A nurse is reviewing the medication administration record for a client who has cancer and is receiving morphine via a PCA pump. Which of the following prescriptions should the nurse clarify with the provider?

Acetaminophen

Insulin gargine

Ondansetron

Naloxone

Answer and Explanation

The Correct Answer is D

A. Acetaminophen: This is a common pain reliever and fever reducer. Acetaminophen is often used alongside other medications, including opioids like morphine, to manage pain more effectively. It's typically safe to use with morphine and is not an immediate concern for clarification.

B. Insulin glargine: Insulin glargine is a long-acting insulin used to control blood sugar levels in individuals with diabetes. While it's important to monitor blood sugar levels in patients receiving opioids, especially if they have diabetes, insulin glargine itself doesn't directly interact with morphine or the PCA pump.

C. Ondansetron: Ondansetron is an anti-nausea medication commonly used to prevent nausea and vomiting, particularly associated with chemotherapy or surgery. Patients receiving morphine, especially those with cancer, may also be prone to nausea. Ondansetron helps manage this side effect and does not typically interact adversely with morphine.

D. Naloxone: Naloxone is an opioid antagonist used to rapidly reverse the effects of opioid overdose, including respiratory depression, caused by drugs like morphine. It's administered in emergency situations to counteract the potentially life-threatening effects of opioids. While naloxone is critical for opioid safety, its presence on the medication list requires clear understanding and specific instructions regarding its use, dosage, and administration protocols in case of opioid-related emergencies.

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Correct Answer is B

Explanation

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.

A. Bone loss B. Hypoglycemia C. Liver toxicity D. Hemolysic anemia

Correct Answer is A

Explanation

A. Bone loss:
This is the correct answer. Long-term use of corticosteroids, such as prednisone, is associated with an increased risk of osteoporosis and bone loss. This effect is particularly significant in older adults.
B. Hypoglycemia:
Prednisone is more likely to cause hyperglycemia (high blood sugar) rather than hypoglycemia. It can lead to insulin resistance and impaired glucose metabolism.
C. Liver toxicity:
Liver toxicity is not a common adverse effect of prednisone. Prednisone is metabolized in the liver, but significant liver toxicity is not a typical concern with its use.
D. Hemolytic anemia:
Hemolytic anemia is not a common adverse effect of prednisone. Corticosteroids can affect the immune system, but hemolytic anemia is not a typical manifestation.

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A nurse is reviewing the medication administration record for a client who has cancer and is receiving morphine via a PCA pump. Which of the following prescriptions should the nurse clarify with the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

Explanation

A nurse is caring for an older adult client who is taking prednisone for long-term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse effects of this drug?

Correct Answer is A

Explanation

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