A nurse is caring for a client who is to receive a corticosteroid injection. The client states, "I am not taking that injection today." Which of the following responses should the nurse make?

"Why don't you want to take this injection?"

"You should trust your provider and receive the injection."

"I agree it is not something you want, but it will benefit you."

"I will inform your provider about your decision."

Answer and Explanation

The Correct Answer is D

A) "Why don't you want to take this injection?":
While it's important to understand the client's concerns, this response may come across as confrontational or dismissive. It's essential to respect the client's autonomy and decision-making process without immediately questioning their choice.

B) "You should trust your provider and receive the injection.":
This response is not respectful of the client's autonomy and decision-making. It disregards the client's right to refuse treatment and may further erode trust between the client and the healthcare team.

C) "I agree it is not something you want, but it will benefit you.":
This response is dismissive of the client's decision and fails to respect their autonomy. It's important to acknowledge the client's right to refuse treatment and provide support rather than attempting to persuade or coerce them into accepting it.

D) "I will inform your provider about your decision.":
This response respects the client's autonomy and ensures that the healthcare provider is aware of the client's decision. It allows for further discussion between the client and the provider to address any concerns or questions the client may have.

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Correct Answer is C

Explanation

A. “Taking an HMG CoA reductase inhibitor”: HMG CoA reductase inhibitors, also known as statins, are used to lower cholesterol levels. While they can interact with many medications, they do not specifically predispose a client to developing digoxin toxicity.

B. “Having a prolapsed mitral valve”: A prolapsed mitral valve can lead to mitral valve regurgitation and potentially heart failure, but it does not specifically predispose a client to developing digoxin toxicity.

C. “Taking a high-ceiling diuretic”: This is the correct answer. High-ceiling diuretics, also known as loop diuretics, can cause electrolyte imbalances, particularly low potassium levels (hypokalemia). Digoxin toxicity is more likely to occur when potassium levels are low, as digoxin and potassium compete for the same binding sites in the body. Therefore, taking a high-ceiling diuretic can predispose a client to developing digoxin toxicity.

D. “Having a 10-year history of COPD”: While chronic obstructive pulmonary disease (COPD) can exacerbate heart failure symptoms, it does not specifically predispose a client to developing digoxin toxicity.

A. A young adult who has an allergy to eggs B. An older adult client living in a long-term care facility C. A child who recently received the human papillomavirus vaccine D. A client who has AIDS

Correct Answer is D

Explanation

Answer: D. A client who has AIDS

A. A young adult who has an allergy to eggs
An egg allergy is not a contraindication for the varicella vaccine. The varicella vaccine is not produced using eggs, so an allergy to eggs does not pose a risk to clients receiving this immunization.

B. An older adult client living in a long-term care facility
An older adult in a long-term care facility can typically receive the varicella vaccine unless they have specific contraindications (e.g., immunosuppression). Age alone or residence in a long-term care facility is not a contraindication for the vaccine.

C. A child who recently received the human papillomavirus vaccine
Receiving the HPV vaccine does not contraindicate the varicella vaccine. Multiple vaccines can be administered in close succession or even on the same day, as long as the vaccines are indicated and there are no other contraindications.

D. A client who has AIDS
A client with AIDS has a compromised immune system due to the significant reduction in CD4 cell counts. The varicella vaccine is a live attenuated vaccine, and live vaccines are generally contraindicated for individuals with severe immunosuppression, such as those with AIDS, due to the risk of causing infection in immunocompromised individuals. Therefore, the nurse should not administer the varicella vaccine to a client with AIDS.

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A nurse is caring for a client who is to receive a corticosteroid injection. The client states, "I am not taking that injection today." Which of the following responses should the nurse make?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?

Correct Answer is C

Explanation

A nurse is preparing to administer the varicella vaccine to a group of clients. The nurse should identify which of the following clients as having a contraindication for receiving this immunization?

Correct Answer is D

Explanation

A nurse is educating a client who has a new prescription for digoxin. Which of the following statements should the nurse make?

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