A nurse opens unit-dose of a prescribed medication prior to administering it to a client. After education, the client refuses to take the medication. Which of the following actions should the nurse take?

Notify the facility’s ethics committee

Return the opened medication in the medication cart

Report the incident to the provider

Fill out an incident report

Answer and Explanation

The Correct Answer is C

A) Notify the facility’s ethics committee:
While it may be relevant to involve an ethics committee in certain complex situations, such as when there are concerns about patient autonomy or ethical decision-making, the refusal of a medication by a client is generally a standard issue that does not immediately require ethics consultation.

B) Return the opened medication in the medication cart:
Returning an opened unit-dose medication to the cart is not appropriate. Once a unit-dose medication is opened, it cannot be reused due to safety concerns (e.g., contamination, dosage errors). The opened medication should be disposed of properly according to the facility's policies for medication handling and disposal.

C) Report the incident to the provider:
The provider should be notified when a client refuses medication, especially if the medication is essential for the client’s treatment or health condition. It is important for the nurse to document the refusal and inform the provider so that appropriate follow-up can be arranged, including possible reassessment of the treatment plan, alternative medications, or further education for the client.

D) Fill out an incident report:
An incident report is typically completed for situations that involve safety issues, errors, or accidents that may affect patient safety or quality of care. While refusal of medication is an important event, it does not generally require an incident report unless it involves an unusual or dangerous situation, such as a medication error or patient harm.

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Correct Answer is B

Explanation

A) Improved sexual function:
While ACE inhibitors like lisinopril may have a beneficial impact on overall health, improved sexual function is not a direct therapeutic effect of this medication. In fact, ACE inhibitors can sometimes cause side effects like sexual dysfunction in some individuals. Therefore, improved sexual function is not considered a therapeutic outcome for lisinopril.

B) Decreased blood pressure:
Lisinopril is an ACE (angiotensin-converting enzyme) inhibitor that works by blocking the conversion of angiotensin I to angiotensin II, which results in vasodilation and lowered blood pressure. Therefore, a decreased blood pressure is the expected and desired outcome when a client is on lisinopril. This is the primary therapeutic effect of the medication.

C) Increase of HDL cholesterol:
Lisinopril does not have a direct effect on increasing HDL (high-density lipoprotein) cholesterol. While ACE inhibitors may have some indirect cardiovascular benefits, such as improving endothelial function or reducing risk factors for heart disease, raising HDL cholesterol is not one of their specific effects. This outcome would not indicate a therapeutic effect of lisinopril.

D) Prevention of bipolar manic episodes:
Lisinopril is not used for the treatment or prevention of bipolar disorder or its manic episodes. While certain medications, such as mood stabilizers or antipsychotics, may be used in the management of bipolar disorder, lisinopril is not effective for this purpose. Therefore, preventing bipolar manic episodes is not a therapeutic outcome of lisinopril.

A. Uncomplicated grief B. Prolonged grief C. Anticipatory grief D. Disenfranchised grief

Correct Answer is B

Explanation

A) Uncomplicated grief:
Uncomplicated grief refers to the normal, expected process of grieving after a loss, where the individual experiences sadness and mourning, but with time, they are able to gradually accept the loss and move forward. The key difference is that uncomplicated grief tends to resolve over a relatively short period (typically within months), and the individual can begin to adjust to life without the deceased.

B) Prolonged grief:
Prolonged grief (also known as complicated or persistent grief) occurs when an individual continues to experience intense emotional pain and difficulty accepting a loss long after the typical grieving period has passed. This can lead to a persistent sense of yearning or preoccupation with the deceased, and difficulty with daily functioning. The client in this case, who is still unable to accept the loss three years after the partner's death, is experiencing manifestations consistent with prolonged grief.

C) Anticipatory grief:
Anticipatory grief occurs when an individual begins to grieve before the actual loss, often in cases of terminal illness or when death is imminent. In these cases, individuals experience grief while the person is still alive, knowing the loss is inevitable. Since the partner has already passed away, this does not apply to the client in this scenario, who is dealing with the grief after the fact.

D) Disenfranchised grief:
Disenfranchised grief occurs when an individual's grief is not openly acknowledged or socially supported, such as when the relationship is not recognized by society (e.g., a non-marital partner or a complicated relationship). While the client might feel unsupported or unable to express their grief in certain situations, there is no information provided suggesting that the client’s grief is disenfranchised.

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A nurse opens unit-dose of a prescribed medication prior to administering it to a client. After education, the client refuses to take the medication. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for client who is taking lisinopril (ACE inhibitor). Which of the following outcomes indicates a therapeutic effect of the medication?

Correct Answer is B

Explanation

A nurse is caring for a client whose partner died 3 years ago and reports that they are still unable to accept the loss. The nurse should identify that the client has manifestations of which of the following types of grief?

Correct Answer is B

Explanation

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