A nurse is preparing to administer medication to a post-operative client.
Which of the following prescriptions should the nurse verify with the provider?
Morphine 4 mg IV every 4 hr PRN pain.
Hydromorphone 2 mg IV every 2 hr PRN severe pain.
Ondansetron 4 mg PO every 8 hr PRN nausea.
Docusate sodium 240 mg PO daily PRN constipation.
The Correct Answer is B
Choice A rationale
Morphine is a potent opioid analgesic commonly prescribed for moderate to severe pain. A dosage of 4 mg intravenously every four hours as needed for pain is within the typical therapeutic range for post-operative pain management, and the frequency allows for sufficient time between doses to assess the analgesic effect and minimize accumulation.
Choice B rationale
Hydromorphone is a very potent opioid, significantly stronger than morphine. A dosage of 2 mg intravenously every two hours for severe pain is a high dose and a relatively short interval. This combination increases the risk of opioid toxicity, including respiratory depression and profound sedation, necessitating verification with the prescribing provider.
Choice C rationale
Ondansetron is a serotonin receptor antagonist used to prevent and treat nausea and vomiting. A dosage of 4 mg orally every eight hours as needed for nausea is a standard and safe therapeutic dose, commonly employed in the post-operative setting to manage emesis with minimal adverse effects.
Choice D rationale
Docusate sodium is a stool softener that works by increasing water and fat penetration into the stool, making it easier to pass. A dosage of 240 mg orally daily as needed for constipation is a common and appropriate dose for preventing and managing post-operative constipation, which is a frequent side effect of opioid analgesics.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
A history of migraine headaches is not a contraindication for metformin. Metformin's primary mechanism involves reducing hepatic glucose production and improving insulin sensitivity in peripheral tissues. Migraine headaches are neurological conditions not directly influenced by or interacting adversely with metformin's metabolic actions.
Choice B rationale
Alcohol use disorder is a significant contraindication for metformin due to an increased risk of lactic acidosis. Alcohol consumption can impair hepatic lactate metabolism and increase lactate production, while metformin itself can elevate lactate levels. The combination markedly raises the likelihood of this severe metabolic complication.
Choice C rationale
A history of peptic ulcer disease is not a direct contraindication for metformin. While some gastrointestinal side effects like nausea or diarrhea can occur with metformin, these are generally not severe enough to preclude its use in patients with a history of peptic ulcer disease, especially if the ulcer is currently resolved.
Choice D rationale
Tobacco use is not a direct contraindication for metformin. While tobacco use is a risk factor for various health issues, including cardiovascular disease and complications of diabetes, it does not physiologically interact with metformin in a manner that would contraindicate its use. The primary concerns with tobacco are unrelated to metformin's metabolism or side effect profile.
Correct Answer is C
Explanation
Choice A rationale
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can exacerbate gastric ulcers by inhibiting prostaglandin synthesis, which normally protects the gastric mucosa. Continuing ibuprofen would counteract the therapeutic effects of esomeprazole, a proton pump inhibitor, and increase the risk of gastrointestinal bleeding and ulcer perforation.
Choice B rationale
Esomeprazole delayed-release capsules contain enteric-coated pellets to protect the active ingredient from gastric acid degradation, allowing absorption in the small intestine. Crushing the medication would destroy this protective coating, leading to premature drug release in the stomach and reduced bioavailability, thereby diminishing its therapeutic efficacy.
Choice C rationale
Esomeprazole is a proton pump inhibitor that irreversibly binds to and inhibits the H+/K+-ATPase pump in gastric parietal cells, thereby reducing gastric acid secretion. Taking it 60 minutes before a meal ensures that peak plasma concentrations coincide with the maximal activity of these pumps, which are stimulated by food intake, optimizing its acid-suppressing effect.
Choice D rationale
While some medications can cause insomnia, it is not a commonly reported adverse effect of esomeprazole. Common adverse effects of proton pump inhibitors typically include headache, nausea, diarrhea, abdominal pain, and flatulence, reflecting their primary actions on the gastrointestinal system and potential systemic effects.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.