At the start of the shift, the practical nurse (PN) reviews a client’s medication administration record and notes that a client has a new prescription for a diuretic to be administered at bedtime. Which action should the PN take?

Explain the purpose of the medication to the client just prior to giving the medication as scheduled

Review the prescription with the charge nurse to determine if a change in time of administration is needed

Withhold the medication until the next day for clarification when the healthcare provider (HCP) makes rounds

Administer the medication early in the day to reduce risk of disturbing the client’s nighttime sleep schedule

Answer and Explanation

The Correct Answer is B

Choice A reason: Explaining the medication’s purpose is important but does not address the inappropriate bedtime dosing. Diuretics increase urination, causing nocturia and sleep disruption. Administering as scheduled without review risks client discomfort, making this choice less appropriate than verifying timing.

Choice B reason: Reviewing the prescription with the charge nurse is critical, as bedtime diuretic administration causes nocturia, disrupting sleep. Diuretics, like hydrochlorothiazide, increase urine production, and morning dosing aligns with daily activity, minimizing nighttime disturbance, ensuring safe and effective administration timing.

Choice C reason: Withholding the medication until the next day delays treatment, risking conditions like edema or hypertension. Consulting the charge nurse allows timely clarification of dosing time, ensuring therapeutic benefits without sleep disruption, making this choice overly cautious and unnecessary.

Choice D reason: Administering the diuretic early without confirmation violates protocol, as the prescription specifies bedtime. Unilateral changes risk errors, and morning dosing requires provider approval. Reviewing with the charge nurse is safer, ensuring alignment with clinical intent while addressing sleep concerns.

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Correct Answer is A

Explanation

Choice A reason: Increasing pain before the next opioid dose suggests inadequate analgesia, possibly due to tolerance or disease progression. Consulting the charge nurse facilitates dosage adjustment or schedule changes, ensuring effective pain control in terminal cancer, where maintaining comfort is critical for quality of life.

Choice B reason: Notifying the provider that the dosage has been increased is incorrect, as the PN cannot unilaterally adjust controlled substances. Pain management requires collaboration, and premature notification without consultation risks legal and clinical errors, making this choice inappropriate.

Choice C reason: Withholding opioid doses risks uncontrolled pain, which is unethical in terminal cancer care. The client’s increasing pain indicates a need for dosage review, not cessation, as opioids are essential for palliation, making this choice harmful and contrary to care goals.

Choice D reason: Administering opioids only when pain exceeds 5 is arbitrary and delays relief. Breakthrough pain before scheduled doses requires proactive dosage or interval adjustments, not reactive thresholds, to maintain consistent analgesia, making this choice inadequate for managing terminal cancer pain.

A. Allergy to iodine B. Flu vaccination date C. Recent tuberculosis test D. Use of oral contraceptives

Correct Answer is C

Explanation

Choice A reason: Iodine allergy is irrelevant to golimumab, a tumor necrosis factor (TNF) inhibitor, as it is not iodine-based. Allergic reactions to biologics are possible but unrelated to iodine sensitivity, making this choice unnecessary for ensuring safe administration of the medication.

Choice B reason: Flu vaccination status is relevant for general health but not critical before golimumab administration. While immunosuppression increases infection risk, tuberculosis screening is more urgent, as TNF inhibitors can reactivate latent TB, posing a severe health threat.

Choice C reason: A recent tuberculosis test is essential, as golimumab suppresses TNF, increasing the risk of reactivating latent TB into active disease. Screening with a tuberculin test or interferon-gamma assay prevents potentially fatal infections, making this the most critical information before starting therapy.

Choice D reason: Oral contraceptive use is unrelated to golimumab’s safety or efficacy. While some drugs interact with contraceptives, golimumab does not, and psoriasis treatment does not involve reproductive considerations, making this choice irrelevant for pre-administration assessment.

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At the start of the shift, the practical nurse (PN) reviews a client’s medication administration record and notes that a client has a new prescription for a diuretic to be administered at bedtime. Which action should the PN take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with terminal cancer reports increasing pain that occurs 1 to 2 hours before the next scheduled dose of a prescribed opioid analgesic. Which action should the practical nurse (PN) implement?

Correct Answer is A

Explanation

A client receives a prescription for golimumab for psoriasis. Which information should the practical nurse (PN) obtain prior to administration?

Correct Answer is C

Explanation

Which symptom reported by a client alerts the practical nurse (PN) to withhold a scheduled dose of hydrochlorothiazide and notify the healthcare provider?

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The practical nurse (PN) is preparing to administer a maintenance dose of an antihypertensive medication to an adult client and notes that the client’s blood pressure is 120/72 mm Hg. Which action should the PN take?

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