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Question 1 of 5

The nurse is providing teaching to the parents of a 1-year-old who was just prescribed a 10-day course of amoxicillin for acute otitis media. Which of the following instructions are appropriate for the nurse to include in the teaching? Select all that apply.

Correct Answer: C, E

Rationale: Returning if no improvement (
C) and hearing screening (E) are appropriate. Decongestants (
A) are not recommended, loose stools (
B) do not warrant stopping, and stopping early (
D) risks resistance.

Question 2 of 5

Diphenoxylate hydrochloride with atropine sulfate (Lomotil) is prescribed for a client. The nurse knows that the drug is prescribed for which of these problems the client has?

A. Diarrhea B. Hypertension C. Depression D. Tachycardia

Correct Answer: A

Rationale: Lomotil is an antidiarrheal, slowing intestinal motility to reduce diarrhea.

Question 3 of 5

The nurse is caring for a client who has bacterial meningitis. Which of the following actions should the nurse take? Select all that apply.

A. Minimize environmental stimuli. B. Implement seizure precautions. C. Maintain the head of bed at 30 degrees. D. Keep a surgical mask on the client at all times. E. Place the client in a room with monitored negative air pressure.

Correct Answer: A, B, C

Rationale: Minimizing stimuli (
A), seizure precautions (
B), and elevating the head (
C) reduce complications in meningitis. Masks (
D) are unnecessary, and negative pressure rooms (E) are for airborne diseases.

Question 4 of 5

The nurse is caring for a hospitalized client. Which is the best example of narrative documentation to provide legal malpractice protection for the nurse after an adverse event?

A. Client found on floor this morning at 6:50 AM. No verbalized symptoms. I think client tripped over a cord. Client instructed on safety during ambulation.' B. Client reports IV pole hit head at 7:30 AM. Denies pain. IV pole removed for client safety. Will continue to monitor. Health care provider (HCP) notified.' C. IV site in right hand is red and swollen at 9:30 AM. IV line removed, bleeding controlled, and warm compress administered at 9:40 AM. Will monitor for swelling and pain every hour.' D. Package of green leaves found in client drawer at 1:00 PM. Client acting suspicious at 2:00 PM. HCP notified. Will call security. Client has multiple tattoos and piercings.'

Correct Answer: C

Rationale: Detailed, objective documentation (
C) with times, actions, and follow-up plans provides the best legal protection. Options A, B, and D include assumptions, vague details, or irrelevant information.

Question 5 of 5

A client with borderline personality disorder says to the nurse, 'You're the only one I trust around here. The others don't know what they are doing and they don't care about anyone except themselves. I only want to talk with you.' What is the priority nursing action?

A. Assign different staff members to care for the client each day B. Assign the client's stated preferred nurse to care for the client C. Reassure the client that all staff members are competent in their jobs D. Reinforce unit guidelines and appropriate boundaries with the client

Correct Answer: D

Rationale: Reinforcing boundaries (
D) addresses splitting behavior and maintains therapeutic relationships. Rotating staff (
A), assigning the preferred nurse (
B), or reassuring competence (
C) may reinforce manipulation.

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