A nurse is preparing to administer morphine 4 mg IV bolus to a client who reports pain. Available is morphine 10 mg/mL. Which of the following actions should the nurse take?

Have another nurse witness the disposal of the extra medication.

Discard the extra medication in a sharps container.

Save the extra medication for a later dosing.

Send the waste amount to the pharmacy.

Answer and Explanation

The Correct Answer is A

A.   In many institutions, when a nurse administers a controlled substance and has leftover medication, it is standard practice to have another nurse witness the disposal of the excess. This is a safeguard against misuse and ensures accountability.
B.   While a sharps container is appropriate for disposing of needles and other sharp objects, it is not suitable for liquid medications. Discarding liquid medications in a sharps container could lead to contamination and is not compliant with disposal protocols.
C.   Medications, especially controlled substances, should never be saved for later use once they have been drawn up or prepared. This practice poses a significant risk for medication errors and misuse.
D.   Generally, the waste amount is not sent to the pharmacy. Instead, it should be wasted according to the facility's policy, typically in the presence of another nurse. Sending it to the pharmacy is unnecessary and could create logistical complications.

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Correct Answer is B

Explanation

A. Protamine is an antidote for heparin and is used to reverse anticoagulation effects. It is not relevant in the context of administering morphine, which is an opioid analgesic.
B. Naloxone is an opioid antagonist that is specifically used to reverse the effects of opioid overdose, including respiratory depression caused by morphine. Having naloxone available is a critical safety measure when administering opioids, as it can quickly counteract the effects if the patient experiences severe sedation or respiratory distress.
C. Neostigmine is a medication used to treat myasthenia gravis and to reverse the effects of non- depolarizing neuromuscular blockers. It is not related to the administration of morphine and does not serve as a reversal agent for opioid effects.
D. Flumazenil is a benzodiazepine antagonist used to reverse the effects of benzodiazepine sedation. It is not used for opioid reversal and would not be applicable in the context of morphine administration.

A. Promptly confront the nurse to discuss this suspicion B. Ask the other nurses and staff members on the unit if they have noticed the same thing C. Document this finding and communicate with the personnel department D. Monitor the nurse's behavior closely for the remainder of the shift

Correct Answer is D

Explanation

A. While it is important to address concerns about impairment, confronting the nurse directly can be counterproductive and may escalate the situation. It is essential to approach the situation with caution and follow established protocols for dealing with suspected substance impairment.
B. While gathering observations from colleagues may seem reasonable, it can create a culture of gossip and may violate confidentiality. This approach can also lead to misinformation and should not be the first step in addressing a serious concern about a colleague's safety and well-being.
C. Documenting observations is important, but it should not be the sole action taken at this point. Communicating with the personnel department is part of the process if the situation escalates, but immediate action is necessary to ensure patient safety.
D. This option is the most appropriate initial action. By closely monitoring the nurse’s behavior, the manager can gather more information before taking further steps. This approach allows for the collection of objective data and ensures patient safety while avoiding premature accusations.

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A nurse is preparing to administer morphine 4 mg IV bolus to a client who reports pain. Available is morphine 10 mg/mL. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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