A nurse is transcribing a new prescription in a client's medical record for enoxaparin 30 milligrams, subcutaneously every 12 hours. Which of the following documentation should the nurse use?
Enoxaparin 30 mg SQ q AM and q HS
Enoxaparin 30 mg subcut every 12 hr
Enoxaparin 30 mcg SC q12 hour
Enoxaparin 30 mg sub q every AM and HS
The Correct Answer is B
Choice A reason: "SQ q AM and q HS" is incorrect because it specifies morning and bedtime administration rather than every 12 hours. This could lead to dosing errors.
Choice B reason: "Enoxaparin 30 mg subcut every 12 hr" is the correct documentation. It uses standard terminology, specifies the correct dose, route, and frequency, and avoids abbreviations that could be misinterpreted.
Choice C reason: "30 mcg" is incorrect because it changes the dosage from milligrams to micrograms, which is a thousand-fold difference. This would result in a dangerous underdose.
Choice D reason: "sub q every AM and HS" is incorrect because it specifies administration twice daily at morning and bedtime rather than strictly every 12 hours. This could cause uneven dosing intervals.
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Correct Answer is B
Explanation
Choice A reason: Reaching an appropriate body weight is a long-term goal, not a short-term one. Clients with anorexia nervosa require gradual weight restoration to avoid complications such as refeeding syndrome. Setting this as a short-term goal is unrealistic and potentially unsafe.
Choice B reason: Gaining 2 to 3 lb weekly is the correct short-term goal because it is measurable, realistic, and safe. This gradual increase helps stabilize the client’s nutritional status while minimizing medical risks. It also provides a tangible benchmark for progress during inpatient treatment.
Choice C reason: Verbalizing a realistic body image is important but represents a long-term psychosocial goal. Distorted body image is a core feature of anorexia nervosa and requires extended therapy and counseling. It cannot be expected as a short-term outcome during initial hospitalization.
Choice D reason: Developing a personalized meal plan is a collaborative long-term strategy involving dietitians and therapists. While important, it is not the immediate short-term focus. The priority is safe, gradual weight gain.
Correct Answer is A
Explanation
Choice A reason: Increased swallowing in a child after a tonsillectomy can indicate bleeding at the surgical site. Because children may not be able to verbalize bleeding, frequent swallowing is a subtle but critical sign. This requires immediate medical attention, making this the correct answer.
Choice B reason: A warm-mist vaporizer is not recommended because it increases humidity and warmth, which can promote bacterial growth and increase infection risk. Cool-mist vaporizers are safer and more effective for soothing the throat and reducing discomfort. Therefore, this option is incorrect.
Choice C reason: Blowing the nose frequently can increase pressure in the oropharynx and disturb the surgical site, potentially leading to bleeding. This option is unsafe and incorrect.
Choice D reason: Using a straw after tonsillectomy is contraindicated because the suction action can dislodge clots and increase the risk of bleeding. Smoothies can be offered, but they should be given with a spoon or cup, not a straw. This option is incorrect.
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