A community health nurse is performing a home health admissions assessment with a client. The client reports being unable to obtain their prescriptions. Which of the following actions should the nurse take first?

Notify the client's family member regarding their inability to obtain prescriptions.

Call the local pharmacist on behalf of the client.

Assess the barriers to the client's ability to obtain prescriptions.

Initiate a referral to a social worker.

Answer and Explanation

The Correct Answer is C

Rationale:
A. Notify the client’s family member regarding their inability to obtain prescriptions: Involving family members can be helpful later, but the nurse must first understand why the client cannot obtain medications before deciding whether family assistance is necessary.

B. Call the local pharmacist on behalf of the client: Contacting the pharmacist may help resolve access issues such as refills or delivery, but this step is premature without identifying the specific barriers that prevent the client from getting medications.

C. Assess the barriers to the client’s ability to obtain prescriptions: The first action is assessment to determine the root cause of the problem. Barriers may include lack of transportation, financial hardship, limited mobility, or misunderstanding of the prescription process. Once the cause is identified, appropriate interventions or referrals can be made.

D. Initiate a referral to a social worker: A social worker can assist with financial or community resources, but the nurse should first gather assessment data to provide accurate information for an effective referral.

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Correct Answer is D

Explanation

Rationale:
A. Select a vein on the back of the hand: Veins on the dorsum of the hand are more fragile in older adults and have less subcutaneous tissue, increasing the risk of infiltration or phlebitis. Larger veins on the forearm are preferred for safer and more stable IV access.

B. Apply a tourniquet firmly above the insertion site: Excessive tourniquet pressure can damage fragile veins and impair circulation in older adults. The tourniquet should be applied gently enough to distend the vein without causing bruising or discomfort.

C. Clean the site using vigorous friction: Vigorous scrubbing can irritate or damage delicate skin in older adults. The site should be cleansed using gentle, circular motions with appropriate antiseptic solution to reduce infection risk without causing trauma.

D. Use a 22-gauge catheter for insertion: A 22-gauge catheter provides an appropriate balance between ease of insertion and adequate flow rate for older adult clients. Smaller-gauge catheters minimize trauma to fragile veins while still allowing effective IV therapy.

A. "Massage the ointment into the skin." B. "Spread the ointment in a thin, even layer." C. "Apply the ointment to the forearm." D. "Apply the ointment to the skin every 4 hr."

Correct Answer is B

Explanation

Rationale:
A. "Massage the ointment into the skin.": The ointment should not be massaged into the skin because doing so alters the absorption rate and can cause unpredictable vasodilation and hypotension.

B. "Spread the ointment in a thin, even layer.": The nurse should instruct the client to apply the prescribed amount of nitroglycerin ointment in a thin, even layer to a hairless area of the upper body or chest. This ensures consistent absorption of the medication.

C. "Apply the ointment to the forearm.": The forearm is not a recommended site for application. The preferred areas are the chest, back, or upper arm where the skin is less likely to be disturbed and has better absorption.

D. "Apply the ointment to the skin every 4 hr.": Nitroglycerin ointment is usually applied every 6 to 12 hours depending on the prescription, with a nitrate-free interval to prevent tolerance. Every 4 hours is not standard practice.

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A community health nurse is performing a home health admissions assessment with a client. The client reports being unable to obtain their prescriptions. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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