A nurse from the adult medical unit is pulled to the geriatric unit. The nurse notes that many of the common medications provided are in lower doses than typically prescribed. What action by the nurse is the highest priority?

Notify the charge nurse that patients may have received inappropriate medication dosages.

Evaluate the laboratory values of each patient to determine liver and kidney function as a possible reason for decreased dosages

Do not worry about the discrepancy because this is not the nurse's unit.

Call the nursing supervisor to investigate the nurse's concerns.

Answer and Explanation

The Correct Answer is B

A. Notify the charge nurse that patients may have received inappropriate medication dosages.
Jumping to conclusions about inappropriate dosages without first investigating the rationale for the dosing is premature and could cause unnecessary alarm.

B. Evaluate the laboratory values of each patient to determine liver and kidney function as a possible reason for decreased dosages. Lower dosages are often prescribed for older adults due to decreased liver and kidney function, which can affect drug metabolism and excretion. Evaluating lab values ensures that these dosages are appropriate and safe.

C. Do not worry about the discrepancy because this is not the nurse's unit.
Ignoring the discrepancy is not appropriate, as it’s important for all nurses to advocate for patient safety, regardless of the unit.

D. Call the nursing supervisor to investigate the nurse's concerns.
The nursing supervisor may need to be involved, but the first step is to review the relevant clinical data (lab values) to assess the situation.

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Correct Answer is D

Explanation

A. Complete blood count (CBC): A CBC is a standard laboratory test to evaluate overall health and detect a wide range of disorders, including infection or anemia. It is not contraindicated and may be necessary for comprehensive patient care.

B. Placement on a cardiac monitor: Cardiac monitoring is appropriate in cases of overdose as many substances can affect the heart. It helps in early detection of any arrhythmias or other cardiac complications.

C. Activated charcoal: Activated charcoal is typically used to bind substances in the gastrointestinal tract to prevent absorption. However, in the case of a caustic substance, it is generally contraindicated because it does not bind well to such substances and may obscure endoscopic evaluation.

D. Inducing vomiting: Inducing vomiting is contraindicated in cases of caustic substance ingestion because it can cause additional damage to the esophagus and mouth. It is important to avoid this action to prevent further injury.

A. Ask if the co-worker needs help with child care. B. Encourage the co-worker to switch to herbal remedies. C. Refer the co-worker to the employee assistance program (EAP). D. Suggest the co-worker try to get a daytime position.

Correct Answer is C

Explanation

A. Ask if the co-worker needs help with child care. While offering practical help like child care might seem supportive, it doesn’t directly address the underlying issue of the co-worker’s struggle with the night shift.

B. Encourage the co-worker to switch to herbal remedies. Suggesting herbal remedies is not appropriate, as it doesn't address the root cause of the co-worker's difficulties. Herbal remedies are also not a proven or necessarily safe solution for stress or shift work issues.

C. Refer the co-worker to the employee assistance program (EAP). This is the most appropriate action. The EAP is designed to help employees deal with personal problems, including work-related stress, and can provide professional counseling and support services.

D. Suggest the co-worker try to get a daytime position. While shifting to a daytime position might be a long-term solution, it is not an immediate action. The EAP can help address the stress and explore options, including a potential shift change.

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A nurse from the adult medical unit is pulled to the geriatric unit. The nurse notes that many of the common medications provided are in lower doses than typically prescribed. What action by the nurse is the highest priority?

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