The nurse continues to care for the client.

A nurse on the inpatient mental health unit is planning care for the client.

For each potential provider's prescription, click to specify if the prescription is anticipated or contraindicated for the client.

Encourage the client to avoid napping during the day.

Minimize environmental stimuli for the client.

Provide the client with high-calorie fluids every hr.

Weigh the client each day.

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"}}

Rationale:

• Encourage the client to avoid napping during the day: A manic client has a severely diminished drive for sleep and is at risk for physical exhaustion. Any opportunity for rest or sleep, even a brief nap, should be encouraged to protect the client's physiological health.

• Minimize environmental stimuli for the client: Manic clients are highly distractible and easily overstimulated. Reducing noise, dimming lights, and providing a private room helps decrease the "manic energy" and promotes safety and calm.

• Provide the client with high-calorie fluids every hr: The client has not eaten for an extended period and exhibits poor recall of the last meal, indicating risk of malnutrition. High-calorie fluids are an appropriate intervention to ensure adequate caloric intake and hydration, thus supporting metabolic needs during the maniac episodes.

• Weigh the client each day: Daily weight monitoring helps track nutritional status and detect early signs of fluid imbalance or rapid weight loss, which can occur in clients with poor intake or hyperactivity during mania. It also assists in evaluating effectiveness of nutritional interventions. This practice provides objective data to guide care planning and assess health risks associated with inadequate intake.

Nursing Test Bank

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Correct Answer is B

Explanation

A. Morphine 2 mg IV bolus every 4 hr PRN pain: The prescription clearly indicates the dose, route, frequency, and PRN instructions, making it complete and appropriate for administration.

B. Acetaminophen 1,000 PO three times daily: The prescription is missing the unit of measure (mg, g, etc.), which is essential to ensure safe dosing. Without the unit, there is a risk of overdose or underdose, so the nurse must verify this prescription with the provider before administration.

C. Ibuprofen 800 mg PO every 8 hr: This prescription includes the dose, route, and frequency, making it complete. While monitoring for side effects is important, there is no issue requiring verification.

D. Ceftriaxone 250 mg IM x1 dose now: The prescription specifies the dose, route, and single administration, making it clear and safe to administer without additional verification.

A. "Take the medication with an antacid if gastrointestinal upset occurs." B. "Use a hormonal contraceptive when sexually active." C. "Avoid taking this medication with milk." D. "Exposure to direct sunlight can help this medication improve acne."

Correct Answer is C

Explanation

Rationale:

A. "Take the medication with an antacid if gastrointestinal upset occurs.": Antacids can bind to tetracycline and significantly reduce its absorption, making the antibiotic less effective. Clients should be instructed to avoid taking tetracycline simultaneously with antacids.

B. "Use a hormonal contraceptive when sexually active.": Tetracycline can decrease the effectiveness of hormonal contraceptives, so clients should use an additional form of contraception rather than relying solely on hormonal methods. This statement should emphasize using a backup method rather than suggesting hormonal contraceptives alone.

C. "Avoid taking this medication with milk.": Calcium-containing products, including milk, can bind to tetracycline and impair absorption. Clients should take the medication with water and separate it from dairy products by at least 2 hours to ensure effectiveness.

D. "Exposure to direct sunlight can help this medication improve acne.": Tetracycline increases photosensitivity, making clients more prone to sunburn. Clients should avoid direct sunlight and use protective measures such as sunscreen, hats, and protective clothing, rather than seeking sun exposure.

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The nurse continues to care for the client. A nurse on the inpatient mental health unit is planning care for the client. For each potential provider's prescription, click to specify if the prescription is anticipated or contraindicated for the client.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing medication prescriptions for a group of clients. Which of the following prescriptions should the nurse verify with the provider?

Correct Answer is B

Explanation

A nurse is providing teaching to a client who is taking tetracycline to treat acne. Which of the following instructions should the nurse include?

Correct Answer is C

Explanation

A nurse in a surgical clinic is providing teaching to a client who is scheduled for a modified radical mastectomy. Which of the following statements by the client indicates an understanding of the teaching?

A nurse manager is confronted by a staff nurse who states that an assignment is unfair. Which of the following responses should the nurse manager make?

A nurse is caring for a client who has schizophrenia and is hearing voices. Which of the following actions should the nurse take?

A nurse is reviewing laboratory results for a client who has heart failure and notes a serum potassium level of 5.2 mEq/L (3.5 to 5.0 mEq/L). Which of the following medications should the nurse withheld?

A nurse is caring for a client who has appendicitis. Which of the following findings should the nurse identify as a manifestation of this condition? (Select all that apply.)

A mental health nurse is caring for a client who recently attempted to self-harm. The client states, "I wish I were dead." Which of the following responses should the nurse make?

A nurse is caring for a group of clients who have chronic pain. Which of the following clients should the nurse identify as a candidate for occupational therapy?

The nurse continues to care for the client.

A nurse on the inpatient mental health unit is planning care for the client.

For each potential provider's prescription, click to specify if the prescription is anticipated or contraindicated for the client.