A nurse inadvertently administers an incorrect medication to a client. Which action should the nurse take first?
Inform the unit supervisor.
Notify the health care provider.
Document the error in the client’s medical record.
Record the error on the appropriate quality improvement report.
The Correct Answer is B
Notify the health care provider. The nurse should take this action first because the provider can prescribe appropriate interventions to prevent or minimize harm to the client.
The nurse should also inform the unit supervisor, document the error in the client’s medical record, and record the error on the appropriate quality improvement report, but these are not the priority actions.
Choice A is wrong because informing the unit supervisor is not the most urgent action. The supervisor can provide support and guidance to the nurse, but cannot prescribe interventions for the client.
Choice C is wrong because documenting the error in the client’s medical record is not the most urgent action.
The nurse should document the error after notifying the provider and assessing the client. Documentation should include the medication name, dose, route, time, client’s response, and actions taken.
Choice D is wrong because recording the error on the appropriate quality improvement report is not the most urgent action.
The nurse should record the error after notifying the provider and assessing the client. The report should include a factual description of what happened and what was done.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
120/77 mmHg. This is because this blood pressure reading is within the normal range of less than 120/80 mmHg. Hypertension is defined as a blood pressure of 140/90 mmHg or higher.
Choice A is wrong because 84/50 mmHg is too low and may indicate hypotension, which can cause dizziness, fainting, or shock.
Choice C is wrong because 148/88 mmHg is above the normal range and indicates prehypertension, which is a risk factor for developing hypertension and cardiovascular disease.
Choice D is wrong because 160/90 mmHg is above the normal range and indicates stage 1 hypertension, which requires treatment with lifestyle changes and medication.
Correct Answer is B
Explanation
Are you taking the medication as prescribed? This is because warfarin is a blood-thinning medication that affects the prothrombin time (PT) and the international normalized ratio (INR).
The PT measures how long it takes for blood to clot, and the INR is a calculation based on the PT that standardizes the results across different laboratories. A normal INR range is 0.8 to 1.1 for people who are not taking warfarin. People who take warfarin usually have a target INR range of 2 to 3, depending on their condition.
An INR of 0.8 means that the blood clots faster than normal, which increases the risk of blood clots and strokes.
This could indicate that the client is not taking enough warfarin or is taking other medications or foods that interfere with warfarin’s effect.
Choice A is wrong because bleeding gums are a sign of excessive bleeding, which could happen if the INR is too high, not too low.
Choice C is wrong because blood in stools is also a sign of excessive bleeding, which could happen if the INR is too high, not too low.
Choice D is wrong because unusual bruising is another sign of excessive bleeding, which could happen if the INR is too high, not too low.
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