A nurse is reviewing prescriptions for a client's medications. Which of the following prescriptions should the nurse clarify with the provider?

Digoxin 0.250 mg PO QD

Morphine 4 mg IV bolus every 4 hr PRN pain

Furosemide 10 mg PO every morning

Regular insulin 4 units subcutaneous AC breakfast

Answer and Explanation

The Correct Answer is A

A. Digoxin 0.250 mg PO daily should be clarified with the provider because it is a relatively high dose for many clients, especially older adults or those with renal impairment. The usual maintenance dose is often 0.125 mg daily or lower, and dosing must be individualized based on serum digoxin levels, renal function, and heart rate. Because digoxin has a narrow therapeutic range and risk for toxicity (e.g., bradycardia, nausea, visual disturbances), this prescription requires clarification before administration.

B. Morphine 4 mg IV bolus every 4 hours PRN pain is an appropriate prescription. Morphine is commonly used for moderate to severe pain and IV dosing every few hours as needed is within standard safe prescribing guidelines when appropriately monitored.

C. Furosemide 10 mg PO every morning is a reasonable low dose of a loop diuretic and may be appropriate depending on the client’s condition (e.g., mild fluid overload, hypertension, or heart failure management). There is no immediate indication that this dose requires clarification.

D. Regular insulin 4 units subcutaneous before breakfast is also appropriate. Short-acting insulin is commonly administered before meals to manage postprandial glucose levels, and this dose is within typical low-dose correction or scheduled regimens depending on blood glucose monitoring.

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Correct Answer is A

Explanation

Rationale:

A. The individual is squatting with the knees bent, back straight, and using a wide base of support while keeping the box close to the body. They are using their leg muscles to initiate the lift while keeping the object close to their body. This posture minimizes strain on the lower back and promotes safe lifting mechanics, which aligns with proper ergonomic principles.

B. The individual is standing upright while holding the boxes away from the body. This increases the lever arm and places excessive strain on the lumbar spine, increasing the risk of injury.

C. The individual is bending at the waist (twisting the torso) while lifting the boxes onto a surface. Bending at the waist with a rounded back significantly increases pressure on the lumbar vertebrae and is considered unsafe body mechanics.

D. The individual is bending at the waist with a curved spine. This focuses all the weight of the object and the upper body onto the small muscles and ligaments of the lower back, rather than the powerful muscles of the legs.

A. Administer a bronchodilator after the procedure. B. Hold hand flat to perform percussions on the child. C. Perform the procedure prior to meals. D. Perform the procedure twice each day.

Correct Answer is C

Explanation

Rationale:

A. A bronchodilator is typically administered before postural drainage and chest physiotherapy to help open the airways, loosen secretions, and improve their mobilization. Giving it after the procedure does not enhance secretion removal during therapy.

B. Chest percussion should be performed with a cupped hand, not a flat hand. The cupped shape creates an air cushion that helps loosen thick secretions without causing discomfort or tissue injury.

C. Postural drainage should be performed before meals or at least 1–2 hours after meals. This timing helps prevent nausea, vomiting, and aspiration during the procedure, especially in children with cystic fibrosis who have increased mucus production and may have difficulty clearing secretions.

D. While frequency depends on the severity of the condition, children with cystic fibrosis often require chest physiotherapy 2–4 times daily, not strictly twice a day for all cases. The key nursing priority is appropriate timing (before meals) rather than a fixed frequency in this question.

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A nurse is reviewing prescriptions for a client's medications. Which of the following prescriptions should the nurse clarify with the provider?

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