A nurse is preparing to administer morphine to a client. Which of the following actions should the nurse plan to take?
Request that an assistive personnel obtain the medication.
Verify the dosage of the medication with the provider.
Record the client's temperature before administering the medication.
Document obtaining the medication from the locked location.
The Correct Answer is D
A. Request that an assistive personnel obtain the medication: Controlled substances like morphine must be handled and administered by a licensed nurse. Delegating this task to assistive personnel violates safe medication administration regulations.
B. Verify the dosage of the medication with the provider: The dosage is typically verified against the provider’s order and the medication administration record rather than contacting the provider each time, unless there is a discrepancy or unusual dose.
C. Record the client's temperature before administering the medication: Morphine administration does not require a temperature check. Assessment should focus on pain level, respiratory rate, blood pressure, and level of consciousness to ensure safe administration.
D. Document obtaining the medication from the locked location: Controlled substances must be securely stored, and accurate documentation of removal from the locked medication location is essential for accountability, legal compliance, and prevention of diversion.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}
Explanation
Rationale for Correct Choices:
- Diltiazem: Diltiazem is a calcium channel blocker commonly used to control ventricular rate in atrial fibrillation. The client’s ECG confirms atrial fibrillation with rapid ventricular response, making rate control a priority to prevent hemodynamic instability.
- Cardiac rhythm: The rapid, irregular heart rate documented on ECG is the primary finding necessitating medication intervention to prevent further complications such as decreased cardiac output or thromboembolism.
Rationale for Incorrect Choices:
- Dopamine: Dopamine is a vasopressor used to support blood pressure in hypotension or shock. While the client’s BP is mildly decreased, the immediate concern is rapid atrial fibrillation rather than hypotensive crisis.
- Furosemide: Furosemide treats fluid overload and edema but does not directly address the acute arrhythmia causing tachycardia and hemodynamic compromise.
- Albuterol nebulizer: Albuterol is used for bronchospasm and respiratory distress related to airway constriction. The client has clear lung sounds, so this is not indicated.
- Alprazolam: Alprazolam can reduce anxiety but does not manage the underlying atrial fibrillation or prevent cardiovascular complications.
- Edema, blood pressure, anxiety, dyspnea: While these are relevant assessments, they are secondary to the urgent need to control the cardiac rhythm in acute atrial fibrillation.
Correct Answer is D
Explanation
A. Kidney transplant: Phenytoin is not used to prevent organ rejection or manage transplant-related complications. Immunosuppressive therapy is indicated in kidney transplants, and phenytoin does not play a role in this context.
B. Endocarditis: Endocarditis is treated with antibiotics and sometimes surgical interventions, not antiepileptic drugs. Phenytoin does not address the bacterial infection or associated inflammation in the heart.
C. Hypokalemia: Low potassium levels are managed with potassium supplements or dietary adjustments. Phenytoin does not correct electrolyte imbalances and is not indicated for hypokalemia.
D. Seizures: Phenytoin is an antiepileptic medication used to prevent and control seizures. It stabilizes neuronal membranes and reduces the spread of seizure activity, making it appropriate for clients experiencing convulsive episodes.
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