Which action should be implemented next when a patient states they are allergic to the medication the nurse is ready to administer?.
Give the medication as ordered and record the patient's statements in the nurse's notes.
Withhold the medication and check the drug insert for information on reactions to the drug.
Withhold the medication and notify the prescriber of the situation.
Give the medication and monitor the patient at regular intervals for adverse effects.
The Correct Answer is C
Choice A rationale:
Giving the medication as ordered despite the patient’s stated allergy could lead to a severe allergic reaction.
Choice B rationale:
While checking the drug insert for information on reactions to the drug is important, the immediate action should be to withhold the medication.
Choice C rationale:
Withholding the medication and notifying the prescriber of the situation is the safest course of action when a patient states they are allergic to the medication.
Choice D rationale:
Giving the medication and monitoring the patient for adverse effects is not safe if the patient has stated they are allergic to the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Evaluation is the final step in the nursing process where the nurse determines if the goals set in the planning stage have been met. This does not involve identifying the therapeutic intent of a medication.
Choice B rationale:
Assessment is the first step in the nursing process where the nurse gathers information about the patient’s physical, psychological, sociocultural, and spiritual status. While this may involve understanding the patient’s medication regimen, it does not specifically involve identifying the therapeutic intent of a medication.
Choice C rationale:
Planning involves setting goals and developing a plan to meet those goals. While this may involve considering the therapeutic intent of a medication, it is not the step where this identification occurs.
Choice D rationale:
Implementation is the step of the nursing process where the nurse executes the plan of care. This includes identifying the therapeutic intent of a prescribed medication.
Correct Answer is C
Explanation
Choice A rationale:
Trough levels are the lowest concentration in the patient’s bloodstream, hence they are not the best indicator of the amount of circulating medication.
Choice B rationale:
The term ‘Drug’ is too general and does not specifically refer to the amount of medication in the patient’s bloodstream.
Choice C rationale:
Peak levels are the highest concentration of a drug in the patient’s bloodstream after administration. This is when the amount of the medication in the body is likely to be highest.
Choice D rationale:
Therapeutic levels refer to the range in which a drug is expected to be effective without causing any serious problems to the patient. It does not directly indicate the amount of circulating medication.
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