A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. The medication is provided as hydromorphone 8 mg per tablet. Which of the following actions is appropriate for the nurse to take?

Store the remaining half of the pill in the automated medication dispensing system.

Dispose of the remaining medication while another nurse observes.

Return the remaining medication to the facility’s pharmacy.

Place the remaining half of the pill in the unit-dose package.

Answer and Explanation

The Correct Answer is B

This is because hydromorphone is a controlled substance and any unused portion should be discarded in the presence of a witness. Some possible explanations for the other choices are:

Choice A is wrong because storing the remaining half of the pill in the automated medication dispensing system could lead to errors in dosage or diversion of the drug.

Choice C is wrong because returning the remaining medication to the facility’s pharmacy is not a recommended practice for controlled substances and could also result in errors or diversion.

Choice D is wrong because placing the remaining half of the pill in the unit-dose package could compromise the integrity and stability of the medication and expose it to environmental factors.

Normal ranges for hydromorphone are not applicable as it is a synthetic opioid analgesic that does not have a therapeutic level.

However, some factors that may affect its pharmacokinetics and pharmacodynamics are age, weight, renal function, liver function, genetic polymorphisms, and drug interactions.

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Correct Answer is C

Explanation

Atorvastatin is a medication that belongs to a group of drugs called statins. It is used to lower blood levels of “bad” cholesterol (low-density lipoprotein, or LDL), to increase levels of “good” cholesterol (high-density lipoprotein, or HDL), and to lower triglycerides (a type of fat in the blood). The treatment has been effective if the LDL level is reduced, as high LDL levels can increase the risk of heart disease and stroke. A normal range for LDL is less than 100 mg/dL.

Choice A is wrong because urine specific gravity is a measure of how concentrated the urine is, not how much cholesterol is in the blood. A normal range for urine specific gravity is 1.005 to 1.0304.

Choice B is wrong because BUN (blood urea nitrogen) is a measure of how well the kidneys are working, not how much cholesterol is in the blood. A normal range for BUN is 7 to 20 mg/dL.

Choice D is wrong because blood glucose is a measure of how much sugar is in the blood, not how much cholesterol is in the blood.

A normal range for blood glucose is 70 to 100 mg/dL.

A. Morphine 6 mg IV push every 3 hr PRN acute pain. B. MS6 mg IV push every 3 hr PRN acute pain. C. MSO4 6 mg IV push every 3 hr PRN acute pain. D. Morphine 6.0 mg IV push every 3 hr PRN acute pain.

Correct Answer is A

Explanation

This is because it uses the full name of the drug, the exact dose, the route of administration, the frequency, and the indication for use. It also avoids any abbreviations that could be confused with other drugs or measurements.

Choice B is wrong because MS is an abbreviation for morphine sulfate which could be mistaken for magnesium sulfate.

Choice C is wrong because MSO4 is an abbreviation for morphine sulfate that could be mistaken for magnesium sulfate.

Choice D is wrong because 6.0 mg could be misread as 60 mg and lead to a tenfold overdose.

Normal ranges for morphine dosage depend on the route of administration, the indication, and the patient’s tolerance and response.

For acute pain, the usual oral dose is 10 to 30 mg every 4 hours as needed. For chronic pain, the usual oral dose is 15 to 30 mg every 8 to 12 hours as needed.

For intravenous (IV) administration, the usual dose is 2.5 to 15 mg every 4 hours as needed.

The morphine equivalent daily dose (MEDD) is a concept that attempts to establish an equivalency in terms of dose when comparing any opioid to morphine.

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A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. The medication is provided as hydromorphone 8 mg per tablet. Which of the following actions is appropriate for the nurse to take?

Nursing Test Bank

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Explanation

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Correct Answer is A

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