A nurse is discussing issues regarding controlled substances and reporting with a newly licensed nurse in an inpatient facility. Which of the following statements made by the newly licensed nurse indicates an understanding of the teaching?

"Controlled substances are kept in the bottom drawer of the medication cart."

"I should verify the number of controlled substances at the end of the shift. The provider is responsible for inventory of controlled substances."

"If a controlled substance requires a waste, a second nurse must witness the waste."

"Computer controlled substance inventory is reported to the Drug Enforcement Administration every 10 years."

Answer and Explanation

The Correct Answer is C

Rationale:

A. "Controlled substances are kept in the bottom drawer of the medication cart.": Controlled substances are stored in locked, secure medication dispensing systems or locked drawers—not casually in the bottom drawer. Security measures are in place to prevent diversion and ensure accurate tracking.

B. "I should verify the number of controlled substances at the end of the shift. The provider is responsible for inventory of controlled substances.": While end-of-shift counts are standard practice, the nurse not the provider is responsible for verifying inventory at shift change. Accountability for handling and documenting controlled substances lies with nursing staff.

C. "If a controlled substance requires a waste, a second nurse must witness the waste.":
This is a correct and essential safety protocol. When wasting part of a controlled substance dose, a second licensed nurse must witness and document the waste to prevent diversion and ensure accurate medication tracking.

D. "Computer controlled substance inventory is reported to the Drug Enforcement Administration every 10 years.": Facilities are required to maintain records and conduct regular audits, and the DEA mandates inventory at least every 2 years not every 10. Reporting frequency and requirements are more stringent.

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Correct Answer is C

Explanation

Rationale:

A. Librium: Librium (chlordiazepoxide) is a benzodiazepine used primarily during alcohol withdrawal to manage symptoms such as anxiety, tremors, or seizures. It is not used for long-term relapse prevention due to the risk of dependence and lack of deterrent effect on alcohol use.

B. Clonidine: Clonidine is an antihypertensive agent that can help reduce autonomic symptoms during acute alcohol or opioid withdrawal. However, it does not play a role in preventing relapse or deterring future alcohol use.

C. Disulfiram: Disulfiram works by producing unpleasant effects like nausea and vomiting when alcohol is consumed, thereby discouraging the client from drinking. It is specifically used for relapse prevention in clients who are motivated to remain abstinent and understand the consequences of drinking while on the medication.

D. Phenobarbital: Phenobarbital, a barbiturate, may be used in certain alcohol withdrawal protocols for seizure control or severe withdrawal symptoms. However, it is not used for relapse prevention and carries a high potential for dependence and sedation.

A. Search for the medication on the National Library of Medicine's MedlinePlus website. B. Ask the charge nurse to explain the purpose of the medication. C. Ask the client to state the indication for the medication. D. Allow the client to self-administer the prepared medication.

Correct Answer is A

Explanation

Rationale:

A. Search for the medication on the National Library of Medicine's MedlinePlus website: This action allows the nurse to independently access a reliable, evidence-based source to gather essential information about the medication, including its purpose, dosage, side effects, and precautions. It promotes safe and informed medication administration.

B. Ask the charge nurse to explain the purpose of the medication: While consulting experienced colleagues is acceptable, relying solely on another person without verifying the medication through a formal, credible source may lead to misinformation. Independent verification is a safer and more accountable approach.

C. Ask the client to state the indication for the medication: Clients may not always have accurate knowledge of their medications or may misunderstand the reason for their use. Relying on client input does not ensure medication safety and is not a substitute for clinical validation.

D. Allow the client to self-administer the prepared medication: Allowing a client to self-administer a medication that the nurse does not understand is unsafe and violates standards of medication administration. Nurses are responsible for knowing what they administer and ensuring it is appropriate for the client's condition.

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A nurse is discussing issues regarding controlled substances and reporting with a newly licensed nurse in an inpatient facility. Which of the following statements made by the newly licensed nurse indicates an understanding of the teaching?

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