A nurse is caring for a client who refuses a prescribed influenza immunization. Which of the following actions should the nurse take first?
Ask the client to describe their concerns.
Contact the provider who prescribed the immunization.
Provide the client with education about the immunization.
Document the client’s refusal of the immunization.
The Correct Answer is A
Choice A rationale
Asking the client to describe their concerns allows the nurse to understand the client’s perspective and address any misconceptions or fears they may have about the influenza immunization.
Choice B rationale
Contacting the provider is important but should be done after understanding the client’s concerns to provide a comprehensive report.
Choice C rationale
Providing education is essential but should follow understanding the client’s specific concerns to tailor the information effectively.
Choice D rationale
Documenting the refusal is necessary but should be done after addressing the client’s concerns and providing education.
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Correct Answer is ["A","E"]
Explanation
Choice A rationale
Muscle weakness is a common symptom of hypokalemia due to decreased potassium levels affecting muscle function.
Choice B rationale
Hyperactive bowel sounds can indicate hypokalemia because potassium is essential for normal gastrointestinal motility. Low potassium levels can lead to increased activity in the intestines, resulting in hyperactive bowel sounds.
Choice C rationale
Tingling of fingers, or paresthesia, can be a symptom of hypokalemia, as low potassium levels may affect nerve conduction. This results in abnormal sensations like tingling or numbness.
Choice D rationale
Peaked T waves are more commonly associated with hyperkalemia rather than hypokalemia. Therefore, this option would not indicate hypokalemia. However, a nurse should be vigilant about monitoring potassium levels as both conditions can lead to significant cardiovascular effects.
Choice E rationale
Fatigue is another symptom of hypokalemia as low potassium levels can impair cellular function and energy production.
Correct Answer is D
Explanation
Choice A rationale
Taking ibandronate immediately after a meal is incorrect because food and beverages can significantly decrease the absorption of ibandronate. It should be taken on an empty stomach at least 60 minutes before any food or drink.
Choice B rationale
Drinking 8 ounces of milk when taking ibandronate is incorrect because calcium in milk can interfere with the absorption of the medication. It should be taken with plain water only.
Choice C rationale
Taking ibandronate before bedtime is incorrect because the patient needs to remain upright for at least 60 minutes after taking the medication to prevent esophageal irritation.
Choice D rationale
Taking one tablet of ibandronate on the same date each month is correct. This ensures consistent dosing and helps maintain the medication’s effectiveness.