A nurse discovers that a client was administered an antihypertensive medication in error. What would be the priority action for the nurse to do first?

Call the provider.

Notify risk management.

Check the client's vital signs.

Complete an incident report.

Answer and Explanation

The Correct Answer is C

Choice A reason: Calling the provider is important, but it is not the immediate priority. Before contacting the provider, the nurse needs to assess the client's condition to provide accurate information about any potential adverse effects of the medication error.

Choice B reason: Notifying risk management is a necessary step in reporting the medication error, but it should be done after ensuring the client's safety and stability. Immediate patient assessment takes precedence.

Choice C reason: Checking the client's vital signs is the priority action because it allows the nurse to assess the client's current condition and identify any immediate adverse effects of the medication error. This information is critical for determining the appropriate next steps and ensuring the client's safety.

Choice D reason: Completing an incident report is essential for documenting the medication error, but it should be done after addressing the client's immediate needs and ensuring their safety. The nurse's first responsibility is to assess and manage the client's condition.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A reason: A 32-year-old male with a femur fracture in traction is stable but needs ongoing pain management and monitoring for complications like infection or deep vein thrombosis (DVT). While this client requires attention, they are not in immediate critical condition compared to other patients on the list.

Choice B reason: A 38-year-old female with a grade 1 liver laceration admitted 2 days ago also requires close observation for signs of bleeding or worsening liver function. However, given that the liver laceration is of a lesser severity (grade 1), the immediate priority is less critical compared to a client with respiratory compromise.

Choice C reason: A 41-year-old male with 4 rib fractures, pneumothorax, and a chest tube is the highest priority. The presence of pneumothorax indicates a potential life-threatening condition that requires close monitoring to ensure the chest tube is functioning correctly and the lung is re-expanding. Any compromise in the chest tube's functionality can lead to respiratory distress or failure, making this client the most critical and requiring immediate assessment.

Choice D reason: A 55-year-old female admitted 6 days ago with a chest contusion and scheduled for discharge today is likely stable and does not have the same level of urgency as a client with a pneumothorax. This client needs final evaluations and discharge planning, but their condition does not present an immediate life-threatening risk.

A. Risk for impaired nutrition B. Risk for thrombosis C. Risk for bleeding D. Risk for constipation

Correct Answer is B

Explanation

Choice A reason: While hormone therapy can have various effects on the body, impaired nutrition is not a common complication associated with estrogen therapy for transgender women. Nutrition-related issues would more likely arise from other factors unrelated to hormone treatment.

Choice B reason: Estrogen therapy can increase the risk of thrombosis (blood clots). This is a significant potential complication that must be discussed with clients considering estrogen therapy. Blood clots can lead to serious conditions such as deep vein thrombosis, pulmonary embolism, and stroke.

Choice C reason: Increased risk of bleeding is not a typical complication of estrogen therapy. Hormone therapy for transgender women generally does not affect the body's ability to clot blood in a way that would cause increased bleeding.

Choice D reason: Constipation is not a common complication of estrogen therapy. Gastrointestinal side effects are generally not a major concern with hormone therapy for transgender women.

View Question and Answer

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

A nurse discovers that a client was administered an antihypertensive medication in error. What would be the priority action for the nurse to do first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is working on the step-down unit and receives the shift-to-shift report on four clients. Based on the report information, which client would be the highest priority to assess first?

Correct Answer is C

Explanation

The nurse is counseling a new client who identifies as a transgender female and is expressing the desire to start estrogen therapy for their transition. What potential complication will the nurse include in the client teaching?

Correct Answer is B

Explanation

A newly hired nurse is learning about the appropriate use of touch when communicating with clients diagnosed with psychiatric disorders. Which statement by the nurse educator best provides information about this aspect of therapeutic communication?

The nurse is assessing a mechanically ventilated client with pneumonia after providing deep oral suctioning to the client. Which assessment finding would be unexpected and be a priority for the nurse to address?

The nurse working on a medical-surgical unit finds a client lying on their bathroom floor. After assessing the client and notifying the provider and nursing supervisor, the nurse completes a hospital incident report. What is the purpose of completing the hospital incident report?

A nurse is caring for a client with a stroke and is scheduled for transfer to a rehabilitation center. Which of the following tasks are the responsibility of the nurse from the sending facility? (Select All that Apply)

A nurse has several tasks to delegate to assistive personnel (AP). Which of the following tasks should the nurse ask the AP to perform first?

The nurse observes an unlicensed assistive personnel (UAP) reprimanding a client for not using the urinal properly. The UAP tells him that he will be put in a diaper if he does not use the urinal more carefully next time. Which of the following torts is the UAP committing?

A charge nurse notes that a staff nurse delegates a large number of tasks to the assistive personnel (AP). The nurses on the next shift also report that the staff nurse frequently leaves tasks uncompleted. Which of the following statements should the charge nurse make to resolve this conflict?