Physiological Integrity

While conducting morning rounds, a nurse carries a prescribed dose of oral levothyroxine into a client's room. The client is currently using the bathroom, and dietary staff has just placed a breakfast tray on the bedside table. Which action is the most appropriate for the nurse to perform next?

A practical nurse (PN) is assigned to care for a $68$-year-old client with chronic obstructive pulmonary disease (COPD). The PN is reviewing the client's morning data prior to administering the scheduled 0900 medications.

Current Data:
- Vital signs: Blood pressure $138/84\text{ mmHg}$, Heart rate $118\text{ beats/min}$, Respiratory rate $22\text{ breaths/min}$.
- Laboratory results: Serum theophylline level $24\text{ mcg/mL}$, Fasting blood glucose $165\text{ mg/dL}$.
- Scheduled 0900 medications: Oral theophylline, oral prednisone, and inhaled albuterol.

Based on the data provided, which of the following actions by the PN demonstrate safe and appropriate pharmacological management? (Select all that apply.)

A practical nurse is assigned to care for a client who is receiving daily immunosuppressive therapy following a recent kidney transplant. The client has several scheduled interventions and medications for the morning shift. Which actions by the practical nurse demonstrate safe pharmacological practice and adherence to the legal scope of practice? Select all that apply.

A practical nurse is assisting a client who has a traumatic brain injury with right-sided weakness and moderate dysphagia. The client's dietary order specifies pureed foods and nectar-thick liquids. Which action is the most appropriate for the nurse to implement during the meal?

A client with mild fluid retention is prescribed furosemide $30\text{ mg}$ by mouth every morning. The client's morning vital signs include a blood pressure of $122/78\text{ mmHg}$ and a heart rate of $76\text{ beats/min}$, with a recent serum potassium level of $4.1\text{ mEq/L}$. The pharmacy delivers furosemide oral solution labeled $40\text{ mg}$ per $5\text{ mL}$. How many milliliters (mL) should the practical nurse administer for the morning dose? Record your answer to the nearest tenth. Do not include units in your answer.

A practical nurse enters a client's room and observes the client coughing vigorously with enteral nutrition formula visible in their mouth. The client is currently receiving a continuous enteral tube feeding. In which order should the nurse perform the following actions to minimize the risk of aspiration and respiratory complications? Arrange the steps from first to last.

A practical nurse is preparing a client for a scheduled computed tomography (CT) scan that requires the administration of intravenous contrast dye. The nurse is reviewing the client's electronic health record. Which of the following documented findings indicate an increased risk for complications and require immediate notification to the registered nurse? Select all that apply.

A practical nurse (PN) is preparing to administer morning medications to a client who is receiving continuous enteral nutrition via a nasogastric (NG) tube. The client's medication administration record includes phenytoin oral suspension, an extended-release metoprolol tablet, and a PRN sublingual nitroglycerin tablet for chest pain. Which of the following actions should the PN take? Select all that apply.

A practical nurse (PN) is contributing to the care of a client who is 4 hours postoperative following a total thyroidectomy. Which interventions should the PN implement to reduce the client's risk for postoperative complications? (Select all that apply.)

A practical nurse (PN) is monitoring a client who is 4 hours post-percutaneous coronary intervention (PCI) via the right femoral artery approach. Which of the following assessment findings should the PN identify as an impending complication requiring immediate escalation to the registered nurse (RN)? Select all that apply.

A $6\text{-year-old}$ client weighing $55\text{ lb}$ is admitted to the pediatric unit with a soft tissue infection. The client's vital signs are temperature $100.8^\circ\text{F}$ ($38.2^\circ\text{C}$), heart rate $110\text{ beats/min}$, and blood pressure $98/64\text{ mm Hg}$. The client has no known drug allergies. The healthcare provider prescribes oral cephalexin $25\text{ mg/kg/day}$ divided into two equal doses every $12\text{ hours}$. The medication available is cephalexin oral suspension $250\text{ mg}/5\text{ mL}$. How many $\text{mL}$ should the practical nurse administer per dose? (Record answer to the nearest tenth. Do not include units in answer.)

A client who underwent a right above-the-knee amputation 36 hours ago is receiving care on the surgical unit. Which actions should the practical nurse include in the client's care plan to promote comfort, maintain skin integrity, and prevent complications? Select all that apply.

During a shift on a medical-surgical unit, a provider prescribes 'Regular insulin 8 units intravenous (IV) push immediately' for a client experiencing severe hyperglycemia. The available medication vial is labeled 'Regular insulin 100 units/mL'. What is the most appropriate action for the practical nurse to take?

A semi-conscious client who underwent a supratentorial craniotomy two days ago receives continuous enteral nutrition via a nasogastric tube. The nurse is preparing to perform a complete bed bath, linen change, and repositioning to maintain skin integrity. Which of the following actions represents the safest approach for providing this care?

A client with a documented history of severe asthma is receiving care on a medical-surgical unit. The practical nurse is preparing to administer scheduled morning medications, which includes a new prescription for oral propranolol to manage a familial tremor. During the pre-administration assessment, the client's vital signs are: blood pressure 132/84 mm Hg, heart rate 86 beats/min, and respiratory rate 18 breaths/min. The nurse notes faint expiratory wheezes upon auscultation. What is the most appropriate action for the practical nurse to take?

While caring for a client who had an open appendectomy 4 hours ago, the practical nurse reviews the client's postoperative status. The client's preoperative heart rate was 76/min and blood pressure was 118/74 mm Hg. Which current finding is the most critical to report to the registered nurse?

An older adult client is receiving daily oral warfarin for atrial fibrillation management. The electronic health record displays a morning International Normalized Ratio (INR) of 5.2. When the practical nurse enters the room, the client complains of a new, severe headache and asks for their prescribed as-needed acetaminophen. Which action is the priority for the practical nurse?

A practical nurse is providing care for a client who is 72 hours post-operative following a right above-the-knee amputation. The client reports a dull, aching discomfort in the right hip and requests that the head of the bed be raised to 60 degrees with a thick pillow placed under the residual limb. Which action is most appropriate for the nurse to take?

A registered nurse (RN) is caring for a client who was recently admitted with severe sepsis. The RN is busy initiating an emergency blood transfusion for another client and asks the practical nurse (PN) to assist with the septic client's medication administration. Which pharmacological task is most appropriate for the PN to accept?

A practical nurse is assigned to care for a client with a history of heart failure. The client is scheduled to receive oral furosemide and oral digoxin at this time. Upon reviewing the morning laboratory report, the nurse notes a serum potassium level of 2.9 mEq/L (2.9 mmol/L). The client's most recent apical pulse is 62 beats per minute. Based on these findings, which of the following is the most appropriate next action for the practical nurse?