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?

Store the remaining half of the pill in the automated medication dispensing system.

Dispose of the remaining medication while another nurse observes.

Return the remaining medication to the facility’s pharmacy.

Place the remaining half of the pill in the unit-dose package.

Answer and Explanation

The Correct Answer is B

This is because hydromorphone is a controlled substance and any unused portion should be discarded in the presence of a witness. Some possible explanations for the other choices are:

Choice A is wrong because storing the remaining half of the pill in the automated medication dispensing system could lead to errors in dosage or diversion of the drug.

Choice C is wrong because returning the remaining medication to the facility’s pharmacy is not a recommended practice for controlled substances and could also result in errors or diversion.

Choice D is wrong because placing the remaining half of the pill in the unit-dose package could compromise the integrity and stability of the medication and expose it to environmental factors.

Normal ranges for hydromorphone are not applicable as it is a synthetic opioid analgesic that does not have a therapeutic level.

However, some factors that may affect its pharmacokinetics and pharmacodynamics are age, weight, renal function, liver function, genetic polymorphisms, and drug interactions.

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Correct Answer is B

Explanation

Carbamazepine is an anticonvulsant medication that is used to treat seizures and nerve pain. It works by reducing the activity of certain nerve cells in the brain.

Choice A is wrong because beclomethasone is a corticosteroid that is used to treat asthma and allergic rhinitis. It does not interact with carbamazepine.

Choice B is correct because the estrogen-progestin combination is a hormonal contraceptive that is used to prevent pregnancy and regulate menstrual cycles. It interacts with carbamazepine because carbamazepine can increase the breakdown of estrogen and progestin in the body, making them less effective. The nurse should instruct the client to use an alternative or additional method of birth control while taking carbamazepine.

Choice C is wrong because diphenhydramine is an antihistamine that is used to treat allergies, motion sickness, and insomnia. It does not interact with carbamazepine.

Choice D is wrong because the nicotine transdermal system is a nicotine replacement therapy that is used to help people quit smoking. It does not interact with carbamazepine.

A. Hypomagnesemia. B. Hypocalcemia. C. Hyponatremia. D. Hypokalemia.

Correct Answer is C

Explanation

Lithium can cause hyponatremia by increasing the secretion of antidiuretic hormone and reducing the renal clearance of sodium.

Strenuous exercise can also cause hyponatremia by increasing sweat loss and fluid intake. Therefore, a client who is taking lithium and starting a new exercise program is at risk of developing hyponatremia.

Choice A is wrong because hypomagnesemia is not a common side effect of lithium or exercise.

Choice B is wrong because hypocalcemia is not a common side effect of lithium or exercise.

Choice D is wrong because hypokalemia is not a common side effect of lithium or exercise.

However, lithium can interact with some diuretics that can cause hypokalemia, so the client should avoid taking these drugs without consulting their doctor. Normal ranges for electrolytes are:

Sodium: 135-145 mmol/L

Magnesium: 0.7-1.1 mmol/L

Calcium: 2.1-2.6 mmol/L

Potassium: 3.5-5.0 mmol/L

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the list of current medications for a client who is to start a new prescription for carbamazepine. The nurse should identify which of the following medications interacts with carbamazepine?

Correct Answer is B

Explanation

A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?

Correct Answer is C

Explanation

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