A nurse is preparing to administer a medication to a client and discovers that the incorrect dose of medication was administered during the previous shift. Which of the following actions should the nurse take first?
Notify the charge nurse of the error.
Contact the provider.
Check the client for a change in condition.
Complete an incident report.
The Correct Answer is C
A. Notifying the charge nurse is an important action, as it ensures that other team members are aware of the error and can support corrective actions. However, this is not the first action the nurse should take, as assessing the client’s condition takes priority.
B. Informing the provider about the error is essential to allow for any additional orders or corrective measures, such as treatments to mitigate adverse effects. However, the nurse should first assess the client for any changes in condition to report specific findings to the provider if an intervention is needed.
C. Assessing the client’s condition is the first priority when a medication error is discovered. This action helps determine whether the incorrect dose has affected the client, allowing the nurse to provide immediate care if needed.
D. Completing an incident report is necessary to document the error, allowing the facility to review and address any procedural gaps. However, completing the report is not an immediate action in terms of client safety and should occur after assessing the client and notifying the necessary parties.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["300"]
Explanation
To calculate the infusion rate (mL/hr), you can use the following formula:
Infusion Rate (mL/hr)=Total Volume (mL)/Total Time (hr)
In this case:
- Infusion Rate=1,800 mL/6 hr
- Infusion Rate=300mL/hr
Therefore, the nurse should ensure the IV pump is set to deliver 300 mL/hr for the 0.9% sodium chloride infusion over 6 hours, rounded to the nearest whole number.
Correct Answer is A
Explanation
A. Repositioning the client by log-rolling is a critical intervention after lumbar laminectomy surgery. Log-rolling involves turning the entire body as a unit to prevent twisting or bending at the waist, which can strain the surgical site and potentially cause injury. This method helps protect the spine and maintain alignment during movement.
B. Placing a pillow under the client's back while supine is generally not recommended after a lumbar laminectomy. It may cause hyperextension of the spine, leading to discomfort and potential strain on the surgical site.
C. Removing the back brace when the client is out of bed is not a standard practice without specific orders from the surgeon. Back braces are often prescribed for support and stabilization during movement, especially in the early postoperative period.
D. Maintaining the head of the bed at 90° is not advisable after a lumbar laminectomy. The positioning of the bed should be individualized based on the surgeon's preferences, but typically, keeping the bed flat or in a slightly elevated position is more appropriate to reduce strain on the surgical site.
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