A nurse received a prescription to administer a medication NOW to a client. Which action should the nurse take?

Administer the medication within 90 minutes of the provider prescribing the medication.

Administer the medication at specific times until directed by the provider.

Administer the medication at every 4-hour intervals.

Administer the medication whenever the client reports specific manifestations, such as pain.

Answer and Explanation

The Correct Answer is A

Choice A reason: Administering the medication within 90 minutes of the provider prescribing it aligns with the definition of a “NOW” order. A “NOW” order is intended to be given promptly but not as urgently as a STAT order, which requires immediate administration. This timeframe ensures that the medication is given in a timely manner to address the client’s needs without unnecessary delay.

Choice B reason: Administering the medication at specific times until directed by the provider is not appropriate for a “NOW” order. This approach is more suitable for routine or scheduled medications, where the timing is predetermined and consistent. A “NOW” order requires prompt action rather than adherence to a fixed schedule.

Choice C reason: Administering the medication at every 4-hour intervals is incorrect for a “NOW” order. This frequency is typical for PRN (as needed) medications or those requiring regular dosing intervals. A “NOW” order is a one-time directive that necessitates timely administration soon after the order is given.

Choice D reason: Administering the medication whenever the client reports specific manifestations, such as pain, is characteristic of PRN orders. PRN orders are given based on the client’s symptoms and needs at the time. A “NOW” order, however, is a one-time order that should be carried out promptly, regardless of the client’s immediate symptoms.

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Correct Answer is A

Explanation

Choice A reason: Applying compression stockings is a key prophylactic intervention to prevent complications of immobility, such as deep vein thrombosis (DVT) and venous thromboembolism (VTE). Compression stockings help improve blood circulation in the legs by applying graduated pressure, which reduces the risk of blood clots forming in the deep veins. This is particularly important for immobile patients who are at higher risk of developing DVT due to prolonged periods of inactivity.

Choice B reason: Raising all side rails is primarily a safety measure to prevent falls and does not directly address the complications of immobility. While it is important for patient safety, it does not have a significant impact on preventing issues like DVT, pressure ulcers, or muscle atrophy. Therefore, it is not considered a prophylactic intervention for immobility-related complications.

Choice C reason: Inserting a urinary catheter is not a prophylactic intervention for preventing complications of immobility. Catheters are used to manage urinary retention or incontinence but can increase the risk of urinary tract infections (UTIs) if not managed properly. They do not address the primary complications associated with immobility, such as DVT or pressure ulcers.

Choice D reason: Using friction-reducing devices is important for preventing pressure ulcers and skin injuries in immobile patients. These devices help minimize friction and shear forces on the skin, which can lead to pressure ulcers. While this is a valuable intervention, it is not as comprehensive as compression stockings in preventing a range of immobility-related complications.

A. Date of birth B. Photograph identification C. Facility room number D. Client’s full name

Correct Answer is ["A","D"]

Explanation

Choice A Reason:

Date of birth is an acceptable client identifier. The Joint Commission specifies that using the date of birth helps ensure accurate identification of the client. This identifier is unique to each individual and is less likely to be duplicated.

Choice B Reason:

Photograph identification is not typically listed as an acceptable identifier by the Joint Commission. While it can be useful in some settings, it is not one of the primary identifiers recommended for ensuring patient safety.

Choice C Reason:

Facility room number is not an acceptable client identifier. The Joint Commission explicitly states that room numbers should not be used as identifiers because they can change and are not unique to the individual.

Choice D Reason:

Client’s full name is an acceptable client identifier. Using the full name helps to accurately identify the client and match them with their medical records and treatment plans.

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A nurse received a prescription to administer a medication NOW to a client. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is immobile. Which prophylactic intervention would be used to prevent complications of immobility?

Correct Answer is A

Explanation

A nurse is preparing to administer oral medications to a client. According to the Joint Commission, which are acceptable client identifiers? (Select all that apply.)

Correct Answer is ["A","D"]

Explanation

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