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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A: Placing the head of the client’s bed in the flat position is not the appropriate first action. While it may help reduce strain on the abdominal area, it does not address the immediate issue of the exposed bowel.
B: Gently reinserting the bowel back into the client’s wound is not recommended. This action could cause further injury or introduce infection. The nurse should avoid manipulating the exposed bowel.
C: Positioning the client on his left side does not directly address the issue of the exposed bowel. While it may help with comfort, it does not provide the necessary protection for the exposed tissue.
D: Applying moistened sterile gauze to the site is the correct action. This helps protect the exposed bowel from contamination and keeps it moist, which is crucial to prevent tissue damage. The nurse should then notify the surgeon immediately for further instructions.
Correct Answer is ["4.0"]
Explanation
Step 1: Determine the dosage required. 320 mg
Step 2: Determine the concentration of the suspension. 400 mg per 5 mL
Step 3: Calculate the volume needed. 320 mg ÷ 400 mg per 5 mL = 320 ÷ 400 × 5 = 0.8 × 5 = 4 mL
The nurse should administer 4.0 mL per dose.
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