A nurse is caring for a client who has anxiety and a prescription for oral lorazepam PRN. Which of the following is the correct way to transcribe the prescription into the electronic medical record?

Lorazepam 2.5mg PO qhs before bed

Lorazepam 2.5 mg PO QD at hs

Lorazepam 2.5 mg PO every 8 hours as needed for anxiety

Lorazepam 2.50 mg PO Q 8 hours for anxiety

Answer and Explanation

The Correct Answer is C

A. Lorazepam 2.5mg PO qhs before bed: This transcription suggests a fixed dose to be taken before bed (qhs = every bedtime), which does not align with the "as needed" or PRN (pro re nata) instruction for anxiety.

B. Lorazepam 2.5 mg PO QD at hs: This suggests that the medication should be taken once daily (QD) at bedtime (hs = at hour of sleep), which again is not appropriate for as-needed (PRN) use in anxiety.

C. Lorazepam 2.5 mg PO every 8 hours as needed for anxiety: This transcription correctly indicates that the lorazepam is to be taken as needed for anxiety, with a dose of 2.5 mg. However, this also suggests it can be taken every 8 hours, which is more of a standard timing than PRN use. But, it is still the most accurate option for a PRN order.

D. Lorazepam 2.50 mg PO Q 8 hours for anxiety: This prescription is incorrect because it implies the medication should be taken every 8 hours regardless of need, which conflicts with the as-needed (PRN) nature of the order.

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Correct Answer is C

Explanation

A. Hemoglobin level: The hemoglobin level measures the amount of hemoglobin, the oxygen-carrying protein in red blood cells, in the blood. Warfarin is not directly responsible for increasing or decreasing the hemoglobin level. While warfarin can lead to bleeding complications in some cases, it does not specifically target the hemoglobin level, so it is not a direct indicator of the medication's effectiveness.

B. Platelet count: The platelet count measures the number of platelets in the blood, which are essential for blood clotting. Warfarin does not directly affect platelet production or count. It works by inhibiting the production of certain clotting factors, not by affecting platelets. Monitoring the platelet count is important, but it is not an indicator of warfarin's effectiveness in preventing excessive clotting.

C. Prothrombin time (PT) or activated partial thromboplastin time (aPTT): Prothrombin time (PT) and activated partial thromboplastin time (aPTT) are coagulation tests used to assess different types of anticoagulant medications, such as heparin. Warfarin's effect is measured using the International Normalized Ratio (INR). PT and aPTT are not specific to warfarin therapy and are not used to monitor its effectiveness. The INR is the appropriate laboratory test for assessing the efficacy of warfarin therapy.

D. International Normalized Ratio (INR): This is the correct answer. The International Normalized Ratio (INR) is the laboratory test used to monitor the effectiveness of warfarin therapy. The INR measures the time it takes for the blood to clot and reflects the anticoagulant effect of warfarin. A therapeutic INR within the target range (e.g., INR = 2.0 to 3.0 for most indications) indicates that warfarin has been effective in preventing excessive clotting and reducing the risk of complications associated with blood clots.

A. Hypoglycemia B. Hyperreflexia C. Osteoporosis D. Inflammatory bowel disease

Correct Answer is C

Explanation

The nurse should monitor the client receiving long-term treatment with oral doses of prednisone for the development of osteoporosis. Prednisone is a corticosteroid medication that can lead to decreased bone density and increase the risk of fractures. Prolonged use of prednisone can interfere with calcium absorption and increase bone resorption, leading to osteoporosis.

Hypoglycemia (A) is not a common adverse effect of prednisone. In fact, prednisone can cause hyperglycemia and increase the risk of developing diabetes.

Hyperreflexia (B) is not typically associated with prednisone use. Hyperreflexia is an exaggerated reflex response and is not a common adverse effect of corticosteroid therapy.

Inflammatory bowel disease (D) is not an adverse effect of prednisone. In fact, prednisone is often used as a treatment for inflammatory bowel disease to reduce inflammation and symptoms.

Therefore, the nurse should primarily monitor the client for the development of osteoporosis when receiving long-term treatment with oral doses of prednisone.

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A nurse is caring for a client who has anxiety and a prescription for oral lorazepam PRN. Which of the following is the correct way to transcribe the prescription into the electronic medical record?

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