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Thirty minutes after receiving meperidine, the client develops a temperature of 101°F and the skin is warm and flushed with a notable rash on the chest and back. The nurse contacts the primary health care provider and begins to document on an incident report. Which information should be included?

A.

The client had an allergic reaction to the ordered meperidine.

B.

The primary health care provider was notified because the client developed a rash after receiving an opioid analgesic.

C.

The client’s skin was warm and flushed, and a rash was noted on the chest and back.

D.

Thirty minutes after receiving meperidine, the temperature was 101°F (38.3°C).

Answer and Explanation

The Correct Answer is D

Choice A rationale

 

Stating that the client had an allergic reaction to the ordered meperidine is not objective and does not provide specific details about the client’s condition.

 

Choice B rationale

 

Notifying the primary health care provider because the client developed a rash after receiving an opioid analgesic is important, but it does not include all the necessary details about the client’s condition.

 

Choice C rationale

 

Documenting that the client’s skin was warm and flushed, and a rash was noted on the chest and back is important, but it does not include the timing of the reaction or the client’s temperature.

 

Choice D rationale

 

Documenting that thirty minutes after receiving meperidine, the temperature was 101°F (38.3°C), the client’s skin was warm and flushed, and a rash was noted on the chest and back provides a complete and objective account of the client’s condition and the timing of the reaction.


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Correct Answer is D

Explanation

Choice A rationale

Use of eye drops helps manage intraocular pressure but does not improve vision over time. The goal is to prevent further vision loss.

Choice B rationale

Double vision is not a common symptom of glaucoma. Glaucoma typically affects peripheral vision first.

Choice C rationale

Glaucoma is caused by increased intraocular pressure, not inadequate production of fluid within the eye.

Choice D rationale

Without treatment, glaucoma can cause blindness. It is essential to manage the condition to prevent vision loss.

Correct Answer is A

Explanation

Choice A rationale

A phlebotomist who collects blood from clients who have HIV is at the greatest risk for contracting HIV. This is because they are frequently exposed to blood, which is a bodily fluid that can transmit HIV if proper precautions are not taken.

Choice B rationale

A nurse who works for an insurance company and collects urine samples from clients who have HIV is at a lower risk compared to a phlebotomist. Urine is not a common transmission route for HIV.

Choice C rationale

An occupational therapist who works with a client who has HIV is at a lower risk compared to a phlebotomist. Occupational therapists are not typically exposed to blood or other high-risk bodily fluids.

Choice D rationale

A personal trainer who works with a client who has HIV is at a lower risk compared to a phlebotomist. Personal trainers are not typically exposed to blood or other high-risk bodily fluids.

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