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

A: Discreetly hiding the medication in the patient’s favorite gelatin is unethical and violates the patient’s right to informed consent. This approach undermines trust and can lead to further resistance or legal issues.

B: Agreeing with the patient’s decision and documenting it in the chart is important, but it should not be the first action. The nurse needs to understand the patient’s reasons for refusal before making any decisions or documentation.

C: Exploring with the patient the reasons for not wanting to take the medication is the appropriate first action. This approach allows the nurse to understand the patient’s concerns, address any misconceptions, and provide relevant information. It also respects the patient’s autonomy and promotes a collaborative approach to care.

D: Educating the patient about the importance of the medication is crucial, but it should follow the exploration of the patient’s reasons for refusal. Understanding the patient’s perspective first ensures that the education provided is relevant and addresses specific concerns.

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Correct Answer is B

Explanation

A: Neostigmine is used to treat myasthenia gravis and to reverse the effects of muscle relaxants after surgery. It is not an antidote for morphine overdose.

B: Naloxone is the correct medication to have available. It is an opioid antagonist used to reverse the effects of opioid overdose, including respiratory depression caused by morphine.

C: Protamine is used to reverse the effects of heparin, an anticoagulant. It is not related to opioid overdose treatment.

D: Flumazenil is used to reverse the effects of benzodiazepines. It is not effective for reversing opioid overdose.

A. Check the client’s motor strength. B. Turn the client’s head to the side. C. Document the time the seizure began. D. Loosen the clothing around the client’s waist.

Correct Answer is B

Explanation

A: Checking the client’s motor strength is not the first priority during a seizure. Ensuring the client’s safety and airway patency is more important.

B: Turning the client’s head to the side is the first action. This helps maintain an open airway and prevents aspiration of saliva or vomit.

C: Documenting the time the seizure began is important for medical records but is not the immediate priority during the seizure.

D: Loosening the clothing around the client’s waist can help with comfort but is not the first action to take during a seizure.

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

Nursing Test Bank

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