A nurse is preparing to administer oral medications to a client. According to the Joint Commission, which are acceptable client identifiers? (Select all that apply.)

Date of birth

Photograph identification

Facility room number

Client’s full name

Answer and Explanation

Correct Answer : A,D

Choice A Reason:

Date of birth is an acceptable client identifier. The Joint Commission specifies that using the date of birth helps ensure accurate identification of the client. This identifier is unique to each individual and is less likely to be duplicated.

Choice B Reason:

Photograph identification is not typically listed as an acceptable identifier by the Joint Commission. While it can be useful in some settings, it is not one of the primary identifiers recommended for ensuring patient safety.

Choice C Reason:

Facility room number is not an acceptable client identifier. The Joint Commission explicitly states that room numbers should not be used as identifiers because they can change and are not unique to the individual.

Choice D Reason:

Client’s full name is an acceptable client identifier. Using the full name helps to accurately identify the client and match them with their medical records and treatment plans.

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Correct Answer is C

Explanation

Choice A reason: Asthma

Diphenhydramine is an antihistamine that can cause drying of the airways and thickening of bronchial secretions, which might exacerbate asthma symptoms. However, it is not strictly contraindicated in asthma patients. Instead, caution is advised, and it should be used under medical supervision if necessary.

Choice B reason: Hypertension

While diphenhydramine can cause mild increases in blood pressure due to its anticholinergic effects, it is not contraindicated in patients with hypertension. Patients with hypertension should use it cautiously and under medical advice, but it is not an absolute contraindication.

Choice C reason: Glaucoma

Diphenhydramine is contraindicated in patients with glaucoma, particularly closed-angle glaucoma. This is because diphenhydramine has anticholinergic properties that can increase intraocular pressure, potentially worsening the condition. Patients with glaucoma should avoid using diphenhydramine to prevent complications related to increased eye pressure.

Choice D reason: Depression

Diphenhydramine is not contraindicated in patients with depression. However, it can cause drowsiness and sedation, which might affect mood and energy levels. Patients with depression should use it cautiously and under medical supervision, but it is not an absolute contraindication.

A. Cardiac monitoring B. Daily weight measurement C. Blood pressure monitoring D. Urine output measurement

Correct Answer is B

Explanation

Choice A Reason:

Cardiac monitoring involves the continuous observation of the heart’s electrical activity, typically using an electrocardiogram (ECG). While cardiac monitoring is essential for detecting arrhythmias and other cardiac events, it does not directly measure fluid retention. Fluid retention in CHF patients can lead to symptoms such as edema and weight gain, which are not directly assessed through cardiac monitoring.

Choice B Reason:

Daily weight measurement is a reliable and practical method for assessing fluid retention in clients with congestive heart failure. Fluid retention leads to an increase in body weight, and monitoring daily weight changes can help detect fluid accumulation early. A sudden weight gain of more than 2-3 pounds in a day or 5 pounds in a week is a significant indicator of fluid retention and worsening heart failure. This method is non-invasive, easy to perform, and provides valuable information for managing CHF.

Choice C Reason:

Blood pressure monitoring is crucial for managing clients with CHF, as hypertension can exacerbate heart failure. However, blood pressure readings alone do not provide a direct measure of fluid retention. While fluid overload can affect blood pressure, it is not a specific or sensitive indicator of fluid status. Blood pressure monitoring should be used in conjunction with other assessment tools to manage CHF effectively.

Choice D Reason:

Urine output measurement is an important parameter for assessing kidney function and fluid balance. In clients with CHF, reduced urine output can indicate worsening heart failure and fluid retention. However, urine output alone may not provide a complete picture of fluid status, especially if the client is on diuretic therapy. Daily weight measurement remains a more direct and reliable method for assessing fluid retention in CHF patients.

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A nurse is preparing to administer oral medications to a client. According to the Joint Commission, which are acceptable client identifiers? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client asks the nurse about a prescription for the antihistamine, diphenhydramine (Benadryl). The nurse should teach the client that this medication is contraindicated in clients who have a history of which condition?

Correct Answer is C

Explanation

A nurse is assessing a client with congestive heart failure (CHF). Which assessment tool will provide a reliable measure of fluid retention for this client?

Correct Answer is B

Explanation

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