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. Opioid drugs are highly addictive, and the healthcare provider concerned you will become addicted. B. Morphine highly bound to protein in your blood and you are at risk for toxicity due to surgery. C. "Morphine taken by mouth pass through the liver and some of the medication is made inactive." D. The healthcare provider is cautious with opioids and starts low adjusts the dose up as needed.

Correct Answer is C

Explanation

A) Opioid drugs are highly addictive, and the healthcare provider is concerned you will become addicted: While it is true that opioids have the potential for addiction, this response does not address the actual reason for the difference in morphine dosages. The provider's decision is likely based on the pharmacokinetics of the drug rather than a concern about addiction. This response could create unnecessary concern for the client and does not explain the dose discrepancy.

B) Morphine is highly bound to protein in your blood, and you are at risk for toxicity due to surgery: While morphine is protein-bound, the primary reason for the difference in the intravenous (IV) dose is not related to protein binding. The main difference is related to the route of administration and how the body processes the drug. The nurse should provide a more accurate explanation regarding the absorption and metabolism of morphine rather than focusing on protein binding or potential toxicity.

C) "Morphine taken by mouth passes through the liver, and some of the medication is made inactive": This is the best response. When morphine is taken orally, it is absorbed into the bloodstream and passes through the liver before reaching systemic circulation, a process known as the "first-pass effect." During this process, a portion of the drug is metabolized and rendered inactive, meaning that a higher oral dose is required to achieve the desired effect. When morphine is administered intravenously, it bypasses the liver and directly enters the bloodstream, leading to a more immediate and potent effect, which is why a lower dose is needed.

D) "The healthcare provider is cautious with opioids and starts low and adjusts the dose up as needed": While this is a valid approach to opioid prescribing, it doesn't fully explain why the client is receiving a smaller dose intravenously. The reason for the dose difference is based on the route of administration and the pharmacokinetic properties of the drug, not just a general cautious approach. This answer doesn't provide a clear explanation of why the IV dose is smaller.

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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?

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

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Correct Answer is C

Explanation

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