A nurse is preparing to administer medications to a client.
The client tells the nurse "I will take the pills but not that liquid medication.”. Which of the following actions should the nurse take?

Document the reason for the missed dose of medication in the nurses notes.

Ask an assistive personnel (AP) to ensure the client drinks the medication after breakfast.

Notify the pharmacist that the client is refusing to take the medication.

Mix the medication in juice on the client's breakfast tray.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Documenting the client's refusal and the stated reason in the nurses' notes is crucial for legal and ethical reasons. It provides a clear record of the event, ensures continuity of care by informing other healthcare providers, and allows for follow-up interventions to address the client's concerns or alternative medication strategies. It upholds the client's right to refuse treatment.

Choice B rationale

Delegating medication administration to an assistive personnel (AP) is inappropriate as medication administration is a complex nursing function requiring assessment, judgment, and patient education, which are outside the scope of practice for an AP. An AP's role is typically limited to basic care activities, and they are not trained or authorized to administer medications.

Choice C rationale

Notifying the pharmacist is not the immediate or primary action when a client refuses medication. While the pharmacist may offer insights into alternative formulations or administration routes, the nurse's initial responsibility is to understand the client's refusal, document it, and then notify the prescribing provider for a revised plan of care.

Choice D rationale

Mixing medication in juice without the client's explicit consent is considered a breach of the client's autonomy and can be construed as coercive or deceptive. It violates the client's right to self-determination and informed consent regarding their treatment. Medications should only be administered with the client's knowledge and cooperation.

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Correct Answer is A

Explanation

Choice A rationale

Ipratropium is an anticholinergic bronchodilator that blocks muscarinic receptors in the bronchial smooth muscle, leading to bronchodilation. A common adverse effect of anticholinergic medications is reduced salivary gland secretion, resulting in xerostomia, or dry mouth, due to inhibition of parasympathetic stimulation.

Choice B rationale

Periorbital edema is not a typical adverse effect of ipratropium. This medication primarily targets muscarinic receptors in the respiratory tract. Edema, particularly around the eyes, is more commonly associated with allergic reactions or fluid retention from other medications.

Choice C rationale

Ipratropium, being an anticholinergic, primarily acts on M3 receptors in the lungs and has minimal systemic absorption, thus rarely causing bradycardia. In fact, anticholinergics can sometimes cause a mild increase in heart rate due to blockade of M2 receptors in the heart, but clinically significant changes are uncommon.

Choice D rationale

While xerostomia can contribute to dental issues over time due to reduced saliva's protective effects, dental caries is not a direct, acute adverse effect of ipratropium itself. It is a potential long-term complication of prolonged dry mouth, rather than a direct drug-induced effect to monitor immediately.

Correct Answer is ["3"]

Explanation

Step 1 is: Convert client weight from pounds to kilograms. 165 Ib ÷ 2.2 Ib/kg = 75 kg.

Step 2 is: Calculate the total dose of verapamil needed. 0.1 mg/kg × 75 kg = 7.5 mg.

Step 3 is: Calculate the volume to administer in mL. 7.5 mg ÷ (2.5 mg/mL) = 3 mL. The nurse should administer 3 mL.

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A nurse is preparing to administer medications to a client. The client tells the nurse "I will take the pills but not that liquid medication.”. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a new prescription for an ipratropium inhaler to control COPD bronchospasm. For which of the following adverse effects should the nurse monitor?

Correct Answer is A

Explanation

A nurse is preparing to administer verapamil 0.1 mg/kg via intermittent IV bolus over 2 min. Available is verapamil 2.5 mg/mL. The client weighs 165 Ib. How many mL should the nurse administer?

Correct Answer is ["3"]

Explanation

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A nurse is preparing to administer medications to a client.
The client tells the nurse "I will take the pills but not that liquid medication.”. Which of the following actions should the nurse take?