Which assessment findings lead the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours? (Select all that apply.)
The patient takes 30 mg morphine sulfate daily.
The patient has severe joint pain due to aggressive arthritis.
The patient has a gastrointestinal bleed.
The patient has a history of diabetes and early renal failure.
The patient has allergies to shellfish, strawberries, and iodine.
Correct Answer : C,D,E
Choice A reason: This is incorrect. The patient takes 30 mg morphine sulfate daily does not lead the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours. Morphine sulfate is an opioid analgesic that can be used in combination with ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), for moderate to severe pain. The nurse should monitor the patient for signs of respiratory depression, sedation, or constipation, but there is no need to clarify the order.
Choice B reason: This is incorrect. The patient has severe joint pain due to aggressive arthritis does not lead the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours. Ibuprofen is indicated for the relief of signs and symptoms of rheumatoid arthritis and osteoarthritis. The nurse should assess the patient's pain level, response to treatment, and adverse effects, but there is no need to clarify the order.
Choice C reason: This is correct. The patient has a gastrointestinal bleed leads the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours. Ibuprofen can cause gastrointestinal irritation, ulceration, bleeding, and perforation. The nurse should question the order and consider alternative analgesics for the patient, especially if they have a history of peptic ulcer disease, gastritis, or bleeding disorders.
Choice D reason: This is correct. The patient has a history of diabetes and early renal failure leads the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours. Ibuprofen can impair renal function, increase blood pressure, and interfere with the effects of antihypertensive and antidiabetic drugs. The nurse should question the order and monitor the patient's renal function, blood pressure, and blood glucose levels closely.
Choice E reason: This is correct. The patient has allergies to shellfish, strawberries, and iodine leads the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours. Ibuprofen can cause hypersensitivity reactions, such as rash, angioedema, bronchospasm, or anaphylaxis. The nurse should question the order and ask the patient about any previous reactions to NSAIDs or aspirin. The patient may need to avoid ibuprofen and use a different analgesic..
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is incorrect. Documenting the finding in the patient’s medical record is an important step, but not the most appropriate first action of the nurse. The nurse should first confirm the irregularity by counting the apical pulse.
Choice B reason: This is incorrect. Assessing the brachial pulse for a pulse deficit is a useful technique, but not the most appropriate first action of the nurse. A pulse deficit is the difference between the apical and radial pulse rates. The nurse should first count the apical pulse before comparing it with the radial pulse.
Choice C reason: This is incorrect. Notifying the health care provider immediately is a necessary step, but not the most appropriate first action of the nurse. The nurse should first gather more information by counting the apical pulse and determining the type and severity of the irregularity.
Choice D reason: This is correct. Counting the patient’s apical pulse for one full minute is the most appropriate first action of the nurse. The apical pulse is the most accurate way to measure the heart rate and rhythm. The nurse should listen to the heart sounds at the apex of the heart, which is located at the fifth intercostal space, left midclavicular line. The nurse should count the number of beats and note any irregularities, such as skipped, extra, or uneven beats.
Correct Answer is D
Explanation
Choice A reason: This is an incorrect choice because calling the operator to activate the fire alarm is not the nurse’s first response when a patient smokes in the hospital bathroom and starts a fire. Calling the operator to activate the fire alarm is an important action to alert the fire department and the other staff and patients, but it is not the most urgent or priority action. The nurse should first ensure the safety of the patient and themselves before calling for help.
Choice B reason: This is an incorrect choice because closing the door to contain the fire is not the nurse’s first response when a patient smokes in the hospital bathroom and starts a fire. Closing the door to contain the fire is a helpful action to prevent the fire from spreading to other areas, but it is not the most urgent or priority action. The nurse should first ensure the safety of the patient and themselves before containing the fire.
Choice C reason: This is an incorrect choice because utilizing a fire extinguisher to put out the fire is not the nurse’s first response when a patient smokes in the hospital bathroom and starts a fire. Utilizing a fire extinguisher to put out the fire is a possible action to control the fire, but it is not the most urgent or priority action. The nurse should first ensure the safety of the patient and themselves before attempting to extinguish the fire.
Choice D reason: This is the correct choice because removing the patient to a safe area is the nurse’s first response when a patient smokes in the hospital bathroom and starts a fire. Removing the patient to a safe area is the most urgent and priority action to protect the patient from the fire, smoke, and heat. The nurse should first assess the patient for any injuries or burns, and then move the patient to a safe and clear location away from the fire.
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