Before administering zolpidem at bedtime, which client assessment should the practical nurse
(PN) complete?
Mental status.
Body temperature.
Bowel sounds.
Skin integrity.
Skin integrity.
The Correct Answer is A
A. Assessing the client's mental status is crucial before administering zolpidem, a sleep aid, as it helps ensure the client is alert enough to take the medication safely. This assessment includes evaluating the client's level of consciousness, orientation, and cognitive function.
B. Monitoring body temperature might be necessary in certain clinical situations, but it's not directly relevant before administering zolpidem unless there are specific concerns related to body temperature.
C. Assessing bowel sounds is an important part of a comprehensive physical assessment, but it's not directly tied to the administration of a sleep aid like zolpidem.
D. Evaluating skin integrity is important for overall patient care, but it's not specifically linked to the assessment needed before administering a sleep medication like zolpidem.
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Related Questions
Correct Answer is D
Explanation
A. Checking the perineum for changes in "show" or discharge is important for monitoring labor progress, but it does not directly address the client's immediate need to empty her bladder. This action would be more relevant if there were signs of labor progression or complications.
B. Reviewing the fetal heart rate pattern is crucial for assessing fetal well-being, but it does not resolve the client's discomfort from a full bladder. While important, it does not address the specific request made by the client.
C. Obtain a straight catheter kit to empty her bladder is unnecessary since the client can ambulate and has expressed the desire to void. Catheterization is typically reserved for clients unable to void independently or when the bladder is distended and interfering with labor progression.
D. Assist the client up to the bathroom is the correct action. Allowing the client to empty her bladder helps facilitate labor progression, as a full bladder can impede fetal descent. Since the vaginal exam is unchanged and the client is stable, ambulation to the bathroom is safe and appropriate. Additionally, this action supports the client’s autonomy and comfort during labor.
Correct Answer is B
Explanation
A. Asking about the bowel sterilization prescription isn't directly related to the client's concern about the visibility of the surgical opening.
B. Reviewing the client's expectations regarding elimination after surgery helps address the client's concerns about the surgical opening and ensures proper education and understanding.
C. Verifying the NPO status is important for surgery preparation but doesn’t address the client's specific concern.
D. Understanding if this is the client's first indwelling catheter doesn’t directly address the immediate concern of the client regarding the visibility of the surgical opening.
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