The nurse is preparing to give an emergency sedative injection to an agitated client.
Which action by the nurse is inappropriate?

Placing a client in restraints without having a healthcare provider's order.

Administering the medication to a client behind a closed curtain.

Enlisting security personnel to assist with restraining the client.

Informing a client that the medication being administered is a sedative.

Answer and Explanation

The Correct Answer is A

Placing a client in restraints without having a healthcare provider’s order.

It is inappropriate for a nurse to place a client in restraints without having a healthcare provider’s order.

Choice B is not the answer because administering the medication to a client behind a closed curtain is not necessarily inappropriate.

Choice C is not the answer because enlisting security personnel to assist with restraining the client may be necessary in some situations.

Choice D is not the answer because informing a client that the medication being administered is a sedative is not necessarily inappropriate.

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Correct Answer is A

Explanation

Inject in abdominal area at least 2 inches from the umbilicus.

When administering subcutaneous heparin injections, it is important to choose an injection site on either your tummy or outer areas of your left or right thigh.

Your tummy is usually best as the injection site and it is important that you change the site each time 1.

The heparin needs to go into the fat layer under the skin 2.

Choice B is incorrect because injections should not be rotated between the abdomen and gluteal areas.

Choice C is incorrect because massaging the injection site is not recommended.

Choice D is incorrect because air bubbles in a pre-filled syringe should not be expelled prior to injection 2.

A. Elevate the head of the bed to a 45-degree angle B. Apply the client's positive airway pressure device C. Lift and lock the side rails in place D. Remove dentures or other oral appliances

Correct Answer is B

Explanation

The client has difficulty sleeping due to obstructive sleep apnea (OSA), and using a positive airway pressure device can help keep their airway open and prevent dangerous pauses in breathing while they sleep 1.

Choice A is not the answer because elevating the head of the bed to a 45-degree angle may provide some relief for OSA, but it is not as effective as using a positive airway pressure device 1.

Choice C is not the answer because lifting and locking the side rails in place is a safety measure but does not directly address the client’s OSA 1.

Choice D is not the answer because removing dentures or other oral appliances may provide some relief for OSA, but it is not as effective as using a positive airway pressure device 1.

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The nurse is preparing to give an emergency sedative injection to an agitated client. Which action by the nurse is inappropriate?

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The nurse is preparing to give an emergency sedative injection to an agitated client.
Which action by the nurse is inappropriate?