At 0200 the nurse phones the healthcare provider to request a PRN medication for a client who is unable to sleep. The healthcare provider is awakened, and gives the nurse a prescription for four times the normal dosage. When questioned by the nurse, the healthcare provider responds in a sleepy voice, "Yeah, OK," and hangs up the phone. Which action should the nurse take first?

Record that the nurse questioned the prescription, and ask the supervisor for guidance.

Notify the medical chief of staff of the situation, and request a prescription for the client.

Call the healthcare provider back, and report that the dosage prescribed is four times the normal dose.

Refuse to administer the medication, and write an incident report describing the event.

Answer and Explanation

The Correct Answer is C

Choice A rationale: Recording that the nurse questioned the prescription and seeking guidance from the supervisor can be done after calling the healthcare provider back.

Choice B rationale: Notifying the medical chief of staff may be necessary, but the nurse should first call the healthcare provider back.

Choice C rationale: Calling the healthcare provider back to report the dosage discrepancy is important, because it will allow the healthcare provider to correct the mistake and give a safe prescription.

Choice D rationale: Refusing to administer the medication and writing an incident report is an appropriate action, but it should be done if the healthcare provider does not respond or insists on giving the wrong prescription.

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Correct Answer is {"dropdown-group-1":"B"}

Explanation

Choice A rationale: Maintaining personal malpractice insurance is important for individual protection but does not directly address preventing litigation related to client dissatisfaction.

Choice B rationale: Discussing how to handle complaints from clients and/or their families is an important objective to include in the orientation classes for staff nurses, because it can help prevent litigation by a dissatisfied client.

Choice C rationale: Completing an adverse occurrence or variance report is a necessary step after an error or incident has occurred, but it does not prevent litigation by itself.

Choice D rationale: Describing how to obtain legal services, while valuable, is a reactive rather than proactive approach to preventing litigation.

A. Two hours after receiving morphine for acute pain, a client's vital signs are BP 112/60 mm Hg, pulse 88 beats/minute, and respirations 14 breaths/minute. B. One hour after receiving hydromorphone prescribed for every 4 hours PRN use, a client reports severe pain. C. The fentanyl transdermal patch for a client with chronic cancer pain needs to be replaced. D. After ambulating, a postoperative client grimaces and reports incisional pain at a "9" on a ten-point scale.

Correct Answer is B

Explanation

Choice A rationale: Vital signs within the normal range two hours after receiving morphine do not indicate an immediate need for intervention by a registered nurse. Choice B rationale: A client reporting severe pain one hour after receiving hydromorphone requires assessment and intervention by a registered nurse to determine the cause of the pain and implement appropriate measures. Hydromorphone is a potent opioid analgesic that can cause serious side effects such as respiratory depression, sedation, hypotension, and constipation. A registered nurse has the knowledge and skills to monitor these effects and intervene if necessary.

Choice C rationale: Changing a fentanyl transdermal patch is a routine procedure and can be safely performed by a practical nurse.

Choice D rationale: A postoperative client reporting incisional pain requires assessment, but the pain level alone does not indica

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Naxlex Comprehensive Predictor Exams

To help prevent litigation by a dissatisfied client, which objective is most important to include in the orientation classes for staff nurses? New nursing staff members will dropdown

Correct Answer is {"dropdown-group-1":"B"}

Explanation

It is most important to assign which client to a registered nurse rather than a practical nurse (PN)?

Correct Answer is B

Explanation

The receptionist working in an outpatient clinic provides the nurse with a list of clients who need a return call from the nurse. The nurse should call the client with which description first?

A group of nurse managers is asked to engage in a needs assessment for a piece of equipment that will be expensed to the organizations budget. Which question is most important to consider when analyzing the cost-benefit for this piece of equipment?

A client with life threatening injuries from a gunshot wound to the abdomen is mechanically ventilated and sedated. The client has a large family present who are asking multiple and repetitive questions. Which intervention should the nurse implement first?

A client with influenza is admitted to the medical unit. The nurse observes an unlicensed assistive personnel (UAP) preparing to enter the client's room to take vital signs and assist with personal care. The UAP has applied gloves and a gown. Which action should the nurse take?

The nurse determines that an intravenous (IV) vesicant chemotherapy infusion is infiltrated. In responding to this finding, which task can the nurse delegate to the unlicensed assistive personnel (UAP)?

A client is admitted with exacerbation of chronic obstructive pulmonary disease (COPD) and reports that it is difficult to eat due to shortness of breath (SOB). Which task(s) should the nurse delegate to the unlicensed assistant personnel (UAP)? Select all that apply.

Aspirin 81 mg at 0900 daily is prescribed for an adult client. At 0800 the client asks for something for low back pain, but does not have any PRN analgesics prescribed. Which action is best for the nurse to take?