A nurse recognizes they administered a medication over one hour when the order dictated the medication be given over 90 minutes. Which should be the first action performed by the nurse?

Prepare and administer the prescribed antidote.

Notify the charge nurse, the nurse manager, and the prescriber.

Assess the identify the presence of urgent safety issues

Complete an incident report detailing the error

Answer and Explanation

The Correct Answer is C

A) Prepare and administer the prescribed antidote: Administering an antidote would only be appropriate if the medication error resulted in a harmful reaction that requires immediate reversal. Since the issue here is the timing of medication administration, it is more important to first assess the client for any immediate effects rather than administering an antidote, which might not be necessary at this stage.

B) Notify the charge nurse, the nurse manager, and the prescriber: While notifying the appropriate staff is crucial, the first action should be assessing the client for any safety concerns or complications resulting from the medication administration error. Immediate evaluation of the client's condition should take precedence over notification.

C) Assess and identify the presence of urgent safety issues: The first priority in this situation is to assess the client for any adverse effects or reactions due to the medication being administered too quickly. This could include monitoring for signs of toxicity, adverse reactions, or changes in vital signs that may indicate a potential risk to the client’s health. Once the client's status is assessed, further actions such as notifying other staff or completing an incident report can follow.

D) Complete an incident report detailing the error: While documenting the error in an incident report is necessary, this should not be the first step. The immediate priority is to ensure the client’s safety by assessing their condition, as an error in the timing of medication administration may result in unwanted side effects or complications that need to be addressed first.

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Correct Answer is B

Explanation

Here's the process for calculating the drug concentration after multiple half-lives:

First half-life: After 1 half-life, 50% of the original dose remains in the body.

200 mg x 0.50 = 100 mg remains after 1 half-life.

Second half-life: After 2 half-lives, 50% of the remaining drug will be eliminated.

100 mg x 0.50 = 50 mg remains after 2 half-lives.

Third half-life: After 3 half-lives, 50% of the remaining drug will be eliminated again.

50 mg x 0.50 = 25 mg remains after 3 half-lives.

Fourth half-life: After 4 half-lives, 50% of the remaining drug will be eliminated once more.

25 mg x 0.50 = 12.5 mg remains after 4 half-lives.

Now, we need to sum up the amount of drug remaining in the body at each half-life:

After 4 half-lives, there are 12.5 mg left from the original dose.

Total drug in the body after 4 half-lives = 200 mg - 12.5 mg = 375 mg.

A. Sodium B. Gastric pH C. Calcium D. Magnesium

Correct Answer is D

Explanation

A. Sodium: Sodium levels are important to monitor, but in the context of pantoprazole use, abnormal sodium levels are less commonly a direct concern. Pantoprazole primarily impacts the gastric environment rather than fluid or electrolyte balance in a way that would dramatically alter sodium levels.

B. Gastric pH: Pantoprazole works to increase gastric pH by reducing acid secretion, which is its primary therapeutic effect. A higher gastric pH is expected and beneficial in conditions like GERD or peptic ulcers.

C. Calcium: Pantoprazole, when used for extended periods, can interfere with calcium absorption, potentially leading to bone health issues like osteoporosis. However, changes in calcium levels typically do not pose an immediate or life-threatening concern unless significantly low or related to prolonged therapy. It is still something to monitor, but magnesium is a higher priority in this case.

D. Magnesium: Pantoprazole and other proton pump inhibitors (PPIs) are known to cause hypomagnesemia, especially with prolonged use. Low magnesium levels can lead to serious complications, including muscle spasms, seizures, and arrhythmias. Hypomagnesemia is a well-documented side effect of long-term PPI use, making it the most critical lab result to address.

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Laboratory Test	Result	Normal Range
Sodium	146 mEq/dL	135-145 mEq/L
Calcium	8.2 mg/dL	8.4-10.2 mg/dL
Magnesium	1.2 mg/dL	1.6-2.2 mg/dL
Gastric pH	6	1-4

A nurse recognizes they administered a medication over one hour when the order dictated the medication be given over 90 minutes. Which should be the first action performed by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client receives 200 mg of a medication on a consistent schedule. How much drug is in the body at 4 half-lives?

Correct Answer is B

Explanation

Correct Answer is D

Explanation

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A nurse recognizes they administered a medication over one hour when the order dictated the medication be given over 90 minutes. Which should be the first action performed by the nurse?