The nurse is preparing to give an emergency sedative injection to an agitated client.
Which action by the nurse is inappropriate?
Placing a client in restraints without having a healthcare provider's order.
Administering the medication to a client behind a closed curtain.
Enlisting security personnel to assist with restraining the client.
Informing a client that the medication being administered is a sedative.
The Correct Answer is A
Placing a client in restraints without having a healthcare provider’s order.
It is inappropriate for a nurse to place a client in restraints without having a healthcare provider’s order.
Choice B is not the answer because administering the medication to a client behind a closed curtain is not necessarily inappropriate.
Choice C is not the answer because enlisting security personnel to assist with restraining the client may be necessary in some situations.
Choice D is not the answer because informing a client that the medication being administered is a sedative is not necessarily inappropriate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The nurse should reassess the client’s pain level and determine if additional interventions are needed to manage the pain.
Choice A is not the answer because while a back rub may provide some temporary relief, it does not address the underlying cause of the pain.
Choice C is not the answer because while deep breathing can help with relaxation, it does not address the underlying cause of the pain.
Choice D is not the answer because telling the client that the medication needs more time to work does not address their current pain level or provide any immediate relief.
Correct Answer is D
Explanation
Prior to performing digital removal of a fecal impaction, it is important for the nurse to assess the client’s vital signs.
This includes checking the client’s blood pressure, pulse rate, respiratory rate, and temperature.
These measurements can provide important information about the client’s overall health status and can help the nurse determine if it is safe to proceed with the procedure.
Choice A is not correct because abdominal girth is not the most important assessment for the nurse to perform prior to performing digital removal of a fecal impaction.
Choice B is not correct because breath sounds are not the most important assessment for the nurse to perform prior to performing digital removal of a fecal impaction.
Choice C is not correct because bowel sounds are not the most important assessment for the nurse to perform prior to performing digital removal of a fecal impaction.
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