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Question 1 of 5.

A nurse who has been named in a lawsuit can use which of these factors for the best protection in a court of law?

A. Clinical specialty certification in the associated area of practice

B. Documentation on the specific client record with a focus on the nursing process

C. Yearly evaluations and proficiency reports prepared by nurse's manager

D. Verification of provider's orders for the plan of care with identification of outcomes

Explanation: Documentation is the key to protect nurses when a lawsuit is filed. The thorough documentation should include all steps of the nursing process - assessment, analysis, plan, intervention, evaluation.

Question 2 of 5.

The client diagnosed with essential hypertension calls the clinic and tells the nurse she needs something for the flu. Which information should the nurse tell the client?

A. OTC medications for the flu should not be taken because of your hypertension.

B. If OTC medications do not relieve symptoms within three (3) days, contact the HCP.

C. Tell the client to ask the pharmacist to recommend an OTC medication for the flu.

D. Make an appointment for the client to receive the influenza vaccine.

Explanation: OTC flu medications (e.g., decongestants) may raise BP but can be used cautiously; persistent symptoms warrant HCP contact. Total avoidance, pharmacist reliance, or vaccines are less appropriate.

Question 3 of 5.

The client with type 2 diabetes mellitus is prescribed glyburide (Micronase), a sulfonylurea. Which statement indicates the client understands the medication teaching?

A. I should carry some hard candy when I go walking.

B. I must take my insulin injection every morning.

C. There are no side effects I need to worry about.

D. This medication will make my muscles absorb insulin.

Explanation: Glyburide can cause hypoglycemia; carrying candy prepares for low blood sugar during activity. Insulin, no side effects, or muscle absorption are incorrect.

Question 4 of 5.

The client with postmenopausal osteoporosis is prescribed the bisphosphonate alendronate (Fosamax). Which discharge instruction should the nurse discuss with the client?

A. The medication must be taken with the breakfast meal only.

B. Remain upright for at least 30 minutes after taking medication.

C. The tablet should be chewed thoroughly before swallowing.

D. Stress the importance of having monthly hormone levels.

Explanation: Alendronate requires upright posture for 30 minutes post-dose to prevent esophageal irritation, per FDA guidelines. Meal timing, chewing, or hormone levels are incorrect.

Question 5 of 5.

The nurse is administering digoxin, a cardiac glycoside, to the client with congestive heart failure. Which interventions should the nurse implement? Select all that apply.

A. Check the apical heart rate for one (1) full minute.

B. Monitor the client's serum sodium level.

C. Teach the client how to take his or her radial pulse.

D. Evaluate the client's serum digoxin level.

E. Assess the client for buffalo hump and moon face.

Explanation: Checking apical HR prevents bradycardia, teaching pulse empowers monitoring, and digoxin levels ensure therapeutic range. Sodium or Cushingoid features are irrelevant.

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