The patient is ordered a nasal spray. Which intervention should the nurse instruct the patient to do prior to administration of the nasal spray?

Ask the patient to use the bathroom

Instruct the patient to look up at the ceiling

Ask the patient to take a deep breath

Ask the patient to blow his/her nose to clear the nasal passages

Answer and Explanation

The Correct Answer is D

A. Asking the patient to use the bathroom is unrelated to the administration of nasal spray and is not necessary.
B. Instructing the patient to look up at the ceiling is not required for nasal spray administration and does not facilitate the process.
C. Asking the patient to take a deep breath is not directly related to the administration of nasal spray and does not affect its effectiveness.
D. Asking the patient to blow his/her nose to clear the nasal passages is important before administering nasal spray. Clearing nasal passages helps ensure that the medication can reach the nasal mucosa effectively, improving absorption and efficacy of the spray.

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Correct Answer is ["A","B","E"]

Explanation

A. A medical record can indeed be used as evidence in a court of law to support or refute claims related to patient care.
B. Documentation should be organized and timely to ensure accuracy and continuity of care.
C. Documentation should not include the nurse's interpretation but rather objective data and actions taken.
D. Data in a client's medical record should only be shared with those directly involved in the client's care unless otherwise authorized.
E. Information recorded in the client's medical record must be accurate and complete to support safe and effective client care and legal purposes.

A. Determine the client's response to the medication. B. Document that the medication was administered. C. Check the client for allergies. D. Mix the medication at the client's bedside.

Correct Answer is C

Explanation

A. Determining the client's response to the medication is important but should occur after ensuring the safety of administering the medication.
B. Documenting medication administration is necessary but should follow the safe administration process.
C. Checking the client for allergies is the first step to ensure the client can safely receive the medication, preventing adverse reactions.
D. Mixing the medication at the client's bedside may be necessary for some medications but is not the initial step in ensuring safe administration.

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The patient is ordered a nasal spray. Which intervention should the nurse instruct the patient to do prior to administration of the nasal spray?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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