a nurse is preparing to administer medications to a client which of the following client identifiers should the nurse use to ensure medication safety
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Nursing Elites

HESI LPN

HESI Fundamentals Study Guide

1. A healthcare professional is preparing to administer medications to a client. Which of the following client identifiers should the healthcare professional use to ensure medication safety?

Correct answer: C

Rationale: Comparing the client's wristband with the medication administration record is a crucial step in ensuring medication safety. The wristband typically contains unique identifiers such as the client's name, date of birth, and medical record number, which should be cross-checked with the medication administration record to confirm the correct patient. Asking the client to state their name (Choice A) or date of birth (Choice B) may not be as reliable as the information can be misunderstood or miscommunicated. Asking for the room number (Choice D) is not a reliable client identifier for medication administration and does not confirm the patient's identity accurately.

2. A home health nurse who has attended a training session for the therapeutic use of aromatherapy with essential oils is planning to use this modality with some of her clients. For which of the following clients should the nurse consult the provider before using this complementary therapy?

Correct answer: A

Rationale: The correct answer is A: a client who has asthma. Essential oils have the potential to trigger asthma symptoms due to their strong scents and chemical components. Consulting with the healthcare provider is crucial before using aromatherapy with essential oils to ensure the safety and well-being of the client with asthma. Choices B, C, and D do not pose immediate risks with aromatherapy use, making them less of a priority for consultation compared to asthma. Clients with diabetes, hypertension, or depression do not have the same immediate risks associated with the use of aromatherapy as clients with asthma. However, it is still advisable for the nurse to be aware of any potential interactions or contraindications with these conditions and consult with the provider if needed.

3. During a physical assessment on a toddler, what should be the first action?

Correct answer: B

Rationale: The correct first action when performing a physical assessment on a toddler is to use minimal physical contact. This approach helps the toddler become comfortable and reduces anxiety during the assessment. Traumatic procedures (Choice A) should never be the first action as they can cause distress. Proceeding from head to toe (Choice C) is a common sequence in physical assessments but does not address the initial need to establish trust and comfort. Explaining the exam in detail (Choice D) is important but should come after establishing a rapport through minimal physical contact.

4. During an admission assessment, a healthcare professional finds a client's radial pulse rate to be 68/min and the simultaneous apical pulse to be 84/min. What is the client’s pulse deficit (per minute)?

Correct answer: A

Rationale: The pulse deficit is calculated by finding the difference between the apical and radial pulse rates. In this case, the difference is 84 - 68 = 16. This indicates that there is a pulse deficit of 16 beats per minute. Choices B, C, and D are incorrect as they do not accurately reflect the difference between the two pulse rates.

5. When teaching a client and their family how to care for the client’s tracheostomy at home, which of the following should the nurse include?

Correct answer: A

Rationale: The correct answer is to use tracheostomy covers when outdoors. This practice helps protect the stoma from foreign particles and temperature changes, reducing the risk of infection. Maintaining a sterile technique when performing tracheostomy care (choice B) is important to prevent infections but is not specific to outdoor care. Removing the outer cannula for routine cleaning (choice C) is not recommended as it may cause trauma or dislodgment of the tracheostomy tube. Cleaning around the stoma with povidone-iodine (choice D) is not advisable as it can be irritating to the skin and may impair the healing process.

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