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

The correct answer is choice C. Keep the tablets at room temperature in their original glass bottle. Rationales: Choice A rationale: Taking one tablet each morning 30 minutes prior to eating is incorrect. Sublingual nitroglycerin is used to relieve acute angina attacks and is taken as needed rather than on a fixed schedule. Choice B rationale: Discarding any tablets not used every 6 months is incorrect. Sublingual nitroglycerin tablets should be replaced every 6 months to ensure potency, but this is not the main teaching point for safe storage. Choice C rationale: Keeping the tablets at room temperature in their original glass bottle is correct. Nitroglycerin tablets are sensitive to light and moisture, and the original glass bottle protects them from these elements, ensuring their effectiveness. Choice D rationale: Placing the tablet between the cheek and gum to dissolve is incorrect. Sublingual nitroglycerin tablets should be placed under the tongue where they dissolve and are absorbed quickly into the bloodstream for rapid relief of angina symptoms

A. WBC count 5,000/mm. B. Total bilirubin 1.5 mg/dL. C. Hct 44%. D. Potassium 5.2 mEq/L.

Correct Answer is D

Explanation

A WBC count of 5,000/mm3 is low and could indicate leukopenia, a possible side effect of amitriptyline. Leukopenia increases the risk of infection and should be reported to the provider.

Choice B is wrong because a total bilirubin of 1.5 mg/dL is within the normal range of 0.3 to 1.9 mg/dL.

Choice C is wrong because a Hct of 44% is within the normal range of 37% to 48% for women and 45% to 52% for men.

Choice D is wrong because a potassium level of 4.2 mEq/L is within the normal range of 3.5 to 5.0 mEq/L.

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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

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has angina about a new prescription for sublingual nitroglycerin tablets. Which of the following instructions should the nurse include in the teaching?

Correct Answer is C

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Correct Answer is D

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