Correct Answer: C

Rationale: The correct answer is C because administering insulin before the scheduled time can lead to hypoglycemia, a serious adverse event that requires documentation in an incident report for quality improvement and accountability. Administering insulin at an incorrect time can result in harm to the client and is considered a medication error.

Choices A, B, and D do not necessarily require incident reports as they are common occurrences in healthcare settings and can be managed through routine documentation and interventions. Vomiting after medication administration and receiving a meal tray slightly early are not considered critical incidents. Experiencing a seizure is a medical emergency that requires immediate intervention but does not necessarily indicate a system error that requires documentation in an incident report.

Correct Answer: B

Rationale: The correct answer is B: Blurred vision. Carbamazepine, an antiepileptic medication, can cause ocular side effects, such as blurred vision, diplopia, and nystagmus. The nurse should instruct the client to monitor for changes in vision and report any visual disturbances immediately to prevent potential complications. Insomnia (choice
A) is not a common adverse effect of carbamazepine. Tachypnea (choice
C) refers to rapid breathing and is not typically associated with this medication. Metallic taste (choice
D) is not a common side effect of carbamazepine.

Correct Answer: A

Rationale: The correct answer is A: Grasp skin between thumb and forefinger throughout the injection. This action helps to stabilize the skin and underlying tissues, reducing the risk of bleeding by preventing unnecessary movement during the injection. Grasping the skin also helps to ensure accurate administration of the medication into the subcutaneous tissue.

B: Aspirating the syringe is not necessary for subcutaneous injections as it is commonly done for intramuscular injections to ensure the needle is not in a blood vessel.

C: The Z-track method is used for intramuscular injections to prevent leakage of medication into surrounding tissues, not applicable for subcutaneous injections.

D: Massaging the site following the injection may increase the risk of bleeding by disrupting the clotting process and causing tissue trauma.

Overall, option A is the most appropriate action to minimize bleeding following a subcutaneous injection.

Correct Answer: D

Rationale: The correct answer is D: Bradycardia. Amiodarone is known to cause bradycardia as an adverse effect due to its impact on the electrical conduction system of the heart. It can slow down the heart rate, leading to bradycardia. This is a common side effect that nurses should monitor for in clients taking amiodarone.

A: Hypertension is not typically associated with amiodarone use; in fact, it is more commonly used to treat hypertension.
B: Bradypnea refers to slow breathing, which is not a typical adverse effect of amiodarone.
C: Fever is not a common adverse effect of amiodarone; it is more likely to cause cardiac and pulmonary side effects.
Overall, the correct answer is D because bradycardia is a known adverse effect of amiodarone, while the other options are not typically associated with this medication.

Correct Answer: D

Rationale: The correct answer is D: Examine the client's vital signs and condition. The nurse should first assess the client's current status to determine if any adverse effects of digoxin, such as bradycardia, are occurring. This step is crucial for immediate intervention if necessary.
A: Notifying the nurse manager can be done later after assessing the client.
B: Filing an incident report is important but not the first priority when the client's safety is at risk.
C: Notifying the provider can be done after assessing the client's condition.
In summary, assessing the client's vital signs and condition is the priority to ensure the client's safety and well-being.