A nurse is reviewing the documentation of a client who has been prescribed a Schedule IV controlled substance for anxiety. Which of the following entries in the medication administration record (MAR) requires correction?

Correct answer: c) Assess the client's vital signs and level of consciousness.

Rationale: The first action that the nurse should take when using the nursing process is to assess the client. Assessing the client's vital signs and level of consciousness is essential to determine the severity of the overdose and the need for immediate interventions. The nurse should also monitor the client for signs of respiratory depression, cardiac arrhythmias, seizures, or other complications.

Incorrect choices:
a) Notify the health care provider and request an order for a urine drug screen.: This is an important action, but not the first one. The nurse should notify the health care provider and request an order for a urine drug screen after assessing the client and stabilizing their condition. A urine drug screen can help to identify the type and amount of drugs that the client has ingested and guide the treatment plan.

b) Administer naloxone as prescribed to reverse the effects of opioids.: This is an important action, but not the first one. The nurse should administer naloxone as prescribed to reverse the effects of opioids after assessing the client and confirming that they have signs of opioid toxicity, such as pinpoint pupils, decreased respiratory rate, and decreased level of consciousness. Naloxone is an opioid antagonist that can rapidly restore normal respiration and alertness in opioid overdose cases. However, naloxone has no effect on other types of drugs and may precipitate withdrawal symptoms in opioid-dependent clients.

d) Educate the client about the risks and consequences of drug abuse.: This is an important action, but not the first one. The nurse should educate the client about the risks and consequences of drug abuse after assessing the client and ensuring their safety and stability. The nurse should also provide emotional support and refer the client to appropriate resources for substance abuse treatment and recovery.

Correct answer: a) "You should keep your medication in its original container with the label attached."

Rationale: Keeping the medication in its original container with the label attached helps to prevent errors, confusion, misuse, or diversion of the medication. The label also provides important information about the medication name, dosage, instructions, expiration date, and prescriber.

Incorrect choices:
b) "You should share your medication with your family members if they have similar symptoms.": This is incorrect as sharing prescription medication with others is illegal and dangerous. Prescription medication should only be taken by the person for whom it was prescribed and as directed by the prescriber.
c) "You should dispose of any unused or expired medication by flushing it down the toilet.": This is incorrect as flushing medication down the toilet can contaminate the water supply and harm the environment. Unused or expired medication should be disposed of properly according to the FDA guidelines or local regulations.
d) "You should stop taking your medication if you experience any side effects.": This is incorrect as stopping medication abruptly can cause adverse effects or worsen the condition. The client should report any side effects to the prescriber and follow their advice on how to manage them or whether to adjust or discontinue the medication.