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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

Answer and Explanation

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.

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Correct Answer is C

Explanation

A) Pain level: Assessing the client's pain level may be important for administering analgesic medications, but it is not directly related to the administration of propranolol. Propranolol is a beta-blocker primarily used to treat conditions such as hypertension, angina, and certain cardiac arrhythmias, so assessing pain level is not the priority.

B) Respiratory rate: While monitoring respiratory rate is important in various clinical situations, propranolol administration does not typically have a direct effect on respiratory function. Therefore, assessing the respiratory rate specifically before administering propranolol may not be as relevant as other vital signs.

C) Heart rate: Propranolol is a beta-blocker that primarily works by slowing the heart rate and reducing the workload on the heart. Therefore, it is crucial for the nurse to assess the client's heart rate prior to administering propranolol to ensure it is within the appropriate range. Administering propranolol to a client with bradycardia or a significantly low heart rate could exacerbate this condition and lead to adverse effects.

D) Temperature: While monitoring temperature is important for assessing for signs of infection or other systemic issues, it is not directly relevant to the administration of propranolol. Propranolol primarily affects cardiovascular function, so assessing temperature is not typically a priority before administering this medication

A. The client will wear his reading glasses when drawing up a dose of insulin glargine. B. The client will administer insulin glargine before each meal. C. The client will use the deltoid muscle as an injection site. D. The client will take an additional dose of insulin glargine prior to exercise.

Correct Answer is A

Explanation

A) The client will wear his reading glasses when drawing up a dose of insulin glargine: This is the correct expected outcome. Older adults may experience visual changes that affect their ability to see clearly. Wearing reading glasses or using other visual aids can help ensure accurate measurement and administration of insulin glargine, reducing the risk of dosing errors.

B) The client will administer insulin glargine before each meal: This statement is incorrect. Insulin glargine is a long-acting insulin analog that is typically administered once daily at the same time each day, rather than before each meal. It provides a steady level of insulin over a 24-hour period and is not directly related to meal timing.

C) The client will use the deltoid muscle as an injection site: Using the deltoid muscle as an injection site for insulin glargine is not recommended. Insulin glargine is usually injected suIcutaneously into the abdomen, thigh, or upper arm. The deltoid muscle may not provide consistent absorption of insulin and is not commonly used for insulin injections.

D) The client will take an additional dose of insulin glargine prior to exercise: Taking an additional dose of insulin glargine prior to exercise is not a typical part of insulin glargine therapy. Adjustments to insulin doses for exercise should be made under the guidance of a healthcare provider, and additional doses of insulin glargine are not usually recommended for this purpose.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer propranolol to a client. Which of the following should the nurse assess prior to administering this medication?

Correct Answer is C

Explanation

A nurse is developing a teaching plan for an older adult client who has a new prescription for insulin glargine. Which of the following expected outcomes should the nurse include in the plan?

Correct Answer is A

Explanation

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