A nurse opens a unit-dose of a prescribed medication prior to administering it to a client.
The client refuses to take the medication. Which of the following actions should the nurse take?
Return the opened medication to the medication cart.
Report the incident to the provider.
Fill out an incident report.
Notify the facility's ethics committee.
Notify the facility's ethics committee.
The Correct Answer is C
Choice A rationale
Returning the opened medication to the medication cart is inappropriate because once a medication is opened and refused by a client, it must be disposed of properly. This action helps maintain safety and prevents contamination.
Choice B rationale
Reporting the incident to the provider is not necessary in this context as the refusal to take medication can be managed by the nurse by following the facility's protocol.
Choice C rationale
Filling out an incident report is required because the client's refusal to take the medication is considered a significant event. Incident reports are used to document and analyze such events to improve patient care and safety.
Choice D rationale
Notifying the facility's ethics committee is unnecessary for a medication refusal incident, as it does not involve an ethical dilemma requiring their intervention.
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Correct Answer is A
Explanation
Choice A rationale
Reflex incontinence is caused by neurological impairment or damage, such as spinal cord injury, which results in a loss of voluntary control over urination. The bladder muscle contracts involuntarily, causing urine leakage.
Choice B rationale
Overflow incontinence occurs when the bladder cannot empty properly, leading to frequent or constant dribbling of urine. It is not typically associated with nerve damage from spinal cord injury.
Choice C rationale
Stress incontinence is caused by physical movement or activity—such as coughing, sneezing, or heavy lifting—that puts pressure on the bladder, leading to urine leakage. It is not related to nerve damage or neurological conditions.
Choice D rationale
Urge incontinence is characterized by a sudden, intense urge to urinate, followed by involuntary urine leakage. It is usually caused by an overactive bladder or other conditions affecting bladder function, but not directly by nerve damage from spinal cord injury.
Correct Answer is A
Explanation
Choice A rationale
Neobladder urinary diversion involves creating an internal reservoir or pouch from a segment of the intestine to store urine. This new bladder is then connected to the urethra,
enabling the client to void through the urethra. This method closely mimics natural urination, allowing the client to have some control over urination.
Choice B rationale
This is incorrect because a neobladder is designed to allow the client to control urination. While there might be a learning curve for the client to adapt to the new bladder, the ultimate
goal is to achieve continence.
Choice C rationale
This describes an ileal conduit, another type of urinary diversion, where a stoma is created on the abdomen for urine to pass into an external bag. The neobladder does not involve a
stoma for urination.
Choice D rationale
This is incorrect as it pertains to an ileal conduit or urostomy. Clients with a neobladder do not require an external collection bag since urine is stored internally in the constructed
bladder and can be passed through the urethra. .