the physician orders the antibiotics ampicillin omnipen and gentamicin garamycin for a newly admitted client with an infection the nurse should
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Nursing Elites

NCLEX-PN

Psychosocial Integrity Nclex PN Questions

1. The physician orders the antibiotics ampicillin (Omnipen) and gentamicin (Garamycin) for a newly admitted client with an infection. The nurse should:

Correct answer: B

Rationale: A client with an infection needs both antibiotics as soon as possible. However, the pH of ampicillin is 8-10, and the pH of gentamicin is 3-5.5, making them incompatible when given together. Flushing well between drugs is necessary to prevent interaction. Choice C is incorrect because the nurse, not the physician or pharmacy, should determine the correct administration sequence. Consulting with the pharmacist is appropriate if uncertain. Choice D is incorrect because delaying the second medication by several hours can slow the treatment of the client's infection, as both antibiotics are needed promptly to address the infection effectively. Therefore, the correct action is to give the medications sequentially and flush well between them to prevent any potential interactions.

2. If the nurse who was not promoted tells another friend, "I knew I'd never get the job. The hospital administrator hates me."? If she actually believes this of the administrator, who, in reality, knows little of her, she is demonstrating:

Correct answer: C

Rationale: The nurse is demonstrating projection, attributing her own feelings of dislike onto the hospital administrator. This defense mechanism involves unconsciously adopting blaming behavior. Compensation involves emphasizing a strong point to make up for a perceived weakness, which is not the case here. Reaction formation is adopting behavior opposite to actual feelings, and denial involves ignoring an unpleasant reality, none of which are demonstrated in this scenario.

3. Two staff nurses were considered for promotion to head nurse. The promotion is announced via a memo on the unit bulletin board. The nurse who was not promoted tells a friend, "Oh, well, I really didn't want the job anyway."? This is an example of:

Correct answer: A.

Rationale: This is an example of rationalization, specifically the sour grapes form, where the individual convinces themselves that they didn't want something after realizing they couldn't have it. Rationalization is an unconscious form of self-deception involving making excuses. In this scenario, the nurse is rationalizing her disappointment by downplaying her desire for the promotion. Denial involves ignoring the existence of a situation, which is not demonstrated here. Projection involves blaming others unconsciously, which is also not present in this situation. Compensation is an attempt to offset a perceived weakness by emphasizing a strong point, which is not shown in the nurse's response.

4. An adolescent female reports being raped at a party where alcohol was served. The client admits to drinking alcohol before being raped by an acquaintance. The nurse should:

Correct answer: C

Rationale: In cases of rape, it is crucial to provide support and reassurance to the victim. The nurse should inform the client that it was not her fault and offer support through the physical examination. Blaming the victim, as in choice A, is inappropriate and can be damaging to the client's well-being. Choice B is not the priority at this moment; the immediate focus should be on supporting the client. Choice D is victim-blaming and implies doubt about the client's report, which is harmful and not supportive. It is essential to create a safe and supportive environment for the client to facilitate healing and recovery.

5. The nurse suspects an elderly client has been the victim of abuse. The client denies abuse and declines assistance. The nurse's next action should be to:

Correct answer: D

Rationale: In cases where elderly clients deny abuse and refuse assistance, it is crucial for the nurse to respect their autonomy while also ensuring their safety. Educating the client about available services is the appropriate action as it empowers the client with information without imposing any decisions on them. It allows the client to make informed choices regarding their well-being. Reporting the incident to the authorities (Choice B) may be necessary if there is immediate danger, but in this scenario, the client denies abuse. Arranging an appointment with the client's family (Choice C) may not be appropriate without the client's consent or in cases where the family might be involved in the abuse. Simply doing nothing (Choice A) is not the best course of action as the nurse should still provide support and resources to the client.

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