What is the most likely reason a patient would discontinue their prescribed hydroxyurea?

worsening anemia

vasoocclusive pain

gastrointestinal upset

itching/hives

Answer and Explanation

The Correct Answer is A

A.   This side effect, known as myelosuppression, is a significant concern and can manifest as anemia.
B.   Hydroxyurea is actually prescribed to reduce the frequency of vasoocclusive crises by increasing fetal hemoglobin levels, which helps to prevent sickling of red blood cells. While a patient might experience pain crises while on hydroxyurea, the medication is intended to help manage this issue rather than be a reason for discontinuation.
C.   While gastrointestinal upset is also a possible side effect, the risk of severe blood-related complications typically takes precedence when considering the discontinuation of hydroxyurea
D.   While allergic reactions like itching or hives can occur with many medications, they are less common with hydroxyurea specifically.

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Correct Answer is D

Explanation

A. While it is important to address concerns about impairment, confronting the nurse directly can be counterproductive and may escalate the situation. It is essential to approach the situation with caution and follow established protocols for dealing with suspected substance impairment.
B. While gathering observations from colleagues may seem reasonable, it can create a culture of gossip and may violate confidentiality. This approach can also lead to misinformation and should not be the first step in addressing a serious concern about a colleague's safety and well-being.
C. Documenting observations is important, but it should not be the sole action taken at this point. Communicating with the personnel department is part of the process if the situation escalates, but immediate action is necessary to ensure patient safety.
D. This option is the most appropriate initial action. By closely monitoring the nurse’s behavior, the manager can gather more information before taking further steps. This approach allows for the collection of objective data and ensures patient safety while avoiding premature accusations.

A. ask each LPN what tasks he or she is comfortable performing. B. delegate the same tasks to the LPNs that the RN normally delegated to NAPS. C. consult a decision tree for delegation to unlicensed assistive personnel. D. review the practical nurse scope of practice in the jurisdiction where they are working.

Correct Answer is D

Explanation

A. While it’s important to consider the comfort and competency of the LPNs, this approach alone does not ensure that the tasks delegated are within their legal scope of practice. It’s essential for the RN to also verify that the tasks align with the LPN’s training and legal scope of practice.
B. LPNs have a different scope of practice compared to nursing assistive personnel (NAP). They are trained to perform more complex tasks and provide a higher level of care than NAPs. Delegating the same tasks would not take advantage of the LPN's training and could lead to issues related to patient safety and quality of care.
C. While consulting a decision tree can be a useful tool for delegating tasks to NAPs, it does not apply to LPNs. LPNs have a different scope of practice and require a different framework for delegation, as they can perform nursing tasks that are not within the NAP scope.
D. This is the most appropriate action for the RN. Understanding the legal scope of practice for LPNs in their specific jurisdiction is crucial for safe and effective delegation. It ensures that the RN delegates tasks that LPNs are qualified to perform, thereby promoting patient safety and adhering to legal standards.

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What is the most likely reason a patient would discontinue their prescribed hydroxyurea?

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Naxlex Comprehensive Predictor Exams

A nurse is uncharacteristically extroverted on today's shift, with an unsteady gait. The manager suspects that the nurse may be chemically Impaired. What is the manager's most appropriate action?

Correct Answer is D

Explanation

A registered nurse has been leading teams of nursing assistive personnel (NAP) for several years and will soon be leading licensed practical nurses (LPNs) for the first time. In preparation for delegating to these nurses, the RN should:

Correct Answer is D

Explanation

Which term best describes sickle cell disease?

A nurse accidentally administers the wrong medication to a client, which results in a severe allergic reaction and prolongs the client's hospitalization. The client could rightfully sue the nurse for which of the following?

A nurse is admitting a client who has sickle cell anemia. Which of the following manifestations should the nurse expect with this condition?(Select All that Apply.)

A nurse is providing discharge teaching to a client who had a sickle cell crisis. Which of the following health promotion strategies should the nurse include in the teaching?(Select All that Apply.)

A nurse is preparing to administer morphine IV to a client. Which of the following medications should the nurse plan to have available?

What is the most likely reason a patient would discontinue their prescribed hydroxyurea?

The busy emergency department at a hospital has experienced a sharp increase in negative outcomes among clients with heart conditions in the past month. Which of the following actions should the nursing staff take to improve client outcomes?

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