A nurse is receiving a telephone prescription from a provider for a client who requires additional medication for pain control. Which of the following entries should the nurse make in the medical record?

"Morphine 3 mg SQ every 4 hr PRN for pain."

"Morphine 3.0 mg sub q every 4 hr PRN for pain."

"Morphine 3 mg subcutaneous every 4 hr PRN for pain."

"Morphine 3 mg SC q4hr PRN for pain.”

Answer and Explanation

The Correct Answer is C

Rationale:

A. "Morphine 3 mg SQ every 4 hr PRN for pain.": The abbreviation "SQ" is considered unsafe and can be misinterpreted. The Joint Commission recommends avoiding this abbreviation and writing out "subcutaneous" to ensure clarity and patient safety.

B. "Morphine 3.0 mg sub q every 4 hr PRN for pain.": Using a trailing zero (e.g., "3.0 mg") increases the risk of a dosing error if the decimal point is missed. Standard documentation practices recommend omitting trailing zeros for whole numbers.

C. "Morphine 3 mg subcutaneous every 4 hr PRN for pain.": This entry uses the full name "subcutaneous," avoids unsafe abbreviations, and omits the trailing zero, adhering to safe and standardized medication documentation guidelines.

D. "Morphine 3 mg SC q4hr PRN for pain.": Both "SC" and "q4hr" are discouraged abbreviations. "SC" can be confused with "SL" (sublingual), and "q" abbreviations can be misread. Writing terms in full reduces the risk of misinterpretation.

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Correct Answer is C

Explanation

Rationale:

A. “I can infuse the medication at a faster rate”: Vancomycin must be infused slowly, typically over 60–120 minutes, to prevent adverse effects such as Red Man Syndrome. Increasing the infusion rate is unsafe and not appropriate.

B. “I can start the medication 30 minutes earlier.” While minor time adjustments may be acceptable, this choice limits flexibility unnecessarily. Medication timing should follow institutional policy, which generally allows a 30-minute window before and a 2-hour window after the scheduled time.

C. “I have up to 2 hours after the usual scheduled time to give you this medication”: This reflects standard medication administration guidelines for time-critical medications like antibiotics. Giving vancomycin within 30 minutes before or up to 2 hours after the scheduled time is acceptable and safe.

D. “I can adjust the time and schedule for when it's convenient for you.” While patient preferences are important, antibiotic timing must align with dosing schedules to maintain therapeutic levels. Adjustments must follow clinical guidelines, not personal convenience.

A. "Avoid high-fiber foods while taking this medication." B. "Apply the patch to your forearm." C. "Avoid hot tubs while wearing the patch." D. "Remove the patch for 8 hours every day to reduce the risk of tolerance"

Correct Answer is C

Explanation

Rationale:

A. "Avoid high-fiber foods while taking this medication." High-fiber foods are encouraged when taking opioids like fentanyl due to the common side effect of constipation. Dietary fiber supports bowel function and should not be avoided.

B. "Apply the patch to your forearm." The patch should be applied to a flat, non-irritated area with minimal hair, such as the chest, back, or upper arm. The forearm is not the preferred site due to its mobility and smaller surface area.

C. "Avoid hot tubs while wearing the patch." Heat increases the absorption rate of transdermal fentanyl, potentially leading to overdose. Clients should avoid hot tubs, heating pads, or prolonged exposure to direct sunlight while wearing the patch.

D. "Remove the patch for 8 hours every day to reduce the risk of tolerance." Fentanyl patches are designed to provide continuous pain control and should not be removed intermittently. Removing the patch disrupts pain management and does not prevent tolerance, which is managed by medical adjustment if necessary.

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A nurse is receiving a telephone prescription from a provider for a client who requires additional medication for pain control. Which of the following entries should the nurse make in the medical record?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Explanation

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