Patient Data

Exhibits

The primary nurse went on break at 1845. The covering nurse gave insulin glargine and decided to manually document the dose but forgot to enter it into the electronic health record. The primary nurse came back from break and gave a second dose of insulin because of being unaware the covering nurse gave the ordered dose.

What medication error prevention techniques would have helped to avoid this error? Select all that apply.

Compare the medication label to the order

Use at least 2 client identifiers before administering a dose

Document all medication in the electronic record as soon as it is given

Involve and educate clients in medication administration

Question unusually large or small doses F Double check all dosage calculations

Answer and Explanation

Correct Answer : C,D

Immediate documentation after drug administration ensures the everyone who comes into contact with the client is aware of what has already been done

Ensuring the client does the administration also avoids such errors. The client is able to understand and question when too many doses are given without proper explanation.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

D. An oxygen saturation of 89% indicates hypoxemia, meaning the client's blood oxygen level is below the normal range. In this situation, the nurse should first attempt to increase the oxygen flow rate to improve oxygenation. Increasing the oxygen flow rate to 3 L/minute may help raise the client's oxygen saturation to an acceptable level.
A. Removing the nasal cannula would deprive the client of oxygen, which could worsen hypoxemia and potentially compromise their recovery.
B. If the pulse oximeter is not properly placed or if there are any issues with the sensor, it could lead to inaccurate readings. However, this action alone may not address the underlying issue of hypoxemia.
C. Switching to a non-rebreather mask would deliver a higher concentration of oxygen to the client compared to a nasal cannula. However, this intervention may be excessive at this point.

A. Use standard precautions and wear a mask. B. Send wound drainage for culture and sensitivity. C. Institute contact precautions for staff and visitors. D. Explain the purpose of a low bacteria diet. E. Monitor the client's white blood cell count.

Correct Answer is ["B","C","E"]

Explanation

B. Sending wound drainage for culture and sensitivity helps identify the specific bacteria causing the infection and determine the most appropriate antibiotic therapy.
C. Instituting contact precautions for staff and visitors is essential to prevent the spread of MRSA to other clients and healthcare workers.
E. Monitoring the client's white blood cell count can provide information about the body's response to infection and the effectiveness of treatment.
A. While using standard precautions, including wearing a mask, is a general practice, it is not specifically required for MRSA unless there is a risk of droplet transmission, which is not typical for MRSA infections.
D. Explaining the purpose of a low bacteria diet (Option D) is not a standard intervention for MRSA infections.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is postoperative and receiving supplemental oxygen at 2 L/minute via nasal cannula. The oxygen saturation is 89%. Which action should the nurse implement?

Correct Answer is D

Explanation

A client who is paraplegic is admitted with a foul-smelling drainage from a sacral ulcer. The client is suspected to have a methicillin resistant Staphylococcus aureus (MRSA) infection. Which nursing intervention(s) should the nurse include in the plan of care? Select all that apply.

Correct Answer is ["B","C","E"]

Explanation

When assuming care of a client at 1900, the nurse learns in report that a client with a urinary tract infection had an indwelling urinary catheter removed during the previous shift. Which information is most important for the nurse to obtain?

The healthcare provider prescribes a 24-hour urine specimen to be collected for creatinine clearance. The client is eager to go home and tells the nurse that the first sample was put in the urinal 2 hours ago. Which action should the nurse implement?

The nurse is administering an intradermal (ID) injection to a client. Which action should the nurse take?

The healthcare provider prescribes streptomycin 200 mg IM every 12 hours. The vial is labeled, "Streptomycin 1 gram/2.5 mL How many milliliters should the nurse administer? (Enter numerical value only. If rounding is required, round to the nearest tenth.)

The palliative care nurse receives a consult for a terminally ill client in the intensive care unit. The client is weak, mouth breathing. and refusing anything to eat or drink. Which intervention should the nurse include plan of care?

Which client assessment should the nurse perform during nasopharyngeal suctioning?

A client is admitted to the rehabilitation unit following a cerebrovascular accident (CVA), which resulted in paralysis of the right arm. When the nurse enters the room, the client is struggling to put on a shirt, and curses at the nurse. Which response is best for the nurse to provide?