A nurse realizes that the wrong medication has been administered to a client. Which of the following actions should the nurse take first?

Fill out an incident report.

Report the incident to the nurse manager.

Notify the provider.

Measure the client's vital signs.

Answer and Explanation

The Correct Answer is D

A. Fill out an incident report. While completing an incident report is necessary for documentation and quality improvement, it is not the priority action. The nurse must first assess the client's condition to address any immediate risks.
B. Report the incident to the nurse manager. Informing the nurse manager is important for accountability and follow-up, but client safety and assessment come first before escalating the issue to management.
C. Notify the provider. The provider should be informed after the nurse has assessed the client and gathered relevant data such as vital signs. This allows the provider to make informed decisions about further treatment or monitoring.
D. Measure the client's vital signs. Assessing the client is the first priority following a medication error to identify any adverse effects. Vital signs provide immediate data on the client’s physiological status and guide urgent interventions if needed.

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Correct Answer is B

Explanation

A. Candidiasis. This is a common fungal infection, often caused by Candida albicans. It is not a reportable disease to public health authorities because it is not typically considered a public health threat.
B. Chlamydia. Chlamydia is a nationally notifiable infectious disease due to its high prevalence and potential for serious complications such as infertility. Providers are required to report it to the state health department to aid in public health surveillance and control efforts.
C. Herpes simplex virus. While herpes is a common sexually transmitted infection, it is not currently on the national notifiable disease list and is not required to be routinely reported to public health agencies.
D. Human papillomavirus (HPV). HPV is widespread and associated with cervical cancer, but routine HPV infection is not reportable. However, certain types of cancer caused by HPV may be included in cancer registries.

A. Heart rate B. Temperature C. Lochia D. Hgb E. WBC count F. Fundal height

Correct Answer is ["A","B","C","E","F"]

Explanation

A. Heart rate. The client’s heart rate decreased from 110/min on postpartum day 3 to 78/min on day 5, returning to normal resting range, which suggests improvement in systemic inflammation or infection, and better overall hemodynamic stability.
B. Temperature. The temperature has decreased from 38.6° C (101.5° F) to 37.1° C (98.9° F), which is within normal limits. This reduction is a key indicator of resolving infection or inflammation, especially considering the earlier febrile response.
C. Lochia. Lochia has improved from a moderate, foul-smelling, dark brown discharge to a small amount of brownish-red lochia with no odor, which suggests infection resolution and appropriate progression of postpartum uterine involution.
D. Hgb. The client’s hemoglobin dropped from 11.1 g/dL to 10 g/dL, which is below the normal postpartum range. This is likely due to ongoing recovery, recent surgery, and fluid shifts, but it does not indicate improvement and may require continued monitoring.
E. WBC count. The WBC count normalized from a significantly elevated 33,000/mm³ to 10,000/mm³, which is within the normal reference range. This is a strong sign that the infection or inflammatory response is resolving.
F. Fundal height. The fundus has decreased from 1 cm above the umbilicus on day 3 to 4 cm below on day 5, which is consistent with normal involution of the uterus during the postpartum period and is a positive sign of recovery.

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A nurse realizes that the wrong medication has been administered to a client. Which of the following actions should the nurse take first?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is ["A","B","C","E","F"]

Explanation

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