Question

A nurse administers the wrong dose of medication to a client. Which of the following actions should the nurse implement first?

Answer 1

Correct Answers:

Monitor the client's condition.

Rationale :

🔴 When a medication error occurs, the first priority is client safety.

🔴 Monitoring ensures early detection of adverse effects or toxicity.

🔴 Notifying the provider, manager, or completing an occurrence report comes after ensuring the client’s stability.

🔴 Monitoring includes vital signs, level of consciousness, and symptoms related to the drug.

🔴 This action aligns with nursing priorities: safety, assessment, and timely intervention.

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Answer 2

Correct Answers:

Compile a list of all medications the client is currently taking.

Rationale :

🔵 Medication reconciliation starts with gathering complete and accurate medication history.

🔵 Comparison and addressing discrepancies occur after the initial compilation.

🔵 Documentation and communication with pharmacy are final steps.

🔵 Ensures continuity of care and reduces risk of errors.

🔵 Accurate lists are critical for safety during transitions of care.

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Answer 3

Correct Answers:

Arrythmia

Rationale :

🔴 Potassium chloride is given to correct or prevent hypokalemia, which can lead to cardiac arrhythmias.

🔴 Kidney transplant may alter potassium excretion but is not an indication for supplementation by itself.

🔴 Endocarditis or seizures are not indications for potassium chloride.

🔴 Administration requires careful monitoring of serum potassium and cardiac rhythm.

🔴 Ensures safe and effective replacement therapy.

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Answer 4

Correct Answers:

"Use a soft-bristled toothbrush to brush your teeth."

Rationale :

🔵 Phenytoin may cause gingival hyperplasia, which is prevented by gentle oral care.

🔵 Antacids may interfere with absorption, so avoid simultaneous administration.

🔵 Discontinuing phenytoin without provider guidance risks seizures.

🔵 Extended-release capsules should not be dissolved, they must be swallowed whole.

🔵 Patient education promotes oral health and adherence to therapy.

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Answer 5

Correct Answers:

A period of asystole

Rationale :

🔴 IV adenosine is used for supraventricular tachycardia.

🔴 It temporarily blocks AV node conduction, causing brief asystole.

🔴 Heart rate increases or conversion of atrial fibrillation are not expected effects.

🔴 Loss of consciousness may occur briefly if prolonged or in sensitive clients, but asystole is the primary anticipated effect.

🔴 Nurses must monitor cardiac rhythm and prepare for resuscitation if needed.

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Answer 6

Correct Answers:

2000

Rationale :

🔵 Insulin degludec is ultra-long-acting with a peak effect approximately 12 hours after administration.

🔵 Administered at 0800 → peak occurs around 2000.

🔵 Timing ensures monitoring for hypoglycemia during peak hours.

🔵 Provides steady basal insulin coverage over 24 hours.

🔵 Patient education includes recognizing and managing hypoglycemia during peak times

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Answer 7

Correct Answers:

A young adult who has a febrile illness

Rationale :

🔴 Inactivated influenza vaccine is contraindicated in clients with acute moderate or severe febrile illness.

🔴 Hypersensitivity to amoxicillin is not a contraindication; only severe egg protein allergy may require caution.

🔴 Pregnancy and cerebral palsy do not contraindicate the inactivated flu vaccine.

🔴 Administering the vaccine to a febrile client may worsen illness or reduce vaccine efficacy.

🔴 Screening for current fever or acute illness is a standard safety practice.

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Answer 8

Correct Answers:

Chlordiazepoxide

Rationale :

🔵 Chlordiazepoxide is a benzodiazepine used to manage alcohol withdrawal symptoms safely.

🔵 Reduces anxiety, tremors, and risk of seizures associated with withdrawal.

🔵 Buprenorphine and methadone are used for opioid withdrawal, not alcohol.

🔵 Varenicline is for nicotine dependence, not alcohol withdrawal.

🔵 Administering appropriate medications prevents complications and stabilizes the client.

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Answer 9

Correct Answers:

Furosemide

Rationale :

🔴 Vancomycin and furosemide together increase risk of nephrotoxicity.

🔴 Morphine, calcium chloride, and nitroglycerin do not have significant interactions with vancomycin.

🔴 Monitoring renal function and urine output is essential during co-administration.

🔴 Dose adjustments or spacing of vancomycin and furosemide may be necessary to prevent kidney damage.

🔴 Nurses must educate clients and monitor labs to detect early signs of nephrotoxicity.

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Answer 10

Correct Answers:

Check the client's other medications for potential interactions.

