A nurse is reviewing a new order on the Electronic Health Record.
The dose of the medication is abnormally high.
What would be the nurse's best next action?
Refuse to administer the medication.
Administer the medication as ordered.
Document concerns about the order.
Query the physician about the order.
The Correct Answer is D
Choice A rationale
Refusing to administer the medication without further investigation could jeopardize the client's timely treatment. While safety is paramount, the nurse's initial action should be to gather more information rather than outright refusal, which could delay necessary care.
Choice B rationale
Administering a medication that appears to be abnormally high without verifying the order is unsafe and could lead to serious adverse effects for the client. Nurses have a professional responsibility to question orders that seem incorrect or potentially harmful.
Choice C rationale
Documenting concerns is an important step in the process, but it is not the best *next* action. While documentation is crucial for legal and communication purposes, directly addressing the potentially erroneous order with the prescriber takes precedence to ensure patient safety.
Choice D rationale
Querying the physician about the order is the most appropriate immediate action. This allows the nurse to clarify the dosage, route, and rationale for the high dose. It opens a dialogue with the prescriber to confirm the order's accuracy or identify a potential error, directly addressing the safety concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
High blood urea nitrogen (BUN) levels primarily indicate impaired kidney function or dehydration, as urea is a waste product of protein metabolism filtered by the kidneys. While severe protein catabolism can elevate BUN, it is not the most direct or sensitive indicator of inadequate protein intake. Normal BUN ranges typically fall between 7 to 20 mg/dL.
Choice B rationale
Low specific gravity of urine suggests that the kidneys are excreting dilute urine, which can be caused by various factors such as excessive fluid intake, diabetes insipidus, or kidney dysfunction. It is not a reliable indicator of protein nutritional status. Normal urine specific gravity ranges from 1.005 to 1.030.
Choice C rationale
Serum albumin is a protein synthesized by the liver and is a key indicator of long-term protein status. Inadequate protein intake leads to decreased albumin synthesis, resulting in low serum albumin levels. Albumin has a relatively long half-life (around 20 days), making it a reflection of chronic protein deficiency. Normal serum albumin levels typically range from 3.5 to 5.0 g/dL.
Choice D rationale
Hemoglobin is the protein in red blood cells responsible for oxygen transport. While severe protein deficiency can eventually affect hemoglobin levels due to the protein component, it is not the most direct or immediate indicator of inadequate protein intake. Other factors like iron deficiency are more commonly associated with low hemoglobin. Normal hemoglobin ranges for adults are typically 13.5 to 17.5 g/dL for males and 12.0 to 15.5 g/dL for females.
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Moderate consumption of red wine has been associated with potential cardiovascular benefits, primarily attributed to the presence of antioxidants like resveratrol. Resveratrol may help prevent damage to blood vessels, reduce low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol), and prevent blood clots. However, these potential benefits must be balanced against the risks associated with alcohol consumption.
Choice B rationale
Generally, three glasses of red wine would be considered beyond moderate alcohol consumption for most individuals. Moderate drinking is typically defined as up to one drink per day for women and up to two drinks per day for men. Three glasses could lead to significant impairment, increased risk of accidents, and potential long-term health consequences associated with excessive alcohol intake.
Choice C rationale
Individuals with liver disease should generally avoid alcohol consumption altogether. The liver is the primary organ responsible for metabolizing alcohol, and liver disease impairs this function. Consuming alcohol can further damage the liver, exacerbate existing conditions, and lead to serious complications.
Choice D rationale
Alcohol is a diuretic, meaning it increases urine production. This diuretic effect can lead to dehydration if fluid intake does not adequately compensate for the increased fluid loss through urination. Therefore, consuming three glasses of red wine, without sufficient water intake, can contribute to dehydration.
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