Another nurse on the unit meets you as you leave the medication room and states ' really need to go to break now or I will not get one, can you administer this morphine that I have ready for you?" The nurse hands you an empty vial of morphine and a syringe containing 2 mL of clear fluid. What is your best response?

"I know it is really busy but I do not have time to help you either. I have my own clients."

"Are you sure the doctor ordered that much morphine? It seems like a lot to give all at once.":

"I can give your client their pain medications, but I need to draw up and prepare it myself."

"Sure thing, give me that syringe and I will give it for you while you are on break.":

Answer and Explanation

The Correct Answer is C

A) "I know it is really busy but I do not have time to help you either. I have my own clients.": While it may be tempting to express frustration due to being busy, this response lacks professionalism and does not address the situation appropriately. As healthcare professionals, it is important to communicate effectively and collaborate with colleagues to ensure safe patient care, even when busy. Instead, the nurse should express the need to follow protocols while offering help in a safe manner.

B) "Are you sure the doctor ordered that much morphine? It seems like a lot to give all at once.": Although questioning the dosage is part of safe nursing practice, this response is unnecessary in this situation. If there is a concern about the prescribed amount of morphine, it should be verified with the healthcare provider. However, this question does not directly address the issue of administering the medication safely. It also does not ensure that the nurse is following correct protocols for preparing and administering medication.

C) "I can give your client their pain medications, but I need to draw up and prepare it myself.": This response is the most appropriate because it ensures the nurse is adhering to safe medication administration practices. The nurse should always prepare and administer medications themselves to verify the correct dosage, route, and patient. Allowing another nurse to prepare medication and administering it without proper verification can lead to medication errors. This response also shows willingness to help while maintaining safety standards.

D) "Sure thing, give me that syringe and I will give it for you while you are on break.": This response is inappropriate because it involves accepting medication from another nurse without verifying that the correct drug, dose, and preparation have been followed. It is unsafe to administer medications prepared by others without reviewing the medication and ensuring that everything is accurate. Nurses must always prepare and administer their own medications to prevent potential medication errors.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

A) Cut the 50 mcg/hr patch in half to obtain 25 mcg/hr dosing: Cutting a fentanyl patch in half is not recommended because it can lead to inconsistent dosing. The patches are designed to release medication at a controlled rate, and cutting them could cause the medication to be released too quickly or unevenly, which could result in overdose or insufficient relief of pain. It’s essential to follow the manufacturer's guidelines and avoid altering the patch.

B) Ask pharmacy to send a 25 mcg/hr transdermal patch: The best course of action is to ask the pharmacy to send the correct 25 mcg/hr transdermal patch. This ensures that the patient receives the prescribed dose in the most accurate and safe manner. The 25 mcg/hr patch is formulated to deliver the correct amount of medication, and it will avoid any risk associated with altering the patch.

C) Contact the healthcare provider and request to increase the dose to 50 mcg/hr: Requesting an increase in the dose is premature without a clear justification from the healthcare provider. The healthcare provider decreased the dose to 25 mcg/hr for a reason, possibly due to side effects, effectiveness, or other clinical factors. Altering the prescribed dose without a proper review would be inappropriate. The nurse should follow the current prescribed dose and resolve the issue by requesting the correct patch from the pharmacy.

D) Remove the previous patch and apply the 50 mcg/hr patch in a different location: Switching to the 50 mcg/hr patch without approval could lead to administering an incorrect dose of fentanyl, which can increase the risk of overdose or severe side effects like respiratory depression. The nurse should adhere to the prescribed 25 mcg/hr dose and request the correct patch from the pharmacy rather than substituting with a higher dose patch.

A. "I will avoid alcohol and cigarettes." B. I will have. small snack right before bedtime." C. I will wear loose fitting clothes." D. I will take all NSAIDs and steroids with food."

Correct Answer is B

Explanation

A) "I will avoid alcohol and cigarettes.": This is a correct and important statement for a client with GERD. Both alcohol and cigarettes can relax the lower esophageal sphincter, increasing the likelihood of acid reflux and exacerbating GERD symptoms. Avoiding these substances is a standard recommendation for managing GERD.

B) "I will have a small snack right before bedtime.": This statement indicates the need for additional education. Eating a meal or snack right before bedtime can exacerbate GERD symptoms because lying down after eating can increase the likelihood of acid reflux. It is generally recommended for clients with GERD to avoid eating at least 2-3 hours before going to bed to reduce the risk of reflux.

C) "I will wear loose fitting clothes.": Wearing loose-fitting clothes is an appropriate measure for managing GERD. Tight clothing around the abdomen can increase pressure on the stomach, promoting acid reflux. Loose clothing helps avoid this additional pressure, which can alleviate symptoms.

D) "I will take all NSAIDs and steroids with food.": This is generally good advice for reducing the risk of stomach irritation caused by NSAIDs and steroids, which can worsen GERD symptoms or cause gastric ulcers. Taking these medications with food can help buffer the stomach lining and reduce irritation.

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Naxlex Comprehensive Predictor Exams

The healthcare provider decreased the ordered dose of fentanyl to 25 mcg/hr transdermal patch. The pharmacy delivers a 50 mcg/hr patch to the nurse when the next dose is scheduled. What is the best action by the nurse?

Correct Answer is B

Explanation

A client with active GERD presents to clinic. Which statement by the client indicates they need additional education?

Correct Answer is B

Explanation

During a period of time when the computerized medication order system was down, the prescriber wrote admission the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber's handwriting. Which is the best action for the nurse to take at this time?

The nurse is caring for client with liver failure admitted with hepatic encephalopathy, Lactulose is ordered Q2 hours. What assessment finding should the nurse use to best evaluate therapeutic response of the medication?

A client with seasonal allergies takes diphenhydramine at bedtime to help their symptoms. The client develops low hemoglobin low white blood cell counts which is otherwise unexplained. What type of reaction is the client experiencing?

The nurse is administering a prescribed medication to neonatal client. Which factor is most likely to increase the risk for drug toxicity in this client?

A client is ordered to receive a laxative by rectal suppository. How should the nurse position the client during the administration of the suppository?

A client is to receive a penicillin intramuscular (IM) injection in the ventrogluteal site. What is the correct angle that the nurse should use for the needle insertion?

The health care provider prescribes scopolamine for a client who is planning to take cruise and is concerned about motion sickness. What information in the past medical history would serve as a contraindication for this medication?

A client is ordered to receive 1000ml of 0.9% saline over 4 hours. At what rate will the nurse set the IV pump in mL/hr? (Enter a number only).