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A nurse on a medical-surgical unit is reconciling a newly admitted client's medication. The nurse is reviewing the process of medication reconciliation with a newly licensed nurse. The nurse should include which of the following information?

The American Hospital Association requires accredited facilities to have protocols in place requiring medication reconciliation

The nurse who performs medication reconciliation is demonstrating the ethical principal of veracity:

The International Council of Nurses Code of Ethics stipulates that the nurse performs medication reconciliation when a client is admitted to a facility, is transferred to another facility, and when a client is discharged from a facility

The purpose of medication reconciliation is to prevent adverse medication reactions

Answer and Explanation

The Correct Answer is D

Answer: D

Rationale:

A. The American Hospital Association requires accredited facilities to have protocols in place requiring medication reconciliation: The American Hospital Association does advocate for medication reconciliation as part of safety protocols, but the primary focus of medication reconciliation is not solely based on AHA requirements. It is more about improving patient safety and preventing errors.

B. The nurse who performs medication reconciliation is demonstrating the ethical principle of veracity: While medication reconciliation involves accurate and truthful communication, it primarily serves to ensure safety and accuracy in medication management rather than directly demonstrating the ethical principle of veracity.

C. The International Council of Nurses Code of Ethics stipulates that the nurse performs medication reconciliation when a client is admitted to a facility, is transferred to another facility, and when a client is discharged from a facility: Although medication reconciliation is crucial at these points of care transition, the International Council of Nurses Code of Ethics does not explicitly mandate this process.

D. The purpose of medication reconciliation is to prevent adverse medication reactions: Medication reconciliation aims to ensure accurate medication lists and prevent errors, which in turn helps prevent adverse medication reactions. This aligns with the primary goal of the process, which is to enhance medication safety.

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Correct Answer is C

Explanation

Answer: C. Hyperventilate the client on 100% oxygen prior to suctioning

Rationale:

A) Lubricate the suction catheter tip with sterile saline: Lubricating the suction catheter tip is not recommended, as it can introduce additional fluids into the airway and may contribute to complications or further secretions.

B) Suction two to three times with a 50-second pause between passes: While it is appropriate to limit suctioning passes to minimize trauma, the pause should generally be 30 seconds to allow for reoxygenation. A 50-second pause could result in hypoxia.

C) Hyperventilate the client on 100% oxygen prior to suctioning: This action is crucial as it helps to preoxygenate the client, minimizing the risk of hypoxia during the suctioning procedure. Hyperventilation with 100% oxygen helps maintain adequate oxygen levels, especially when the airway may be compromised.

D) Perform chest physiotherapy prior to suctioning: While chest physiotherapy can help mobilize secretions, it is typically done as a separate intervention and not immediately before suctioning. The priority during suctioning is to clear secretions efficiently and safely, and chest physiotherapy may not be necessary right before this procedure.

A. Battery B. Assault C. Invasion of privacy D. False imprisonment

Correct Answer is D

Explanation

A. Battery involves the unauthorized or harmful touching of another person without their consent. Restraint without proper justification could potentially lead to a charge of battery, but the situation described does not involve actual physical contact.
B. Assault involves the threat of bodily harm to another person, creating fear or apprehension that the harm will be carried out. While the threat of restraint might cause fear, actual restraint is necessary to constitute assault.
C. Invasion of privacy refers to the unauthorized intrusion into an individual's private affairs or the public disclosure of private information. It does not apply to the act of physically restraining a client.
D. False imprisonment occurs when an individual is unlawfully restrained or confined against their will. In this scenario, the provider's directive to restrain the client against her wishes constitutes false imprisonment if the restraint is not justified by the client's medical condition or pose an immediate danger to herself or others.

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A nurse on a medical-surgical unit is reconciling a newly admitted client's medication. The nurse is reviewing the process of medication reconciliation with a newly licensed nurse. The nurse should include which of the following information?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is performing tracheostomy care for a client and suctioning to remove copious secretions. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

Correct Answer is D

Explanation

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