A nurse is reviewing the medication administration records from the previous shift. Which of the following findings should indicate to the nurse a need for an incident report?

A client received crushed bupropion XL tablet mixed with applesauce.

A nurse injected Demerol 1M into the vastus lateralis site of adult.

A nurse used a 25-gauge inch needle to administer heparin injection.

A client received gentamicin intermittent IV bolus over I hr.

Answer and Explanation

The Correct Answer is A

Bupropion XL tablets should be taken whole. Crushing the tablet interferes with the pharmacokinetics of the drug leading to reduced efficacy and increased risk of toxicity. Administering bupropion XL inappropriately could result in harm to the client and should prompt the nurse to file an incident report to document the error and ensure appropriate follow-up and monitoring.

B. Meperidine is a commonly administered opioid analgesic and can be given intramuscularly in appropriate doses and sites.

C. Selection of the needle length and gauge depend on the route of administration and individual client's characteristics

D. Gentamicin can be administered by intermittent IV bolus over a prolonged period as part of its dosing regimen.

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Correct Answer is A

Explanation

Cefoxitin is a cephalosporin with potential cross reactivity with penicillins (amoxicillin)and hence must be avoided in known history of penicillin allergy
B. A recent history of diarrhea for 3 days is not a contraindication for the administration of cefoxitin.
C. A history of phlebitis following an IV infusion of 0.9% sodium chloride with 10 mEq of potassium chloride is not directly related to the administration of cefoxitin.
D. A serum creatinine level of 0.8 mg/dL is within the normal range

A. Clamp the catheter. B. Position the client in left lateral Trendelenburg. C. Auscultate breath sounds. D. Initiate oxygen therapy.

Correct Answer is A

Explanation

Acute shortness of breath in a client with a central venous catheter could be secondary to various respiratory complications such as pulmonary embolism and pneumothorax. Taking the appropriate action requires a quick assessment through auscultation as the emergency management of the various complications is different.
A. This is the immediate action to prevent more air from entering the venous system.
B. The left lateral trendelenburg position is relevant in hypotension but not a priority action.

C.uscultating breath sounds is an important assessment, especially if the cause of the shortness of breath is unclear. It can help identify wheezing, crackles, or absence of breath sounds, which may suggest conditions like pneumothorax, pulmonary embolism, or infection. However, while auscultation is an important diagnostic step, it is typically done after initial interventions (such as positioning or administering oxygen) to stabilize the client.
D. Initiating oxygen therapy is important in cases of respiratory distress but assessment is priority in this case

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A nurse is reviewing the medication administration records from the previous shift. Which of the following findings should indicate to the nurse a need for an incident report?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical record of a client who is to receive the first dose of cefoxitin via intermittent IV bolus. Which of the following findings should the nurse identify as a contraindication for the client to receive cefoxitin and report to the provider?

Correct Answer is A

Explanation

A nurse is caring for a client who has a central venous catheter and develops acute shortness of breath. Which of the following actions should the nurse take first?

Correct Answer is A

Explanation

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