A client with frequent watery stools and a possible Clostridium difficile infection is hospitalized with dehydration. Which nursing action should the charge nurse assign to an LPN?
Performing assessments of the client's hydration status.
Administering the prescribed metronidazole 500 mg orally to the client.
Reviewing client's medical history for any risk factors for diarrhea.
Explaining the purpose of the ordered stool cultures to the client and family.
The Correct Answer is B
A. While LPNs can perform some assessments, the charge nurse should assign this task to an RN. Assessing hydration status requires critical thinking and a comprehensive understanding of the client's overall clinical condition, which typically falls within the RN’s scope of practice.
B. Administering medications, including antibiotics like metronidazole, is within the scope of practice for LPNs. As long as the LPN is competent in administering medications and there are no specific contraindications for the client, this task can be appropriately assigned.
C. This task involves critical thinking and comprehensive analysis of the client's medical history, which is typically conducted by an RN. While LPNs may review aspects of the medical history, the charge nurse should assign more complex evaluations and assessments to RNs.
D. While LPNs can provide some patient education, explaining the rationale behind specific tests, especially in the context of complex infections, typically requires the knowledge and expertise of an RN. This task may involve more detailed clinical reasoning and the ability to address specific questions and concerns that the client or family may have.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. While monitoring temperature is important in assessing for infection, it is not the priority assessment before administering morphine. Temperature does not directly relate to the immediate effects or risks associated with opioid administration.
B. Blood pressure monitoring is essential, especially in a postoperative patient. However, opioids primarily impact the respiratory system rather than directly causing significant changes in blood pressure. While hypotension can occur with opioids, it is not the most immediate concern when administering morphine.
C. This is the priority assessment. Opioids, including morphine, can cause respiratory depression, which is a serious and potentially life-threatening side effect. Before administering morphine, it is crucial to assess the respiratory rate to ensure the patient is not at risk for respiratory distress. If the respiratory rate is low (typically less than 12 breaths per minute), the nurse may need to hold the medication and notify the healthcare provider.
D. While it is important to monitor heart rate, especially in postoperative patients, the primary concern with morphine administration is its effect on respiration. The heart rate may not be as critical to assess immediately before administering morphine as the respiratory rate is.
Correct Answer is ["B","D","F"]
Explanation
A. While nonsteroidal anti-inflammatories (NSAIDs) are commonly used medications, they do not typically have a high potential for abuse or addiction. Monitoring these medications for diversion is generally not a primary concern compared to other classifications.
B. Opioids are one of the most commonly abused medication classes due to their pain-relieving properties and high potential for addiction. They are frequently monitored closely for signs of diversion and theft in healthcare settings.
C. Although some antidepressants may have mild abuse potential, they are not generally associated with the same level of diversion or abuse as opioids, benzodiazepines, or stimulants. Therefore, they are not typically monitored as closely.
D. Benzodiazepines are known for their sedative effects and potential for dependency and abuse. They are often misused for their calming effects, making them a priority for monitoring in medication inventories.
E. Anticholinergics are not commonly associated with abuse or diversion. They are used primarily for specific medical conditions and do not have a high potential for addiction, so monitoring these medications is not a primary focus.
F. Central nervous system (CNS) stimulants, such as those used to treat ADHD, have significant potential for abuse and dependency. These medications can lead to feelings of euphoria and are often misused, making them important to monitor closely for diversion.
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