A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. The medication is provided as hydromorphone 8 mg per tablet. Which of the following actions is appropriate for the nurse to take?
Return the remaining medication to the facility's pharmacy.
Dispose of the remaining ’edication while another nurse observes.
Store the remaining half of the pill in the automated medication dispensing system.
Place the remaining half of the pill in the unit-dose package.
None
None
The Correct Answer is B
Answer: B. Dispose of the remaining medication while another nurse observes.
Rationale:
A) Return the remaining medication to the facility's pharmacy: Return the remaining medication to the facility's pharmacy: This is not typical practice for partial doses of controlled substances like hydromorphone. The pharmacy usually does not accept leftover portions of such medications.
B) Dispose of the remaining medication while another nurse observes: This is the correct and appropriate action. When administering controlled substances, any unused portion must be properly disposed of to prevent misuse or diversion. Having another nurse observe and document the disposal ensures accountability and adherence to safety protocols.
C) Store the remaining half of the pill in the automated medication dispensing system: Storing a partial tablet of a controlled substance is not appropriate. The automated medication dispensing system is designed to store and dispense whole doses of medication as prescribed. Storing partial tablets can lead to confusion, contamination, and potential misuse. It also increases the risk of medication errors, as the partial dose may not be easily identifiable or accurately accounted for.
D) Place the remaining half of the pill in the unit-dose package: his practice is not acceptable for controlled substances due to the risk of misuse, contamination, and the potential for medication errors. Controlled substances require strict handling and disposal procedures to ensure safety and compliance with regulatory standards. Placing a partial tablet back into the unit-dose package does not align with these standards and could lead to inappropriate use or administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) The client has an increased creatinine level: While an increased creatinine level may indicate renal impairment, it is not specific to a vancomycin infusion reaction. Elevated creatinine levels may occur due to various factors, including underlying kidney disease or dehydration.
B) The client is experiencing hypotension: This is the correct answer. Hypotension, or low blood pressure, can be a manifestation of a vancomycin infusion reaction. Vancomycin infusion reactions may include anaphylaxis or anaphylactoid reactions, which can lead to systemic vasodilation and subsequent hypotension.
C) The client's IV site is red and edematous: Redness ’nd edema at the IV site may indicate phlebitis or infiltration, which are local complications rather than systemic reactions to vancomycin infusion.
D) The client reports ringing in their ears: Ringing in the ears, also known as tinnitus, is a potential side effect of vancomycin, particularly with high doses or prolonged use. However, it is not specific to a vancomycin infusion reaction and may occur independently of the infusion process.
Correct Answer is A
Explanation
A) Hypertension: Phenelzine is a monoamine oxidase inhibitor (MAOI) used as an antidepressant medication. It works by inhibiting the breakdown of neurotransmitters such as serotonin, norepinephrine, and dopamine in the brain. When phenelzine is taken with foods high in tyramine, such as aged cheese, a potentially dangerous interaction can occur. Tyramine-rich foods can cause the release of stored catecholamines, leading to a sudden increase in blood pressure, known as a hypertensive crisis. Symptoms of a hypertensive crisis can include severe headache, palpitations, chest pain, nausea, vomiting, and sweating. Therefore, hypertension is a manifestation of the interaction between phenelzine and aged cheese.
B) Bradycardia: Bradycardia, or slow heart rate, is not typically associated with the interaction between phenelzine and aged cheese. Instead, the interaction is more commonly associated with a sudden increase in blood pressure (hypertension).
C) Somnolence: Somnolence, or drowsiness, is a common side effect of phenelzine but is not specifically related to the interaction between phenelzine and aged cheese.
D) Diarrhea: Diarrhea is not typically associated with the interaction between phenelzine and aged cheese. Instead, the interaction is more commonly associated with a sudden increase in blood pressure (hypertension).
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