N1 Final Exam Review Test Bank

Question 1 1 out of 1 points Which dietary adjustments does the nurse recommend to an older adult client asking what changes she should institute to prevent or manage constipation? Correct Answer: C. “Include plenty of fiber.” Response Feedback : Older adults are prone to constipation. To manage or prevent constipation, teach the older client to drink eight glasses of water daily and to take in plenty of fiber. These guidelines are good for other clients as well. The other suggestions will not prevent or help manage constipation.Cognitive Level: ComprehensionNCLEX Blueprint: Health Promotion and Maintenance (Self-Care)  Question 2 0 out of 1 points The strategy to avoid medication errors endorsed by the Institute for Safe Medication Practices (ISMP) to differentiate products with look-alike names is referred to as Correct Answer: D. tallman lettering. Response Feedback : Tallman lettering is a term coined by ISMP to describe the practice of using unique letter characteristics of similar drug names known to have been confused with one another. Tallman lettering is used to differentiate products with look-alike names such as BenaDRYL (antihistamine) and BenaZEPRIL (ace inhibitor). The other options are examples of safety-enhancing technologies strategies designed to minimize drug errors, but they are not directed at look-alike medications. Automatic alerts are computer-generated alarms that can be programmed to occur with such things as allergies and incompatible medications. Bar coding is used with medication administration systems that can be programmed to match patient identification bracelets with documentation. Computer order entry systems are designed to include components of a standard medication order.Cognitive level: applicationNCLEX Blueprint: Pharmacology and Parental therapies  Question 3 1 out of 1 points A home care nurse receives a physician order for a medication that the patient does not want to take because the patient has a history of side effects from this medication. The nurse carefully listens to the patient, considers it in light of the patient's condition, questions its appropriateness, and examines alternative treatments. This nurse would most likely Correct Answer: A. call the physician, explain rationale, and suggest a different medication. Response Feedback : Determining how best to proceed on behalf of a patient's best health care outcomes may require clinical judgment. At the committed level of critical thinking, the nurse chooses an action after all possibilities have been examined. A home care nurse who is using good clinical judgment techniques should have confidence in their decision and may not have another nurse available as this is an autonomous setting. Holding the drug might jeopardize the patient's health, so this is not the best solution. The nurse working at this level of critical thinking makes choices based on careful examination of situations and alternatives; whether or not the physician is open to nursing input is not relevant.Cognitive level: applicationNCLEX Blueprint: Management of care  Question 4 0 out of 1 points A nurse is caring for a client with stress incontinence. The nurse knows that which effect could have led to such a condition? Correct Answer: D. Loss of muscle tone Response Feedback : The nurse should know that the loss of muscle tone leads to stress incontinence in the elderly. The bladder muscles become weak, which also leads to urinary retention and dribbling as stress incontinence. Reduced bladder capacity, decreased urine formation, and reduced renal blood flow are common problems associated with the urinary system as a result of advanced age, but they do not specifically lead to stress incontinence.Cognitive Level: ApplicationNCLEX Blueprint: Management of Care