evaluating the client for therapeutic effects are both nursing assessments that should be performed by the nurse.
Checking the client's response to the medication is also a nursing assessment that should be performed by the nurse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Correct answer: C
A) Start the first patch on the seventh day of the menstrual cycle: The patch is typically applied on the first day of the menstrual cycle or the first Sunday after the menstrual period begins, not on the seventh day. This helps ensure effective contraception from the start of use.
B) The contraceptive effect will continue for 6 months following discontinuation of the medication: The contraceptive effect of the patch does not last for 6 months after discontinuation. Once the patch is removed and not replaced, hormone levels drop, and fertility can return relatively quickly, typically within a few days to weeks.
C) Apply the patch to the lower abdomen: The patch should be applied to clean, dry, and intact skin on areas such as the lower abdomen, upper outer arm, buttock, or upper torso (excluding the breasts). This location allows for consistent hormone absorption.
D) Expect to have a headache during the first month: While some individuals may experience headaches as a side effect of hormonal contraceptives, this is not an expected or guaranteed outcome. Any persistent or severe headache should be reported to the healthcare provider, as it could indicate other concerns.
Correct Answer is C
Explanation
A nurse collecting data from a client who reports having diarrhea for the past 3 days should identify that muscle weakness is a symptom of hypokalemia. Hypokalemia is a condition in which the blood potassium level is low and can be caused by excessive fluid loss through diarrhea. Potassium helps regulate muscle contractions, so when blood potassium levels are low, muscles may produce weaker contractions which result in muscle weakness.
The other options are not typical symptoms of hypokalemia.
a) Pitting edema is not a typical symptom of hypokalemia.
b) Diplopia is not a typical symptom of hypokalemia.
d) Hyperactive bowel sounds are not a typical symptom of hypokalemia.
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