A nurse on a medical-surgical unit is performing medication reconciliation for a newly admitted client. Which of the following actions should the nurse take?

Compare the client's list of home medications to the admission prescriptions written for the client.

Compare a list of common medications to treat a condition to the actual prescriptions.

Compare the medication label to the provider's prescription on three occasions before administration.

Compare the prescription to the allergy history of the client.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Medication reconciliation involves reviewing all medications the client was taking at home and comparing them with the prescriptions ordered on admission. This process helps identify discrepancies, prevent omissions, duplications, or potential interactions, and ensures continuity of care.

B. Comparing a standard list of medications for a condition is not part of medication reconciliation because it may not reflect the individual client’s needs, allergies, or previous therapy. The focus should be on the client’s actual home medications.

C. This step refers to the “three checks” of medication administration, which is different from the initial reconciliation process. Reconciliation focuses on matching home medications with admission orders, not verifying labels prior to each dose.

D. While checking for allergies is a critical safety step, it is only one component of safe medication administration. Medication reconciliation is broader, ensuring that all home medications are considered and that any changes or omissions are intentional and documented.

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Correct Answer is D

Explanation

Rationale:
A. "Add salt to season foods.": Adding salt can irritate oral mucosa, especially in clients with AIDS who often develop stomatitis or oral candidiasis. Salty foods worsen pain and delay healing of mucosal lesions, so mild, bland foods are preferred.

B. "Eat foods served at hot temperatures.": Hot foods increase discomfort and can further damage already inflamed oral tissues. Clients should instead consume cool or room-temperature foods to soothe irritation and promote better oral intake.

C. "Rinse your mouth with an alcohol-based mouthwash.": Alcohol-based mouthwashes dry and irritate the mucous membranes, worsening oral pain and increasing the risk of bleeding or infection. Nonalcoholic rinses, such as saline or baking soda solutions, are safer alternatives.

D. "Use ice chips to numb your mouth.": Sucking on ice chips provides local numbing and temporary pain relief, allowing the client to eat and drink more comfortably. This simple intervention also helps keep the oral mucosa moist and reduces inflammation.

A. "You are feeling anxious now; why don't you give it some time before making a final decision? B. "You should talk with your family members before making this decision." C. "I will discuss this with your primary health care provider, and we can discuss this more tomorrow." D. "Let me refer you to talk to someone regarding your treatment options."

Correct Answer is D

Explanation

Rationale:
A. "You are feeling anxious now; why don't you give it some time before making a final decision?": This response minimizes the client’s feelings and delays addressing their emotional distress and right to autonomy. It fails to provide immediate therapeutic support.

B. "You should talk with your family members before making this decision.": While family involvement can be supportive, the client has the right to make autonomous decisions regarding treatment. Directing them to family first disregards the nurse’s role in providing professional support and resources.

C. "I will discuss this with your primary health care provider, and we can discuss this more tomorrow.": Although involving the provider is appropriate, postponing the discussion may neglect the client’s current emotional and psychological needs for immediate counseling and clarification.

D. "Let me refer you to talk to someone regarding your treatment options.": This response acknowledges the client’s concerns and facilitates support through referral to counseling, palliative care, or an ethics consult. This ensures the client’s emotional, psychological, and autonomy needs are appropriately addressed.

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