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A client with multiple sclerosis (MS) fell while walking to the bathroom. Upon transfer to the intensive care unit, the client is confused and has had projectile vomiting twice. Which intervention should the nurse implement first?

The healthcare provider prescribes bismuth subsalicylate, metronidazole, tetracycline, and pantoprazole for a client with H. pylori. Prior to administering the H. pylori treatment regimen, the nurse should review the client’s medication list for which medication?

The antitubercular drug isoniazid is prescribed for a client with active tuberculosis. To evaluate the effectiveness of this medication, which outcome can the nurse expect this client to exhibit?

When performing postural drainage on a client with chronic obstructive pulmonary disease (COPD), which approach should the nurse use?

A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

A client is being cared for in the emergency department with acute abdominal pain and a provisional diagnosis of pancreatitis. Which information is most valuable in reporting the client’s status to the healthcare provider?

Exhibit 1: History and Physical

The client is a 51-year-old male admitted to the medical floor with a diagnosis of pneumonia. He reports a 3-day history of productive cough, shortness of breath, and fever. He also mentions increased fatigue and weakness over the last week. The client has a history of hypertension, which is controlled with enalapril 10 mg daily. His surgical history includes adenoidectomy at age 5 and surgical repair of a fractured femur at age 20. The client takes a multivitamin daily and has no known allergies. He is a non-smoker and reports occasional alcohol use.

Exhibit 2: Nurse's Notes (0800)

At 0800, the client was alert but appeared fatigued and short of breath. His oxygen saturation was 89% on room air, and he was placed on supplemental oxygen at 10 L/min via nasal cannula, which improved his saturation to 94%. The client stated, “I feel tired and weak, and it’s hard to breathe.” His skin was warm to the touch, and he had a productive cough with thick, yellow sputum. He reported a headache and body aches, rating his pain as 4/10. The client denied chest pain but reported feeling feverish throughout the night. His capillary refill was less than 3 seconds, and lung sounds were diminished with crackles heard bilaterally.

Exhibit 3: Vital Signs

• Time: 0800
• Temperature: 101.2°F (38.4°C)
• Pulse: 112 beats per minute
• Respiratory Rate: 28 breaths per minute
• Blood Pressure: 150/92 mmHg
• Oxygen Saturation: 89% on room air, 94% on 10 L/min nasal cannula

Exhibit 4: Physical Examination Results

Upon physical examination, the client appeared ill and was in mild respiratory distress, with shallow and rapid breathing. His skin was warm and flushed, and he was diaphoretic. Lung auscultation revealed bilateral crackles in the lower lobes, more pronounced on the right side. There were no wheezes or rhonchi noted. His heart sounds were regular, but tachycardia was present. The client’s abdomen was soft and non-tender with normal bowel sounds. No edema was noted in the extremities, and there were no visible rashes or skin abnormalities. The client’s capillary refill was normal, and neurological assessment showed no focal deficits.

Exhibit 5: Provider's Prescriptions

1. Admit to the medical floor
2. Vital signs every 4 hours
3. Continuous pulse oximetry
4. Supplemental oxygen 10 L/min via nasal cannula
5. Enalapril 10 mg PO every morning
6. Ibuprofen 400 mg PO every 4 to 6 hours PRN for temperature greater than 100.5°F (38.0°C)
7. Send blood for complete blood count and electrolytes
8. Chest X-ray now

Question: Which of the following provider's prescriptions would the nurse question? Select all that apply.

A client is recovering from the surgical removal of glass in the right eye. Which intervention should the nurse implement immediately following the procedure?

The nurse is caring for a client with chronic obstructive pulmonary disease who develops an onset of dyspnea and tachypnea with coughing. After positioning the client upright, which action should the nurse take next?

A client with cholelithiasis has a gallstone lodged in the common bile duct and is unable to eat or drink without becoming nauseated and vomiting. Which finding should the nurse report to the healthcare provider?

The client with Clostridium difficile in the stool receives a prescription for vancomycin PO. Which action should the nurse take before administering the first dose?