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. Urinary retention: While urinary retention can be a side effect of meperidine and other opioids, it is not the priority assessment before administering the medication. Urinary retention is a concern but is not immediately life-threatening compared to other potential side effects of opioids, such as respiratory depression. Assessing urinary retention is important, but it is not the primary concern in this situation.

B. Vomiting: Vomiting can also be a side effect of opioids, including meperidine. While it is essential to assess for vomiting and its potential impact on the client's overall condition, it is not the priority assessment before administering the medication. Vomiting can be managed, and the nurse should address it as needed. However, the priority assessment is one that can affect the client's immediate safety and well-being, such as respiratory rate and potential respiratory depression.

C. Respiratory rate: This is the correct answer. The priority assessment before administering meperidine is the client's respiratory rate. Opioids can cause respiratory depression, leading to reduced breathing and inadequate ventilation. Monitoring the respiratory rate allows the nurse to detect any signs of respiratory distress or inadequate breathing, enabling them to intervene promptly to prevent serious complications.

D. Level of consciousness: While assessing the client's level of consciousness is essential for overall assessment and monitoring, it is not the priority assessment before administering meperidine. Respiratory depression due to opioid use can occur even when the client is conscious. However, if respiratory depression occurs, it can lead to a decrease in consciousness and potentially unconsciousness, making the assessment of respiratory rate more critical to prevent such complications.

A. "Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide B. "You might need to decrease your insulin dosage while taking hydrochlorothiazide." C. Hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes D. Reducing sodium in your die whim taking your control your blood glucose."

Correct Answer is C

Explanation

The nurse should include in the teaching that hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes. Hydrochlorothiazide is a diuretic commonly used to treat hypertension (high blood pressure). While it is effective in reducing blood pressure, it can sometimes cause adverse effects on blood glucose levels, particularly in individuals with diabetes mellitus.

Hydrochlorothiazide can cause an increase in blood glucose levels by reducing insulin sensitivity, leading to potential hyperglycemia (high blood sugar) in some individuals. Clients with diabetes should closely monitor their blood glucose levels while taking hydrochlorothiazide and inform their healthcare provider if they notice significant changes.

Let's go through the other options:

A. "Blood glucose monitoring is likely to be inaccurate while taking hydrochlorothiazide": This statement is not accurate. Hydrochlorothiazide does not directly affect the accuracy of blood glucose monitoring. However, it is essential for clients with diabetes to be aware of the potential impact of hydrochlorothiazide on their blood glucose levels.

B. "You might need to decrease your insulin dosage while taking hydrochlorothiazide": Hydrochlorothiazide can potentially elevate blood glucose levels, which may require adjustments in diabetes management, including insulin dosage. However, it is not accurate to state that all clients will need to decrease their insulin dosage while taking hydrochlorothiazide. Each client's response to the medication may vary, and adjustments to diabetes medications should be made under the guidance of their healthcare provider based on individual blood glucose monitoring.

D. "Reducing sodium in your diet can help control your blood glucose while taking hydrochlorothiazide": While reducing sodium in the diet is generally a beneficial recommendation for individuals with hypertension, it is not directly related to controlling blood glucose levels in clients with diabetes. The primary focus for individuals with diabetes taking hydrochlorothiazide should be on monitoring blood glucose levels and working with their healthcare provider to manage any changes related to the medication.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

A nurse is providing teaching to a client who has a history of diabetes mellitus and a new prescription for hydrochlorothiazide to treat uncontrolled hypertension. Which of the following information should the nurse include in the teaching?

Correct Answer is C

Explanation

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