The patient is ordered a nasal spray. Which intervention should the nurse instruct the patient to do prior to administration of the nasal spray?
Ask the patient to use the bathroom
Instruct the patient to look up at the ceiling
Ask the patient to take a deep breath
Ask the patient to blow his/her nose to clear the nasal passages
The Correct Answer is D
A. Asking the patient to use the bathroom is unrelated to the administration of nasal spray and is not necessary.
B. Instructing the patient to look up at the ceiling is not required for nasal spray administration and does not facilitate the process.
C. Asking the patient to take a deep breath is not directly related to the administration of nasal spray and does not affect its effectiveness.
D. Asking the patient to blow his/her nose to clear the nasal passages is important before administering nasal spray. Clearing nasal passages helps ensure that the medication can reach the nasal mucosa effectively, improving absorption and efficacy of the spray.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Filling out an incident report is necessary but should not be the first action after administering the wrong medication.
B. Notifying the charge nurse is important, but assessing the client's immediate condition takes priority.
C. Checking the client's vital signs is the first action to assess for any adverse effects from the wrong medication and determine the next steps in care.
D. Documenting the client's condition is important but should occur after assessing the client's vital signs and addressing immediate needs.
Correct Answer is B
Explanation
A. Sublingual medications are meant to be absorbed under the tongue and should not be administered through an NG tube, which bypasses this route of absorption.
B. Administering the medication under the tongue is the correct route for sublingual administration. It ensures that the medication is allowed to dissolve completely and is not swallowed immediately. This allows for the intended rapid absorption through the sublingual route.
C. If a client has an NG tube and needs a medication that is typically given sublingually, the nurse should administer the medication under the tongue.
D. Dissolving sublingual medication in water for NG tube administration is not appropriate as it alters the intended route of absorption.
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