Best NCLEX Next Gen Prep - Nurselytic

Correct Answer: B

Rationale: A side effect of postpartum epidural morphine is the onset of itching within 3 hours of injection and lasting up to 10 hours. Nausea and vomiting might occur 4-7 hours after injection. While urinary retention is a side effect of postpartum epidural morphine, it is not typically assessed within the first 3 hours. Somnolence is a rare side effect and not commonly observed within the first 3 hours.
Therefore, itching is the most likely side effect to be observed within the initial 3 hours after administering postpartum epidural morphine.

Correct Answer: D

Rationale: An internal gynecological examination is performed with the client in the lithotomy position. In this position, the client is supine, with the feet in stirrups, the knees apart, and the buttocks at the end of the examining table. The client is draped so that only the vulva is exposed. The lithotomy position provides optimal access for the healthcare provider to perform the examination effectively. The prone position refers to lying on the stomach, which is not suitable for a gynecological exam. The Sims position is a left side-lying position primarily used for administering enemas, not for gynecological examinations.

Correct Answer: C

Rationale: Glucose is the correct value to monitor closely while a client is on total parenteral nutrition.
Total parenteral nutrition solutions have high glucose concentrations, necessitating monitoring to prevent complications like hyperglycemia. Calcium, magnesium, and cholesterol are not typically closely monitored during total parenteral nutrition as they are not directly related to the solution's composition or potential associated complications.

Correct Answer: A

Rationale: The correct answer is that the client should blow their nose gently before the medication is administered. This step helps clear the nasal passages, ensuring that the medication can reach its intended target.
Choice B is incorrect as the nasal spray should be directed into the nostril, not just in front of the nose. Administering the medication as the client inhales (
Choice
C) is crucial to ensure proper delivery, as it helps the medication reach the desired areas.
Choice D is incorrect because the client should be sitting upright, not lying flat, when administering nasal spray medication to allow for better absorption and prevent the medication from flowing out.

Correct Answer: C

Rationale: The LPN's statement about leaving the narcotics box unlocked after confirming the beginning of shift count was correct requires further investigation. Narcotics should be locked and kept in a secure place during the shift to prevent unauthorized access and ensure patient safety. This statement raises concerns about medication security, which is critical in preventing diversion and ensuring patient safety. The other statements demonstrate appropriate actions:
A) The LPN acknowledges the need for a witness when wasting leftover narcotics, ensuring proper documentation and accountability during medication waste.
B) Checking the facility's policy for proper disposal of controlled substances shows awareness of regulatory compliance regarding controlled substances.
D) Recognizing an incorrect end-of-shift narcotics count and planning to report it reflects the LPN's responsibility in maintaining accurate records and addressing discrepancies, which is essential for medication safety and accountability.