While preparing to administer a scheduled IV medication, a client complains of pain at the IV site and refuses a flush to assess the site.
What should the nurse do next?

Apply ice, then a warm compress to the IV site.

Check the medical record for the date of IV insertion.

Redress the IV site while checking for redness.

Discontinue the current IV site and insert a new one.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Applying ice, then a warm compress to the IV site may help with pain or inflammation, but it does not address the potential problem with the IV site itself. If the client is experiencing pain and refuses a flush to assess the site, it could indicate that the IV site is compromised.

Choice B rationale

Checking the medical record for the date of IV insertion could provide useful information about how long the IV has been in place, but it does not directly address the client’s current complaint of pain at the IV site.

Choice C rationale

Redressing the IV site while checking for redness could help identify signs of infection or inflammation, but it does not address the client’s complaint of pain or their refusal to have the site flushed.

Choice D rationale

Discontinuing the current IV site and inserting a new one is the most appropriate action in this situation. If the client is experiencing pain at the IV site and refuses a flush to assess the site, it suggests that the current IV site may be compromised. Inserting a new IV ensures that the client can continue to receive their scheduled IV medication safely.

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Correct Answer is B

Explanation

Choice A rationale

While fresh fruits and vegetables are part of a healthy diet, they are not specifically recommended for the prevention of osteoporosis. They do not contain significant amounts of calcium, which is crucial for bone health.

Choice B rationale

Low fat dairy products are a good source of calcium, which is essential for bone health and the prevention of osteoporosis.

Choice C rationale

While water and herbal teas can contribute to overall hydration, they do not contain significant amounts of calcium or vitamin D, which are crucial for bone health.

Choice D rationale

While iron-rich meats contribute to overall health, they do not contain significant amounts of calcium or vitamin D, which are crucial for bone health.

A. Diarrhea and flatulence. B. Abdominal cramps. C. Altered taste. D. Muscle pain.

Correct Answer is D

Explanation

Choice A rationale

Diarrhea and flatulence are common side effects of lovastatin, but they are not typically serious enough to require immediate follow-up.

Choice B rationale

Abdominal cramps can occur with lovastatin use, but they are not usually a sign of a serious problem.

Choice C rationale

Altered taste is a less common side effect of lovastatin and is not typically a cause for immediate concern.

Choice D rationale

Muscle pain can be a sign of a rare but serious side effect of lovastatin called rhabdomyolysis. This condition involves the breakdown of muscle tissue, which can lead to kidney damage. Therefore, this symptom should be prioritized for immediate follow-up.

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While preparing to administer a scheduled IV medication, a client complains of pain at the IV site and refuses a flush to assess the site.What should the nurse do next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching an older client about the prevention of osteoporosis.Which foods should the nurse recommend to the client to increase in the diet?

Correct Answer is B

Explanation

Which of the following symptoms reported by a patient taking lovastatin should the nurse prioritize for immediate follow-up?

Correct Answer is D

Explanation

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While preparing to administer a scheduled IV medication, a client complains of pain at the IV site and refuses a flush to assess the site.
What should the nurse do next?