An order is written for phenytoin 500 mg IM q3-4h prn for pain. The nurse recognizes that treatment of pain is not a standard therapeutic indication for this drug. The nurse believes that the health care provider meant to write hydromorphone. What should the nurse do?

Administer the medication and monitor the patient frequently.

Refuse to give the medication and notify the nurse supervisor.

Give the patient hydromorphone, as it was meant to be written.

Call the health care provider to clarify the order.

Answer and Explanation

The Correct Answer is D

A: Administering the medication and monitoring the patient frequently is not appropriate because phenytoin is not indicated for pain management.

B: Refusing to give the medication and notifying the nurse supervisor is a step in the right direction, but the nurse should also seek clarification from the health care provider.

C: Giving the patient hydromorphone without clarification is not appropriate. The nurse must verify the order with the health care provider.

D: Calling the health care provider to clarify the order is the correct action. This ensures that the correct medication is administered as intended.

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Correct Answer is C

Explanation

A: Expecting some swelling in the hands and feet is incorrect. Furosemide is a diuretic used to reduce fluid buildup, so swelling should decrease, not increase.
B: Taking the medication at bedtime is not recommended because furosemide increases urine output, which can disrupt sleep. It is better to take it in the morning.
C: Eating foods that contain plenty of potassium is important because furosemide can cause potassium loss. Consuming potassium-rich foods helps maintain electrolyte balance and prevent hypokalemia.
D: Taking aspirin if headaches develop is not related to the use of furosemide. The nurse should address headache management separately and ensure the client understands the specific instructions for furosemide use.

A. Renal dysfunction B. Pancreatic impairment C. Increased gastric motility D. Increased blood volume

Correct Answer is A

Explanation

A: Renal dysfunction is common in older adults and can lead to decreased clearance of medications from the body, increasing the risk of toxicity. Monitoring for signs of toxicity is crucial in this population.

B: Pancreatic impairment can affect digestion and insulin production but is not the primary reason for monitoring medication toxicity in older adults.

C: Increased gastric motility is not typically associated with aging. In fact, decreased gastric motility is more common and can affect drug absorption.

D: Increased blood volume is not a common physiological change in older adults. Decreased renal function and changes in body composition are more relevant factors affecting medication metabolism and excretion.

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An order is written for phenytoin 500 mg IM q3-4h prn for pain. The nurse recognizes that treatment of pain is not a standard therapeutic indication for this drug. The nurse believes that the health care provider meant to write hydromorphone. What should the nurse do?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide. Which of the following instructions should the nurse include?

Correct Answer is C

Explanation

The nurse closely monitors an older adult for signs of medication toxicity. Which physiological change is the reason for the nurse’s action?

Correct Answer is A

Explanation

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