Rationale :

🔵 Saw palmetto can interact with other medications, such as anticoagulants.

🔵 Checking for interactions ensures client safety while respecting autonomy.

🔵 Telling the client they will get used to side effects or explaining “harmful herbal medications” is not evidence-based and may be dismissive.

🔵 Reporting refusal without assessing safety violates client-centered care principles.

🔵 Nursing interventions focus on safe, informed decision-making.

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QLexNursing

1 :
A nurse administers the wrong dose of medication to a client. Which of the following actions should the nurse implement first?

2 :
A nurse is caring for a client and preparing to complete a medication reconciliation. Which of the following actions should the nurse complete first?

3 :
A nurse is providing teaching to a client who is receiving intermittent parenteral potassium chloride. Which of the following conditions should the nurse recognize as an indication for this medication?

4 :
A nurse is teaching a client who has a new prescription for phenytoin extended-release capsules. Which of the following instructions should the nurse include?

5 :
A nurse is preparing to administer IV adenosine to a client. Which of the following effects should the nurse anticipate?

6 :
A nurse is caring for a client who is taking insulin degludec daily at 0800. Which of the following times should the nurse expect the peak effect?

7 :
A nurse in a community health clinic is preparing to administer the inactivated influenza vaccine to a group of clients. The nurse should recognize that this immunization is contraindicated for which of the following clients?

8 :
A nurse is planning care for a client who is experiencing acute alcohol withdrawal. Which of the following medications should the nurse expect to administer?

9 :
A nurse is preparing to administer vancomycin IV to a client. Which of the following medications may interact with vancomycin?

10 :
A nurse is caring for a client who is diagnosed with benign prostatic hyperplasia. The client refuses to take the prescribed medication and states they would like to try saw palmetto. Which of the following actions should the nurse take?

QLexNursing

1 : A nurse administers the wrong dose of medication to a client. Which of the following actions should the nurse implement first?

2 : A nurse is caring for a client and preparing to complete a medication reconciliation. Which of the following actions should the nurse complete first?

3 : A nurse is providing teaching to a client who is receiving intermittent parenteral potassium chloride. Which of the following conditions should the nurse recognize as an indication for this medication?

4 : A nurse is teaching a client who has a new prescription for phenytoin extended-release capsules. Which of the following instructions should the nurse include?

5 : A nurse is preparing to administer IV adenosine to a client. Which of the following effects should the nurse anticipate?

6 : A nurse is caring for a client who is taking insulin degludec daily at 0800. Which of the following times should the nurse expect the peak effect?

7 : A nurse in a community health clinic is preparing to administer the inactivated influenza vaccine to a group of clients. The nurse should recognize that this immunization is contraindicated for which of the following clients?

8 : A nurse is planning care for a client who is experiencing acute alcohol withdrawal. Which of the following medications should the nurse expect to administer?

9 : A nurse is preparing to administer vancomycin IV to a client. Which of the following medications may interact with vancomycin?

10 : A nurse is caring for a client who is diagnosed with benign prostatic hyperplasia. The client refuses to take the prescribed medication and states they would like to try saw palmetto. Which of the following actions should the nurse take?

1 :
A nurse administers the wrong dose of medication to a client. Which of the following actions should the nurse implement first?

2 :
A nurse is caring for a client and preparing to complete a medication reconciliation. Which of the following actions should the nurse complete first?

3 :
A nurse is providing teaching to a client who is receiving intermittent parenteral potassium chloride. Which of the following conditions should the nurse recognize as an indication for this medication?

4 :
A nurse is teaching a client who has a new prescription for phenytoin extended-release capsules. Which of the following instructions should the nurse include?

5 :
A nurse is preparing to administer IV adenosine to a client. Which of the following effects should the nurse anticipate?

6 :
A nurse is caring for a client who is taking insulin degludec daily at 0800. Which of the following times should the nurse expect the peak effect?

7 :
A nurse in a community health clinic is preparing to administer the inactivated influenza vaccine to a group of clients. The nurse should recognize that this immunization is contraindicated for which of the following clients?

8 :
A nurse is planning care for a client who is experiencing acute alcohol withdrawal. Which of the following medications should the nurse expect to administer?

9 :
A nurse is preparing to administer vancomycin IV to a client. Which of the following medications may interact with vancomycin?

10 :
A nurse is caring for a client who is diagnosed with benign prostatic hyperplasia. The client refuses to take the prescribed medication and states they would like to try saw palmetto. Which of the following actions should the nurse take?