A nurse on a medical-surgical unit is performing medication reconciliation for a newly admitted client. Which of the following actions should the nurse take?

Compare the client's list of home medications to the admission prescriptions written for the client.

Compare a list of common medications to treat a condition to the actual prescriptions.

Compare the medication label to the provider's prescription on three occasions before administration.

Compare the prescription to the allergy history of the client.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Medication reconciliation involves reviewing all medications the client was taking at home and comparing them with the prescriptions ordered on admission. This process helps identify discrepancies, prevent omissions, duplications, or potential interactions, and ensures continuity of care.

B. Comparing a standard list of medications for a condition is not part of medication reconciliation because it may not reflect the individual client’s needs, allergies, or previous therapy. The focus should be on the client’s actual home medications.

C. This step refers to the “three checks” of medication administration, which is different from the initial reconciliation process. Reconciliation focuses on matching home medications with admission orders, not verifying labels prior to each dose.

D. While checking for allergies is a critical safety step, it is only one component of safe medication administration. Medication reconciliation is broader, ensuring that all home medications are considered and that any changes or omissions are intentional and documented.

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Correct Answer is B

Explanation

Rationale:
A. Warm blood products prior to administration: While warming blood can prevent hypothermia during transfusion, ensuring airway patency takes priority in a trauma situation to maintain oxygenation and prevent respiratory compromise.

B. Establish a patent oral airway: Airway management is the first step in the ABCs (Airway, Breathing, Circulation) of emergency care. Securing a patent airway ensures oxygen delivery to vital organs, which is critical in a client with multiple traumatic injuries.

C. Assign the client a score on the Glasgow Coma Scale: Assessing neurological status is important, but it is secondary to establishing airway patency. A GCS score cannot help if the client is not oxygenating adequately.

D. Remove the client's clothing: Removing clothing allows a thorough assessment, but it does not take priority over securing the airway, which is essential to prevent hypoxia.

A. Provide a pacifier for nonnutritive sucking. B. Warm the formula in the microwave prior to administration. C. Change the gastrostomy tube every 3 days. D. Place the infant in a supine position after the feeding.

Correct Answer is A

Explanation

Rationale:
A. Provide a pacifier for nonnutritive sucking: Offering a pacifier promotes nonnutritive sucking, which supports oral motor development and provides comfort for the infant during gastrostomy tube feedings. This practice can help the infant transition more easily to oral feeding later.

B. Warm the formula in the microwave prior to administration: Warming formula in the microwave is unsafe because it can create hot spots that may burn the infant’s mouth or esophagus. Formula should be warmed using a bottle warmer or by placing the container in warm water.

C. Change the gastrostomy tube every 3 days: Routine gastrostomy tube replacement every 3 days is unnecessary and can cause trauma. Tubes are generally changed according to manufacturer recommendations or when malfunction or blockage occurs.

D. Place the infant in a supine position after the feeding: Infants should be kept in an upright or semi-upright position during and after feedings to reduce the risk of aspiration. Supine positioning increases the likelihood of reflux and respiratory complications.

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A nurse on a medical-surgical unit is performing medication reconciliation for a newly admitted client. Which of the following actions should the nurse take?

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