A student nurse is learning about client safety.
The student nurse should recognize that which of the following is true regarding client safety and prevention of harm?

Medical errors are not the result of poorly coordinated care.

Medication errors are intentional.

As many as 50% of adverse drug events are preventable.

Hand-off errors are not causes of adverse events.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Medical errors are frequently the result of poorly coordinated care, often stemming from communication breakdowns, fragmented systems, and lack of clear protocols among healthcare providers and departments. Scientific evidence consistently links systemic failures in care coordination to an increased incidence of adverse events and medical errors. Optimizing coordination across the healthcare continuum is a key strategy for enhancing patient safety.

Choice B rationale

Medication errors are almost universally unintentional. They arise from various factors including miscalculations, transcription errors, improper administration techniques, or miscommunication. While negligence can play a role, the vast majority of medication errors are not deliberate acts. Healthcare systems focus on developing robust error prevention strategies to minimize the likelihood of these unintended events through process improvements and technology.

Choice C rationale

As many as 50% of adverse drug events (ADEs) are preventable. This high percentage underscores the importance of implementing evidence-based strategies, such as medication reconciliation, barcode medication administration, clinical decision support systems, and thorough patient education. Many ADEs result from predictable drug-drug interactions, incorrect dosages, or allergies that could be intercepted with proactive interventions and careful monitoring.

Choice D rationale

Hand-off errors are a significant cause of adverse events. Poor communication during transitions of care, such as shift changes or patient transfers, can lead to critical information being omitted, misunderstood, or miscommunicated. This can result in delayed diagnoses, inappropriate treatments, or medication errors, highlighting the need for standardized and effective hand-off protocols to ensure patient safety and continuity of care.

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Correct Answer is A

Explanation

Choice A rationale

Sun exposure, specifically ultraviolet (UV) radiation, is a well-known trigger for exacerbations in systemic lupus erythematosus (SLE). UV light can induce apoptosis of keratinocytes, leading to the release of nuclear antigens. These antigens can then stimulate the immune system in susceptible individuals, precipitating or worsening disease activity, including skin rashes, fatigue, and organ inflammation. Therefore, sunbathing is contraindicated.

Choice B rationale

Hair dyes and relaxers contain chemicals that can irritate the scalp and potentially trigger a cutaneous lupus flare or hair loss in individuals with SLE, especially during periods of active disease. Avoiding these irritants during remission helps minimize the risk of exacerbations, maintaining scalp health and preventing potential immune system activation which could lead to a flare.

Choice C rationale

Fever in a client with SLE can indicate an active inflammatory process, infection, or a disease flare. The immune dysregulation in SLE makes these clients more susceptible to infections and inflammatory responses. Prompt reporting allows for timely evaluation to differentiate between infection and a lupus flare, enabling appropriate and rapid intervention to prevent complications.

Choice D rationale

Adherence to prescribed medications, even when symptoms improve, is crucial in managing chronic autoimmune diseases like SLE. Medications, often immunosuppressants or anti-inflammatories, work to control disease activity, prevent organ damage, and maintain remission. Discontinuing medication prematurely can lead to a rebound of symptoms, disease flares, and irreversible organ damage.

A. Expect to have increased generalized bruising. B. Monitor for muscle pain. C. Take this medication without food if nausea develops. D. Increase your intake of grapefruit juice.

Correct Answer is B

Explanation

Choice A rationale

Colchicine does not primarily cause increased generalized bruising. Bruising is more commonly associated with medications affecting platelet function or coagulation, such as anticoagulants or antiplatelet agents. Colchicine's primary mechanism of action involves inhibiting neutrophil migration and inflammatory processes, not directly impacting hemostasis, therefore this is not an expected side effect.

Choice B rationale

Monitoring for muscle pain, or myalgia, is important for clients taking colchicine. Colchicine can cause skeletal muscle toxicity, leading to rhabdomyolysis in some individuals, particularly with higher doses or in the presence of renal impairment. Myalgia is a key symptom of muscle breakdown and should prompt further investigation, including creatine kinase (CK) levels (normal range 22-198 U/L).

Choice C rationale

Colchicine should ideally be taken with food if gastrointestinal upset, such as nausea, develops. Taking it on an empty stomach can exacerbate these side effects, which are common with colchicine due to its effects on rapidly dividing cells in the gastrointestinal tract. Consuming food helps to buffer the medication and reduce gastric irritation.

Choice D rationale

Increasing intake of grapefruit juice is contraindicated with colchicine. Grapefruit juice inhibits the cytochrome P450 3A4 (CYP3A4) enzyme system and P-glycoprotein, both of which are involved in the metabolism and excretion of colchicine. This inhibition can lead to increased plasma concentrations of colchicine, significantly raising the risk of toxicity, including severe myopathy and bone marrow suppression.

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A student nurse is learning about client safety. The student nurse should recognize that which of the following is true regarding client safety and prevention of harm?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client newly diagnosed with systemic lupus erythematosus (SLE). The nurse should recognize that which statement made by the client indicates the need for further teaching about the course and management of SLE?

Correct Answer is A

Explanation

A nurse is teaching a client diagnosed with Gout about the new prescription for Colchicine. Which of the following instructions should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is caring for a client who is receiving hospice care in the home. The family asks, "How will we know when death is near?" The nurse should inform the family that which of the following signs indicates that death is approaching? (Select all that apply.)

A nurse is caring for a client with a chest tube in place for treatment of a hemothorax. The nurse should prioritize which nursing intervention when caring for this client?

The nurse is preparing a teaching session for a client recently diagnosed with metastatic breast cancer. Which of the following statements by the nurse is most appropriate to include in the education regarding metastatic disease?

A nurse is caring for a client with a history of an abdominal aortic aneurysm (AAA). Which of the following assessments should be the nurse's priority for a client with an Abdominal Aortic Aneurysm?

A client diagnosed with autoimmune deficiency syndrome (AIDS) expresses to a nurse that they will never permit disclosure of their diagnosis to anyone. The nurse should provide the client with which of the following education? (Select all that apply.)

A nurse is caring for a client admitted with a diagnosis of acute kidney injury. The client asks the nurse, "Are my kidneys failing and will I need a kidney transplant?" The nurse should respond to the client with which of the following statements?

A client is noted to have Type I hypersensitivity reaction with a systemic response. Which clinical manifestations should the nurse anticipate? (Select all that apply.)

A nurse is caring for a client on a ventilator. The nurse should include which of the following interventions in the plan of care to prevent ventilator associated pneumonia? (Select All that Apply)

A student nurse is learning about client safety.
The student nurse should recognize that which of the following is true regarding client safety and prevention of harm?