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?
Dispose of the remaining medication 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.
Return the remaining medication to the facility's pharmacy.
The Correct Answer is A
A. Dispose of the remaining medication while another nurse observes:
This is the correct choice. When a nurse administers a fraction of a tablet, it is not safe or appropriate to store the remaining portion for future use, even if another dose is scheduled. Hydromorphone tablets are meant to be taken whole, and cutting or breaking them can lead to inconsistent dosages. It's important to follow safe medication administration practices and dispose of the unused portion while another nurse observes, ensuring proper disposal.
B. Store the remaining half of the pill in the automated medication dispensing system:
This choice is incorrect. Storing a fraction of a tablet in the automated medication dispensing system is not appropriate. The system is designed for intact medications, and splitting tablets could compromise the accuracy and safety of future doses.
C. Place the remaining half of the pill in the unit-dose package:
This choice is incorrect. Placing a partial tablet back into a unit-dose package could lead to confusion and potential administration errors in the future. The medication packaging should reflect the correct and complete dosage as prescribed.
D. Return the remaining medication to the facility's pharmacy:
This choice is incorrect. Returning a partially used tablet to the pharmacy is not advisable, as the pharmacy cannot ensure the tablet's integrity or accurately verify its dosage. Medication storage and handling standards are in place to ensure patient safety, and using a fraction of a tablet may compromise those standards.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Obtain the client's HDL level.
Explanation: This choice is not relevant to the situation. HDL (High-Density Lipoprotein) level is related to cholesterol levels and cardiovascular health, which is not directly affected by the administration of metformin instead of metoprolol.
B. Check the client's glucose level.
Explanation: Correct Choice. Metformin is an oral antidiabetic medication commonly used to lower blood glucose levels in individuals with type 2 diabetes. It works by improving insulin sensitivity and decreasing glucose production in the liver. Accidentally administering metformin instead of metoprolol could lead to hypoglycemia (low blood sugar) or other adverse effects related to glucose levels. Checking the client's glucose level is essential to assess and address any potential issues arising from this medication error.
C. Monitor the client's thyroid function levels.
Explanation: This choice is not directly relevant to the situation. Metformin and metoprolol do not significantly affect thyroid function levels. Thyroid function monitoring would not be the immediate concern in this scenario.
D. Collect the client's uric acid level.
Explanation: This choice is not directly relevant to the situation. Metformin and metoprolol do not have a primary impact on uric acid levels. Collecting the uric acid level would not be a priority in this context.
Correct Answer is A
Explanation
A. Correct Answer: St. John's Wort
Explanation: The nurse should advise the client to avoid taking St. John's Wort. St. John's Wort is an herbal supplement commonly used to treat depression and anxiety. However, it can have significant interactions with various medications, including sertraline. Sertraline is an antidepressant that belongs to the selective serotonin reuptake inhibitor (SSRI) class. St. John's Wort can increase serotonin levels in the brain, and when combined with medications that also affect serotonin levels (such as sertraline), it can lead to a potentially dangerous condition known as serotonin syndrome. Therefore, it's important to avoid St. John's Wort while taking sertraline to prevent adverse effects and interactions.
B. Incorrect Explanation: Coenzyme Q10
Explanation: Coenzyme Q10 (CoQ10) is a naturally occurring antioxidant that plays a role in energy production within cells. While CoQ10 is generally considered safe, it does not have known interactions with sertraline. Therefore, the nurse would not necessarily advise the client to avoid CoQ10 solely based on its potential interaction with sertraline.
C. Incorrect Explanation: Black Cohosh
Explanation: Black cohosh is an herbal supplement often used to manage symptoms of menopause. It is not typically known to have significant interactions with sertraline. However, it's important for the client to discuss any supplements with their healthcare provider before starting them, especially when taking prescribed medications. The nurse might not necessarily advise the client to avoid black cohosh unless there are specific concerns based on the client's medical history.
D. Incorrect Explanation: Ginger Root
Explanation: Ginger root is a commonly used spice and herbal remedy. It does not have known interactions with sertraline and is generally considered safe for most people. However, as with any supplement, it's a good practice to consult with a healthcare provider before starting it, especially when taking prescribed medications like sertraline. The nurse would not necessarily advise the client to avoid ginger root without specific reasons related to the client's health.
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