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
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Assess the client for adverse reactions:
After ensuring the client's safety and well-being, the nurse can then proceed with the other necessary actions, such as determining the factors that led to the omission, filing an incident report, and reporting the missed dosage to the client's provider. However, assessing the client for any immediate adverse reactions takes precedence to address any potential harm that may have resulted from the missed medication dose.
B. Determine factors that led to the omission:
This is the correct answer. Understanding the factors that led to the omission is crucial for preventing future errors. The nurse should assess if there were any system failures, distractions, or other factors contributing to the missed dose.However, patient's safety and wellbeing comes first.
C. File an Incident report:
Filing an incident report is an important step, but it should not be the first action. The nurse needs to address the immediate situation and assess the factors contributing to the omission first.
D. Report the missed dosage to the client's provider:
Reporting the missed dosage to the provider is an important step, but it should not be the first action. The nurse needs to address the immediate situation, assess the client, and determine factors leading to the omission before reporting to the provider.
Correct Answer is D
Explanation
A. Withhold the medication: An INR of 2.5 is generally within the therapeutic range for many conditions, including atrial fibrillation. Withholding the medication might lead to a decreased INR, potentially increasing the risk of clotting.
B. Decrease the dose of the medication: If the INR is above the therapeutic range (usually 2.0-3.0 for atrial fibrillation), the provider might consider decreasing the dose. However, an INR of 2.5 is within the typical therapeutic range, so a decrease in dose might not be warranted.
C. Increase the dose of the medication: An INR of 2.5 is generally within the therapeutic range for many conditions. Increasing the dose in this situation could elevate the INR further, potentially leading to an increased risk of bleeding.
D. Administer the current dose of the medication: Since the INR is within the therapeutic range, the nurse should expect the provider to maintain the current dose of warfarin. Adjustments to the dose might be considered if the INR deviates significantly from the target range.
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