An adult is to receive an IM injection of Morphine for post op pain. Which of the following is necessary for the nurse to assess prior to giving a narcotic analgesic?

Correct Answer: A

Rationale: When administering a narcotic analgesic like Morphine, assessing the client's level of alertness and respiratory rate is crucial to monitor for any adverse effects such as respiratory depression. Morphine can cause respiratory depression as one of its side effects, especially in higher doses. By assessing the client's respiratory rate and level of alertness before administering the medication, the nurse can ensure the client's safety and take appropriate action if any signs of respiratory depression occur. This assessment is essential in preventing potential complications and ensuring the client's well-being during pain management.

Correct Answer: B

Rationale: A latex condom with spermicide provides the best protection against HIV transmission during sexual intercourse. Safer sex practices for persons with HIV involve using condoms consistently and correctly during every sexual encounter to reduce the risk of HIV transmission to partners, regardless of their HIV status. Spermicide, while offering additional protection against pregnancies, does not provide additional protection against HIV transmission. Other contraceptive methods like birth control pills, implants, and injections are not effective in preventing HIV transmission. The intrauterine device is also not specifically recommended for clients with HIV as it does not provide protection against HIV transmission during sexual activities.

Correct Answer: C

Rationale: During the surgical procedure, the circulating nurse, scrub nurse, and nurse first assistant are responsible for keeping track of all instruments, needles, and sponges used. As the surgical incision is being closed, the circulating nurse and the scrub nurse/nurse first assistant conduct a final count of all needles, sponges, and instruments to ensure that nothing is accidentally left inside the patient's body. This is a critical step in preventing retained surgical items (RSI), which can lead to serious complications for the patient. It is part of the standard protocol in the operating room to have these specific personnel take charge of counting and verifying all items before the procedure is concluded.

Correct Answer: C

Rationale: Drinking lots of water at night is actually a good practice for promoting urinary health and preventing urinary tract infections (UTIs). Adequate hydration helps to flush out bacteria from the urinary tract, reducing the risk of infections. Therefore, the statement that drinking lots of water at night might have caused a UTI is incorrect. The other choices describe common causes of UTIs such as holding the urge to urinate, introducing bacteria through instruments or catheters, and poor hygiene practices after defecation.

Correct Answer: A

Rationale: The best way to determine whether an adolescent girl is sexually active is to ask her directly, "Are you sexually active?" This question is concise, clear, and non-judgmental, allowing the girl to provide a straightforward answer. It is important to create a safe and open environment for discussing sexual health, and using direct language helps ensure accurate communication. Asking about specific partners (options B and C) may lead to confusion or misinterpretation, and involving the parent (option D) without the girl's consent may violate her privacy and autonomy. Therefore, direct communication with the adolescent herself is the most appropriate approach to gather information about her sexual activity.