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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Acetaminophen is contraindicated in patients with severe hepatic impairment or severe active liver disease1 and should be used with caution in patients with hepatic impairment or active liver disease. Alcohol use disorder can cause liver damage and increase the risk of acetaminophen toxicity.
Choice A is wrong because hepatitis B vaccine within the last week is not a contraindication for receiving acetaminophen.
There is no evidence that acetaminophen interferes with the immune response to the vaccine or causes adverse effects.
Choice B is wrong because chronic kidney disease is not a contraindication for receiving acetaminophen.
Acetaminophen is mainly metabolized by the liver and has minimal renal excretion.
However, patients with chronic kidney disease should consult their doctor before taking acetaminophen as they may have other conditions that affect its use.
Choice C is wrong because diabetes mellitus is not a contraindication for receiving acetaminophen.
Acetaminophen does not affect blood glucose levels or interact with oral antidiabetic drugs.
However, patients with diabetes mellitus should consult their doctor before taking acetaminophen as they may have other conditions that affect its use.
Correct Answer is A
Explanation
According to various guidelines12345, the recommended rate of intravenous potassium replacement is 10-20 mEq/h with continuous ECG monitoring. The maximum rate is 40 mEq/h in emergency situations. The prescription given by the provider exceeds this limit and could cause cardiac arrhythmias or hyperkalemia.
Choice B is wrong because potassium chloride is a common and appropriate formulation of potassium for intravenous administration.
Choice C is wrong because potassium chloride should not be diluted in dextrose 5% in water, as this could cause hyperglycemia or osmotic diuresis.
Choice D is wrong because potassium should never be given by IV bolus, as this could cause cardiac arrest or tissue necrosis.
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