A nurse is preparing to administer morphine 4 mg IV bolus to a client who reports pain. Available is morphine 10 mg/mL. Which of the following actions should the nurse take?

Have another nurse witness the disposal of the extra medication.

Discard the extra medication in a sharps container.

Save the extra medication for a later dosing.

Send the waste amount to the pharmacy.

Answer and Explanation

The Correct Answer is A

A.   In many institutions, when a nurse administers a controlled substance and has leftover medication, it is standard practice to have another nurse witness the disposal of the excess. This is a safeguard against misuse and ensures accountability.
B.   While a sharps container is appropriate for disposing of needles and other sharp objects, it is not suitable for liquid medications. Discarding liquid medications in a sharps container could lead to contamination and is not compliant with disposal protocols.
C.   Medications, especially controlled substances, should never be saved for later use once they have been drawn up or prepared. This practice poses a significant risk for medication errors and misuse.
D.   Generally, the waste amount is not sent to the pharmacy. Instead, it should be wasted according to the facility's policy, typically in the presence of another nurse. Sending it to the pharmacy is unnecessary and could create logistical complications.

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Correct Answer is D

Explanation

A. While it is important to address concerns about impairment, confronting the nurse directly can be counterproductive and may escalate the situation. It is essential to approach the situation with caution and follow established protocols for dealing with suspected substance impairment.
B. While gathering observations from colleagues may seem reasonable, it can create a culture of gossip and may violate confidentiality. This approach can also lead to misinformation and should not be the first step in addressing a serious concern about a colleague's safety and well-being.
C. Documenting observations is important, but it should not be the sole action taken at this point. Communicating with the personnel department is part of the process if the situation escalates, but immediate action is necessary to ensure patient safety.
D. This option is the most appropriate initial action. By closely monitoring the nurse’s behavior, the manager can gather more information before taking further steps. This approach allows for the collection of objective data and ensures patient safety while avoiding premature accusations.

A. Temperature B. Blood pressure C. Respiratory rate D. Apical heart rate

Correct Answer is C

Explanation

A. While monitoring temperature is important in assessing for infection, it is not the priority assessment before administering morphine. Temperature does not directly relate to the immediate effects or risks associated with opioid administration.
B. Blood pressure monitoring is essential, especially in a postoperative patient. However, opioids primarily impact the respiratory system rather than directly causing significant changes in blood pressure. While hypotension can occur with opioids, it is not the most immediate concern when administering morphine.
C. This is the priority assessment. Opioids, including morphine, can cause respiratory depression, which is a serious and potentially life-threatening side effect. Before administering morphine, it is crucial to assess the respiratory rate to ensure the patient is not at risk for respiratory distress. If the respiratory rate is low (typically less than 12 breaths per minute), the nurse may need to hold the medication and notify the healthcare provider.
D. While it is important to monitor heart rate, especially in postoperative patients, the primary concern with morphine administration is its effect on respiration. The heart rate may not be as critical to assess immediately before administering morphine as the respiratory rate is.

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A nurse is preparing to administer morphine 4 mg IV bolus to a client who reports pain. Available is morphine 10 mg/mL. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is uncharacteristically extroverted on today's shift, with an unsteady gait. The manager suspects that the nurse may be chemically Impaired. What is the manager's most appropriate action?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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