A nurse is reviewing medication prescriptions for a client. For which of the following entries on the client's medication administration record should the nurse request clarification?

Simvastatin 40 mg PO at bedtime

Morphine 4 mg IV every 4 hr PRN for pain

Levothyroxine 100 mcg PO every morning

Acetaminophen 500 mg every 4 hr PRN for fever

Answer and Explanation

The Correct Answer is B

A. Simvastatin 40 mg PO at bedtime: This prescription is clear and specifies the medication (Simvastatin), the dose (40 mg), route (PO – oral), and timing (at bedtime). There is no need for clarification.
B. Morphine 4 mg IV every 4 hr PRN for pain: The need for clarification arises here because "PRN" (pro re nata) means "as needed," and prescribing an IV medication on an as-needed basis might need further clarification regarding the specific indications and circumstances for administering the medication.
C. Levothyroxine 100 mcg PO every morning: This prescription is clear and specifies the medication (Levothyroxine), the dose (100 mcg), route (PO – oral), and timing (every morning). There is no need for clarification.
D. Acetaminophen 500 mg every 4 hr PRN for fever: Similar to option B, there might be a need for clarification regarding the specific indications and circumstances for administering acetaminophen on an as-needed basis. However, in many cases, PRN for fever is reasonable, so it may not be as critical as in the case of an IV pain medication.

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Correct Answer is B

Explanation

A. "Lie down for 1 hour after administering the medication.": This statement is not necessary for nasal cyanocobalamin administration. There is no need for the client to lie down for an extended period after administering the medication.
B. "Administer the medication into one nostril once per week.": This is the correct information. Nasal cyanocobalamin is typically administered once a week for the treatment of pernicious anemia. It's important for the nurse to emphasize the correct frequency and route of administration to ensure the effectiveness of the treatment.
C. "Plan to self-administer this medication for the next 6 months.": The duration of treatment may vary based on the healthcare provider's prescription. The nurse should instruct the client based on the specific instructions provided by the healthcare provider rather than a predetermined time frame.
D. "Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose.": This statement is not a standard recommendation for nasal cyanocobalamin administration. If the client has concerns about a stuffy nose, they should consult with their healthcare provider rather than using a nasal decongestant without guidance.

A. Withhold the medication. B. Decrease the dose of the medication. C. Increase the dose of the medication. D. Administer the current dose of the medication.

Correct Answer is D

Explanation

A. Withhold the medication: An INR of 2.5 is generally within the therapeutic range for many conditions, including atrial fibrillation. Withholding the medication might lead to a decreased INR, potentially increasing the risk of clotting.
B. Decrease the dose of the medication: If the INR is above the therapeutic range (usually 2.0-3.0 for atrial fibrillation), the provider might consider decreasing the dose. However, an INR of 2.5 is within the typical therapeutic range, so a decrease in dose might not be warranted.
C. Increase the dose of the medication: An INR of 2.5 is generally within the therapeutic range for many conditions. Increasing the dose in this situation could elevate the INR further, potentially leading to an increased risk of bleeding.
D. Administer the current dose of the medication: Since the INR is within the therapeutic range, the nurse should expect the provider to maintain the current dose of warfarin. Adjustments to the dose might be considered if the INR deviates significantly from the target range.

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A nurse is reviewing medication prescriptions for a client. For which of the following entries on the client's medication administration record should the nurse request clarification?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is reviewing the laboratory results of a client who has atrial fibrillation and a prescription for warfarin. After informing the provider that the INR is 2.5, the nurse should expect which of the following prescriptions?

Correct Answer is D

Explanation

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