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Discussion Posts and Replies
,Informed Consent for ECT - correct ans:A client has the right to withdraw consent for the treatment at
any time.
Fraying on Electrical Cord - correct ans:The nurse should first remove the device from the room.
Hydromorphone Prescription - correct ans:The nurse should count the current number of unit doses
available in the medication dispensing system.
Priority Finding Post Cast Placement - correct ans:A client 2 hours post cast placement with 2+ pitting
edema and pallor has the priority finding.
Disulfiram Alcohol Use - correct ans:A client should limit alcohol use to one drink daily while taking
disulfiram.
Fluoxetine and Tyramine - correct ans:A client should avoid foods containing tyramine while taking
fluoxetine.
Sustained-Release Methylphenidate - correct ans:A client should take the sustained-release
methylphenidate every morning.
Major Depressive Disorder Precautions - correct ans:The nurse should implement seizure precautions
for the client.
Narcissistic Personality Disorder Expectation - correct ans:The nurse should expect the client to be
preoccupied with aging.
Time Management in Nursing - correct ans:The nurse should first determine goals of the day.
Change-of-Shift Assessment Priority - correct ans:The priority finding is a client with pneumonia,
productive cough, and fever of 38.8° C (101.8° F).
,Medication Administration Documentation - correct ans:The nurse should document administration of
the medication upon removal from the medication dispensing system.
Withholding Medication - correct ans:The nurse should withhold hydromorphone if the client does not
appear to be in pain.
Client Teaching in Mental Health - correct ans:Understanding is indicated when a client states they will
take their lithium on an empty stomach.
Seizure Precautions - correct ans:Implementing seizure precautions is a priority action for a client with
major depressive disorder.
Client Assessment in Mental Health - correct ans:Encouraging the client to verbalize feelings is an
important action but not the first priority.
Electrical Device Safety - correct ans:Reporting the defect to the equipment maintenance staff is
necessary but should follow immediate removal of the device.
Medication Dispensing System - correct ans:The nurse should ensure the device inspection sticker is
current as part of routine safety checks.
Postoperative Care - correct ans:Monitoring for pain is crucial after administering hydromorphone.
Effective Client Teaching - correct ans:Clients should be able to articulate the importance of medication
adherence.
Managing Nursing Tasks - correct ans:Developing an hourly time frame for tasks can help manage time
effectively.
Client Assessment Findings - correct ans:Identifying priority findings is essential during shift changes.
, Understanding Medication Effects - correct ans:Clients must understand the effects and side effects of
their medications.
Determine goals of the day - correct ans:Establish specific objectives for daily activities.
Magnesium sulfate via continuous IV infusion - correct ans:A treatment for preeclampsia requiring
careful monitoring.
Restrict the client's total fluid intake to 250 mL/hr - correct ans:A guideline for fluid management in
certain medical conditions.
Measure the client's urine output every hour - correct ans:A critical action to monitor kidney function
and fluid balance.
Give the client protamine if signs of magnesium sulfate toxicity occur - correct ans:An emergency
intervention for reversing magnesium toxicity.
Monitor the FHR via Doppler every 30 min - correct ans:A procedure to assess fetal heart rate during
labor.
Wounds healing by primary intention - correct ans:Wounds that heal with minimal scarring, typically
surgical incisions.
Approximated surgical incision - correct ans:A type of wound expected to heal by primary intention.
Client taking clozapine to treat schizophrenia and reports sore throat - correct ans:A priority client due
to potential agranulocytosis risk.
Client has OCD and is upset about a change in daily routine - correct ans:A client with stable condition,
less urgent than others.