A patient refuses medication. Which is the nurse's first action?

Discreetly hide the medication in the patient's favorite gelatin.

Agree with the patient's decision and document it in the chart.

Explore with the patient reasons for not wanting to take the medication.

Educate the patient about the importance of the medication.

Answer and Explanation

The Correct Answer is C

Choice A reason:

Discreetly hiding medication in food without the patient's knowledge or consent is unethical and violates the patient's autonomy and rights. This approach undermines trust and can have legal and professional repercussions for the nurse.

Choice B reason:

Agreeing with the patient's decision and documenting it without further exploration or discussion misses an opportunity to understand the patient's concerns or fears. The nurse should engage with the patient to address any issues or misunderstandings before accepting their refusal.

Choice C reason:

Exploring with the patient the reasons for not wanting to take the medication is the appropriate first step. This approach allows the nurse to understand the patient's perspective, address any concerns or misconceptions, and provide tailored education or support. It respects the patient's autonomy while facilitating informed decision-making.

Choice D reason:

Educating the patient about the importance of the medication is essential, but it should come after understanding their reasons for refusal. Addressing concerns first builds a foundation for effective education and collaborative care.

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Correct Answer is A

Explanation

Choice A reason:

Discontinuing metformin 43 hours before a CT scan with contrast is necessary to prevent the risk of lactic acidosis. Metformin can interact with the contrast dye used in CT scans, potentially causing kidney dysfunction. This dysfunction can lead to the accumulation of metformin in the body, increasing the risk of lactic acidosis, a rare but serious condition. By discontinuing metformin well in advance, it ensures that the medication is sufficiently cleared from the body, minimizing this risk.

Choice B reason:

One week is an excessively long period to discontinue metformin before a CT scan with contrast. While safety is paramount, unnecessarily prolonging the discontinuation of metformin can adversely affect diabetes management, leading to poor blood glucose control. Generally, a shorter duration suffices to reduce the risk of lactic acidosis while maintaining effective diabetes treatment.

Choice C reason:

Two hours is insufficient time to discontinue metformin before a CT scan with contrast. Metformin needs to be discontinued at least 24-48 hours prior to the procedure to adequately reduce the risk of lactic acidosis. The two-hour window does not provide enough time for the drug to be cleared from the body, thereby failing to ensure patient safety.

Choice D reason:

Sixty minutes (or one hour) is also too short a duration to safely discontinue metformin before a CT scan with contrast. The purpose of stopping metformin is to allow enough time for the medication to be eliminated from the system, and one hour is not adequate for this process. Adequate preparation time is crucial to minimize the risk of lactic acidosis associated with metformin and contrast dye interactions.

A. Request the risk manager obtain consent for HIV testing from the client. B. Complete an incident report. C. Wash the site of injury with soap and water. D. Consent to postexposure treatment with antiretroviral medications.

Correct Answer is C

Explanation

Choice A reason:

Requesting the risk manager to obtain consent for HIV testing from the client is important, but it should not be the nurse's immediate action. The priority is to address the immediate risk of infection and prevent any potential pathogens from entering the nurse's body. HIV testing can be done after the immediate threat has been managed. Therefore, while significant, it is not the correct first step.

Choice B reason:

Completing an incident report is a necessary step following a needle stick injury, as it ensures that the incident is documented and that necessary follow-up actions can be taken. However, this action should come after immediate measures to reduce the risk of infection. Documentation is critical for tracking and preventing future incidents, but it does not address the immediate health threat to the nurse.

Choice C reason:

Washing the site of injury with soap and water is the correct immediate action. It is crucial to clean the area to reduce the likelihood of infection. This step helps to remove any potential contaminants from the wound, thereby lowering the risk of transmission of any infectious agents. This immediate response is vital for infection control and is recommended by health authorities as the first step after a needle stick injury.

Choice D reason:

Consenting to postexposure treatment with antiretroviral medications is a significant step in managing potential exposure to HIV or other bloodborne pathogens. However, this should be done after the initial step of cleaning the injury site. Antiretroviral treatment is part of the broader postexposure protocol and is not the immediate action to take right after the injury occurs.

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A patient refuses medication. Which is the nurse's first action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A diabetic client who is currently taking metformin is ordered a computerized tomography (CT) scan with contrast. The nurse understands that the client's metformin should be discontinued how many hours before receiving intravenous (IV) contrast?

Correct Answer is A

Explanation

While caring for a client, the nurse experiences a needle stick injury. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

The nurse is caring for a client currently taking a combination birth control pill for contraception prevention. Which adverse effect would the nurse closely monitor for associated with this medication?

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A nurse is caring for a client who has an infection. The nurse should use which of the following strategies to prevent the transmission of the client's infection?