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. Bradycardia:
Bradycardia is not a typical manifestation of an allergic reaction. Allergic reactions are more likely to involve symptoms such as rash, itching, swelling, and cardiovascular symptoms like tachycardia rather than bradycardia.
B. Hypotension:
This is the correct answer. Hypotension (low blood pressure) can be a sign of an allergic reaction, particularly in severe cases. Anaphylaxis, a severe allergic reaction, can lead to a rapid drop in blood pressure.
C. Polyuria:
Polyuria, excessive urine production, is not a typical manifestation of an allergic reaction. Allergic reactions are more likely to involve skin, respiratory, and cardiovascular symptoms.
D. Nausea:
Nausea can be a side effect of medications, but it is not a specific manifestation of an allergic reaction. Allergic reactions are more likely to present with symptoms such as skin rash, itching, or respiratory distress.

A. Omit over-the-counter medications from the at-home medication list. B. Include medications the client received in the acute setting but will no longer need after transfer. C. Compare the current list of medications to medications the client will receive after transfer D. Remove duplicate medications of different dosages from the reconciliation list

Correct Answer is D

Explanation

A. Omit over-the-counter medications from the at-home medication list:
Over-the-counter medications should be included in the medication reconciliation process to provide a comprehensive overview of all medications the client is taking. These can have interactions or implications for the client's overall health.
B. Include medications the client received in the acute setting but will no longer need after transfer:
Medications that the client will no longer need after transfer should be excluded from the reconciliation list to avoid confusion and unnecessary continuation of those medications.
C. Compare the current list of medications to medications the client will receive after transfer:
This is part of the medication reconciliation process. It is important to ensure continuity of care by comparing the current list of medications with the medications the client will receive after transfer. Any discrepancies or changes should be addressed.
D. Remove duplicate medications of different dosages from the reconciliation list:
This is the correct answer. Duplicate medications with different dosages can lead to confusion and errors. The reconciliation process involves identifying and resolving discrepancies, including duplicates, to ensure accuracy and safety in medication administration

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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

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