Special Considerations

Every question here, with the answer

1. A client with a chronic condition reports taking a prescribed medication only when money is available. Which nursing actions are appropriate? Select all that apply.

   1. Explore whether the client has health insurance.
   2. Tell the client that medication adherence is mainly a matter of personal responsibility.
   3. Use simple, nonjudgmental language when discussing financial concerns.
   4. Ask about barriers to provider visits, treatments, or needed medication.
   5. Collaborate with pharmacy or social work to develop a plan that meets the client’s needs.

   Answer: Explore whether the client has health insurance., Use simple, nonjudgmental language when discussing financial concerns., Ask about barriers to provider visits, treatments, or needed medication., Collaborate with pharmacy or social work to develop a plan that meets the client’s needs.

   The section emphasizes that socioeconomic factors can prevent clients from obtaining care and taking medications as prescribed. The nurse should investigate barriers, discuss finances without judgment, ask about insurance, and collaborate with other disciplines rather than blaming the client.

2. The nurse is preparing a small prescribed medication dose for an infant. Which action best promotes safe administration?

   1. Use the smallest syringe available for the specific dose.
   2. Skip rechecking the calculation if the dose was prescribed electronically.
   3. Base the dose on typical adult dosing information.
   4. Use a larger syringe because it is easier to hold.

   Answer: Use the smallest syringe available for the specific dose.

   Pediatric clients require very accurate dosing because of their smaller body mass and age-related pharmacokinetic differences. The section specifically identifies using the smallest syringe available as a safety measure for more precise measurement.

3. A pregnant client asks whether a newly prescribed medication could affect the fetus. Which responses by the nurse are consistent with the section? Select all that apply.

   1. Teach that no drug can be considered 100% safe to use during pregnancy.
   2. Explain that a known teratogen will always cause harm to every fetus.
   3. Weigh the benefit to the pregnant client and fetus against the risk of treatment.
   4. Assume that any medication taken during pregnancy can reach the fetus.
   5. Explain that lack of safety data proves the medication will not cause harm.

   Answer: Teach that no drug can be considered 100% safe to use during pregnancy., Weigh the benefit to the pregnant client and fetus against the risk of treatment., Assume that any medication taken during pregnancy can reach the fetus.

   The nurse should approach medication use in pregnancy cautiously, assuming fetal exposure is possible and weighing benefits against risks. Lack of data does not prove safety, and even known teratogens do not always harm every fetus.

4. An older adult takes several prescription medications and sees multiple providers. During a clinic visit, which nursing action is the priority for reducing drug-related problems?

   1. Ask only about medications prescribed by the provider at this clinic.
   2. Take a complete drug history at the encounter, including how each drug was prescribed.
   3. Encourage the client to stop any medication that causes an unpleasant effect.
   4. Assume medication use is accurate if the client brought a medication list.

   Answer: Take a complete drug history at the encounter, including how each drug was prescribed.

   Older adults are at increased risk for drug-related problems, especially when taking multiple medications. The section directs nurses to take a complete drug history at each encounter and verify medication use rather than making assumptions or advising independent discontinuation.

5. A client has limited English proficiency, and a family member offers to translate during medication teaching. Which nursing actions are appropriate? Select all that apply.

   1. Avoid using a family member to translate when possible.
   2. Consult someone knowledgeable about the client’s cultural history, but verify beliefs with the client.
   3. Engage an interpreter because the client’s use of English is limited.
   4. Provide health information in the client’s primary language when possible.
   5. Assume the client’s beliefs based on what is typical for the client’s cultural group.

   Answer: Avoid using a family member to translate when possible., Consult someone knowledgeable about the client’s cultural history, but verify beliefs with the client., Engage an interpreter because the client’s use of English is limited., Provide health information in the client’s primary language when possible.

   The section emphasizes culturally humble communication, including use of an interpreter, avoiding family translation when possible, and providing information in the client’s primary language. Cultural information can guide care, but beliefs should be verified with the individual client rather than assumed.

6. A client with significant weight changes is prescribed a medication calculated in milligrams per kilogram. Which nursing action is most important before administration?

   1. Obtain accurate current height and weight information.
   2. Use the client’s previously documented weight to avoid delaying the dose.
   3. Ask whether the client feels the medication dose is too high or too low.
   4. Assume the same dose is appropriate because the medication was already prescribed.

   Answer: Obtain accurate current height and weight information.

   Body size affects drug response and many drugs are calculated by body weight. Accurate height and weight are therefore important to support correct dosing and the intended therapeutic effect.