A nurse is caring for a client who is taking multiple medications. Which of the following medications should the nurse identify as a controlled substance?

Rationale:

A. Metoclopramide: Metoclopramide is an antiemetic and prokinetic agent used to treat nausea and gastroparesis. It is not classified as a controlled substance because it does not have potential for abuse or dependence.

B. Dantrolene: Dantrolene is a muscle relaxant used to treat spasticity and malignant hyperthermia. It is not a controlled substance as it has low potential for abuse or addiction.

C. Midazolam: Midazolam is a benzodiazepine used for sedation, anesthesia, and seizure management. Benzodiazepines are classified as controlled substances due to their potential for dependence, abuse, and misuse, making midazolam a controlled drug.

D. Ketorolac: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term pain management. It is not a controlled substance because it has minimal risk for abuse or dependence.

Rationale:

A. "Can you tune out the voices by listening to music?": This question focuses on coping strategies, which is important, but it is not the immediate priority. The nurse must first assess the content of the hallucinations to determine potential risk.

B. "Are you also seeing unusual persons or things?": Assessing for visual hallucinations is useful, but the client is currently experiencing auditory command hallucinations. Immediate focus should be on the commands to ensure safety.

C. "What are the voices telling you to do?": Determining the content of the voices is the priority because command hallucinations may instruct the client to harm themselves or others. Assessing risk and ensuring safety comes before exploring coping or additional symptoms.

D. "Do the voices cause you to feel anxious?": Assessing emotional response is relevant, but it is secondary to understanding whether the hallucinations pose a safety risk to the client or others.