A nurse is reviewing medication prescriptions for a client. For which of the following entries on the client's medication administration record should the nurse request clarification?

Simvastatin 40 mg PO at bedtime

Morphine 4 mg IV every 4 hr PRN for pain

Levothyroxine 100 mcg PO every morning

Acetaminophen 500 mg every 4 hr PRN for fever

Answer and Explanation

The Correct Answer is B

A. Simvastatin 40 mg PO at bedtime: This prescription is clear and specifies the medication (Simvastatin), the dose (40 mg), route (PO – oral), and timing (at bedtime). There is no need for clarification.
B. Morphine 4 mg IV every 4 hr PRN for pain: The need for clarification arises here because "PRN" (pro re nata) means "as needed," and prescribing an IV medication on an as-needed basis might need further clarification regarding the specific indications and circumstances for administering the medication.
C. Levothyroxine 100 mcg PO every morning: This prescription is clear and specifies the medication (Levothyroxine), the dose (100 mcg), route (PO – oral), and timing (every morning). There is no need for clarification.
D. Acetaminophen 500 mg every 4 hr PRN for fever: Similar to option B, there might be a need for clarification regarding the specific indications and circumstances for administering acetaminophen on an as-needed basis. However, in many cases, PRN for fever is reasonable, so it may not be as critical as in the case of an IV pain medication.

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Correct Answer is D

Explanation

A. I take metformin for my diabetes:
This statement indicates that the client is aware of taking metformin for diabetes. It is relevant information but doesn't raise immediate concerns about the interaction with lovastatin.
B. "I should avoid drinking grapefruit juice:"
This is a correct statement. Grapefruit juice can interact with lovastatin, potentially increasing the risk of side effects. Advising the client to avoid grapefruit juice is a proper precaution when taking lovastatin.
C. I am trying to decrease my dietary fat intake:
This statement indicates a positive lifestyle change that aligns with the goal of using lovastatin to lower cholesterol. It is a positive and relevant statement.
D. "I was just diagnosed with hepatitis B:"
This is the correct answer. Lovastatin is metabolized by the liver, and liver function is an important consideration. The nurse should assess the severity of hepatitis B, the client's liver function, and whether lovastatin is contraindicated or requires dose adjustment based on the hepatic impairment.

A. Cover the medication on the client's skin with a sterile gauze pad. B. Spread the medication over a 12.7 cm (5 in) area of the client's skin, C. Measure the dosage of medication using the applicator paper D. Apply the medication to the same site for three consecutive days

Correct Answer is B

Explanation

A. Cover the medication on the client's skin with a sterile gauze pad:
Nitroglycerin ointment is typically applied directly to the skin, and covering it with a sterile gauze pad is not a common practice. The ointment is absorbed through the skin.
B. Spread the medication over a 12.7 cm (5 in) area of the client's skin:
This is the correct answer. Nitroglycerin ointment is usually applied to a specific area of the skin, and the recommended area is often around 12.7 cm (5 inches). The nurse should spread the ointment evenly over this specified area.
C. Measure the dosage of medication using the applicator paper:
Nitroglycerin ointment is typically measured using a dosing strip or measuring paper provided with the medication. Using the applicator paper to measure the appropriate dosage is a common practice.
D. Apply the medication to the same site for three consecutive days:
Nitroglycerin ointment is often rotated to different sites to prevent local irritation or tolerance. It is not typically applied to the same site for three consecutive days.

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A nurse is reviewing medication prescriptions for a client. For which of the following entries on the client's medication administration record should the nurse request clarification?

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