A client is attempting to put pills in his mouth from a medicine cup and drops one pill on the bed sheet. The nurse should:
discard the pill and get another from the dose pack.
scoop up the pill in a soufflé cup and hand the cup to the client.
retrieve the pill from the linens and allow the client to take it.
report the loss of the pill as a medication error.
The Correct Answer is A
A) Discard the pill and get another from the dose pack: This option is the most appropriate action. Once a pill has fallen onto the bed linens, it may be contaminated and should not be administered to the client. The nurse should discard the dropped pill and provide a new one to ensure patient safety and maintain hygiene standards.
B) Scoop up the pill in a soufflé cup and hand the cup to the client: This action is inappropriate as it fails to address potential contamination. A pill that has fallen onto bedding may carry bacteria or other pathogens, so it should not be given to the client even if it is retrieved in a different container.
C) Retrieve the pill from the linens and allow the client to take it: This option is unsafe and violates infection control protocols. Giving a pill that has been dropped on bedding poses a risk of contamination and should be avoided.
D) Report the loss of the pill as a medication error: While reporting medication errors is important, in this case, the action taken (discarding the pill and providing a new one) aligns with best practices. The loss of one pill due to a drop does not constitute a medication error in the same sense as an administration mistake, so this option is not necessary.
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Correct Answer is C
Explanation
A) Application of a transdermal patch: The application of transdermal patches is typically within the scope of licensed nursing personnel due to the need for appropriate placement, potential absorption risks, and proper documentation. This task requires understanding of the medication's effects, which is outside the scope of a UAP’s duties.
B) Use of MDIs: Metered-dose inhalers (MDIs) involve medication administration, which requires client assessment, monitoring of technique, and evaluation of response to therapy. These are skills that a UAP is not trained to handle, as they fall within a licensed nurse's responsibilities.
C) Application of a skin barrier cream to the perineal area: UAPs can apply non-medicated skin barrier creams to protect the skin in the perineal area, as it is a basic care activity. This task does not require specialized training in medication administration and is within the typical role of a UAP for maintaining skin integrity.
D) Instillation of eye drops: Administering eye drops involves medication administration, which includes proper technique, dosing, and monitoring for side effects, making it a task for licensed nursing personnel rather than a UAP.
E) Inserting rectal medications: Rectal medication insertion is a more advanced procedure that requires medication administration knowledge, correct positioning, and monitoring, which are responsibilities designated for licensed nursing staff, not a UAP.
F) Instillation of ear drops: Administering ear drops requires an understanding of dosing, technique, and monitoring for adverse effects, all of which are beyond the scope of practice for UAPs and are typically carried out by licensed nursing staff.
G) Inserting vaginal medications: Vaginal medication administration requires understanding of proper technique and monitoring for therapeutic effects or side effects, which necessitates a licensed nurse’s assessment skills and should not be delegated to a UAP.
Correct Answer is D
Explanation
A) Cerumen or drainage is occluding the ear canal: While cerumen or drainage can cause discomfort, it is less likely to be the direct cause of dizziness following the administration of eardrops. Dizziness is more commonly associated with changes in pressure or temperature in the ear.
B) Too much pressure was applied during instillation, with subsequent injury to the eardrum: Although excessive pressure can lead to injury, the immediate symptom of dizziness after eardrop administration is more closely related to other factors, particularly temperature or positioning.
C) The client failed to remain in the side-lying position long enough: This option is incorrect because not maintaining the position may affect medication absorption but is unlikely to cause immediate dizziness and nausea.
D) The medication was too cold when it was administered: This is the most likely cause of the dizziness. Cold eardrops can cause a rapid change in temperature within the ear canal, potentially stimulating the vestibular system and leading to dizziness or vertigo. It is generally recommended to warm eardrops to body temperature before administration to minimize this risk.