Mr. Brown is in severe pain and is requesting pain medication before the prn time interval has elapsed. What is the nurse's response?
Give the medication early for any pain score greater than 7
Call the prescriber and request another option
Complete a thorough pain assessment and document immediately after
Discuss the situation with Mr. Brown, and tell him you will advocate for alternative pain management when the physician does rounds for the day
The Correct Answer is C
A. Give the medication early for any pain score greater than 7: Administering a narcotic before the prescribed PRN interval violates safe medication administration principles and provider orders. Doing so increases the risk of opioid toxicity, respiratory depression, and oversedation, especially with drugs such as morphine. Medication timing must follow the ordered frequency unless a new order is obtained.
B. Call the prescriber and request another option: While contacting the prescriber may ultimately be necessary, the nurse must first conduct a comprehensive pain assessment. Clinical decision-making should be based on objective findings, pain characteristics, previous response to medication, and assessment of adverse effects before escalating to the provider.
C. Complete a thorough pain assessment and document immediately after: A detailed pain assessment is the priority nursing action when a patient requests analgesia earlier than scheduled. Assessment should include intensity, location, quality, timing, aggravating/relieving factors, and associated symptoms. This ensures safe opioid administration, identifies potential complications, and provides accurate data if a medication adjustment is required.
D. Discuss the situation with Mr. Brown, and tell him you will advocate for alternative pain management when the physician does rounds for the day: Delaying intervention until physician rounds does not adequately address acute severe pain. Pain management is a priority, and timely assessment and communication are necessary rather than postponing action for several hours.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Wearing gloves prevents needlestick injuries: While gloves provide a barrier against bloodborne pathogens, they do not prevent puncture injuries from needles. Believing gloves alone protect against needlesticks is a misconception, and further instruction is needed to emphasize safe handling techniques, proper disposal, and the use of needleless systems.
B. Never force a needle into the sharps disposal: Forcing needles into sharps containers can cause injury and compromise the container’s integrity. Safe disposal requires placing needles directly into the container without bending, breaking, or forcing them. This statement reflects proper practice.
C. Do not recap the needle after giving an injection: Recapping needles is a common cause of needlestick injuries. Using the “one-handed scoop” technique or not recapping at all is recommended to prevent accidental puncture. This statement aligns with safe practice.
D. Use needleless systems when available: Needleless systems reduce the risk of percutaneous injuries and exposure to bloodborne pathogens. Utilizing needleless devices whenever possible is consistent with evidence-based strategies for reducing needlestick injuries.
Correct Answer is B
Explanation
A. The dosage of medication required: The dose of the medication does not determine whether a spacer is needed. Spacers assist with delivery and coordination, not with altering the prescribed dose.
B. The coordination of the patient: Proper use of a metered-dose inhaler requires the patient to coordinate pressing the canister and inhaling simultaneously. Patients with impaired hand-lung coordination, such as older adults, children, or those with neurological deficits, may benefit from a spacer, which allows the medication to be inhaled more effectively without precise timing.
C. The schedule of administration: The frequency or timing of medication administration does not impact the need for a spacer. Scheduling affects adherence but not the technical requirement for improved inhalation technique.
D. The use of a dry powder inhaler: Dry powder inhalers do not require a spacer because the medication is activated by the patient’s inspiratory effort. Spacers are specifically used with metered-dose inhalers to improve drug delivery when coordination is limited.
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