A. The statement that no drug remains is incorrect. A drug with a half-life of 8 hours will not be completely eliminated in 24 hours, as it follows a predictable pattern of reduction.

B. A reduction to 50 mg would require additional half-life intervals beyond 24 hours. The drug concentration decreases by half every 8 hours, meaning it would take more than 24 hours to reach this level.

C. The correct calculation follows the half-life principle:

- At 8 hours: 800 mg → 400 mg

- At 16 hours: 400 mg → 200 mg

- At 24 hours: 200 mg → 100 mg

Therefore, 100 mg of the drug remains after 24 hours.

D. While 200 mg is a step in the process, it represents the amount remaining after only 16 hours, not the full 24-hour period.

A. Administering an expired medication is unsafe. Even if the medication appears unchanged, its potency, stability, and effectiveness may be compromised.

B. There is no medication error in this scenario, as the nurse has not yet administered the drug. However, the pharmacy should be notified so that a replacement can be provided.

C. The appropriate action is to return the expired medication to the pharmacy for a replacement. Medications should not be administered if they are past their expiration date, as this can affect efficacy and patient safety.

D. Verifying the right patient is part of safe medication administration, but it does not address the issue of the expired medication. The correct response is to obtain a non-expired dose from the pharmacy.

A. While medication adherence is important, the primary reason for asking about alternative therapies is not due to concerns about compliance. Patients may use alternative therapies alongside prescribed medications, potentially leading to harmful interactions.

B. Many complementary and alternative therapies, such as herbal supplements, can interact with prescribed medications, leading to adverse effects or reduced drug efficacy. For example, St. John’s Wort can decrease the effectiveness of certain medications, including anticoagulants and antidepressants. Identifying these therapies ensures patient safety.

C. While some natural products may have therapeutic benefits, they are not necessarily more effective than prescribed medications. Healthcare providers should base treatment decisions on evidence-based practice rather than assuming an alternative therapy is superior.

D. Financial concerns are important but not the primary reason for inquiring about alternative therapies. The nurse’s main concern is the potential for harmful drug interactions rather than the cost burden on the patient.

A. The ages and relationships of household members are subjective data because they are reported by the patient and not directly measured or observed.

B. Usual dietary patterns and intake are also subjective data, as they rely on patient self-reporting rather than measurable, verifiable findings.

C. A list of herbal supplements regularly used is subjective because it depends on the patient’s recall and self-reporting rather than objective measurement.

D. Lab values are considered objective data because they are measurable, verifiable, and obtained through diagnostic testing rather than patient self-reporting. Objective data are based on observable and quantifiable factors, making them more reliable for clinical decision-making.

A. Washing hands before handling medications is essential for infection control but is not the priority action in this scenario. Ensuring drug compatibility is crucial to prevent adverse interactions.

B. When administering two drugs simultaneously, the nurse’s priority is to determine if they are compatible, particularly for IV medications. Some medications can precipitate or cause harmful interactions when mixed, leading to reduced efficacy or adverse effects. Consulting a drug guide ensures safe administration.

C. Checking for drug allergies is important before giving any medication, but it is not the priority in this specific situation. Compatibility must be assessed first to ensure the drugs can be given together safely.

D. Identifying the patient is always necessary for safe medication administration, but in this case, ensuring drug compatibility is the first step before proceeding with administration. If the drugs are incompatible, the nurse must take alternative actions before giving them to the patient.

A. Schedule II drugs are controlled substances with a high potential for abuse. Proper disposal requires a witness, usually another nurse, to verify and cosign the waste to ensure accountability and prevent diversion.

B. Keeping the remaining drug in the patient’s drawer is unsafe and violates controlled substance regulations. Single-use vials should not be stored for later use.

C. While documentation of administered medication is necessary, simply recording the unused amount in the patient’s chart is insufficient. Controlled substances require proper disposal with a witness.

D. Controlled substances cannot be discarded in a general locked collection box without proper witnessing and documentation. The correct procedure is to have another nurse verify and cosign the waste before disposal.

A. Complete blood count (CBC) and serum glucose levels are important for overall health monitoring but do not specifically assess drug metabolism or excretion, which are key factors in drug toxicity.

B. Pancreatic enzymes and urinalysis are useful for detecting pancreatic disorders and infections but are not primary indicators of drug toxicity.

C. Serum creatinine and liver function tests (LFTs) are critical for monitoring drug toxicity, especially in older adults. The kidneys and liver are responsible for drug metabolism and excretion. Impaired kidney function, indicated by elevated serum creatinine, can lead to drug accumulation and toxicity. Abnormal LFTs suggest liver dysfunction, which can affect drug metabolism and increase toxicity risk.

D. Serum lipids and electrolytes are important for cardiovascular and metabolic health but do not directly assess drug metabolism or toxicity risk.

A. While pediatric doses are often weight-based, this does not fully account for differences in drug metabolism and effects in children. Pediatric drug safety requires specific testing beyond weight comparisons to adults.

B. Relying on repeated use over time to determine safety is not an evidence-based approach. Drug approval for pediatric use requires formal clinical trials to establish safety and efficacy.

C. The U.S. FDA and other regulatory agencies require that drugs intended for pediatric use undergo clinical trials specifically designed to assess safety, efficacy, and appropriate dosing in children. This ensures that medications are appropriately tested before being marketed for pediatric patients.

D. While some post-marketing studies may include children, initial approval for pediatric use requires pre-market clinical testing. Relying solely on post-marketing studies does not ensure comprehensive safety data before widespread pediatric use.

A. Duration of action refers to the length of time a drug remains effective after reaching the MEC, but it does not describe the time required to reach this threshold.

B. Onset of action is the time it takes for a drug to reach the minimum effective concentration (MEC) and begin producing a therapeutic effect. This is influenced by factors such as drug absorption and distribution.

C. Peak action time refers to the time at which the drug reaches its highest concentration in the bloodstream, not the time required to reach the MEC.

D. The time response curve is a graphical representation of a drug's effects over time but does not specifically define the time needed to reach the MEC.

A. Assessment is the first phase of the nursing process, during which the nurse gathers relevant patient data, such as allergies and lab values, to ensure safe medication administration. This step helps identify potential risks and contraindications.

B. Evaluation occurs after the medication has been administered and involves assessing the patient's response to the drug. In this case, the nurse is reviewing information before administration, making evaluation an incorrect choice.

C. Implementation refers to carrying out the nursing interventions, such as actually administering the medication. Since the nurse is still reviewing data, this step has not yet been reached.

D. Planning involves setting goals and determining appropriate interventions, but it does not include the direct collection of patient data. Reviewing lab values and allergies falls under the assessment phase.