Ordered: Morphine Sulfate 2 mg every 2-4 hr IV PRN for pain. Available in vial: 1 mg/mL

Safe dose range per drug reference book: 0.05-0.1 mg/kg/dose

Patient weight=36.1 lb

This is a safe dose for this patient.

A. This is ineffective. Waiting until nausea occurs reduces the effectiveness of antiemetics because CINV is often more difficult to control once established. Nonpharmacologic methods (e.g., relaxation, acupressure) can help, but they are usually adjuncts, not first-line preventive therapy.

B. PRN administration is reactive rather than proactive. Chemotherapy often induces anticipatory or acute nausea, which may not respond fully to medication given after symptoms begin. This approach increases discomfort and the risk of dehydration and electrolyte imbalance.

C. Prophylactic administration ensures that the medication is at therapeutic levels in the bloodstream before chemotherapy begins, preventing or reducing the severity of nausea and vomiting. This approach is supported by clinical guidelines and improves patient comfort and treatment adherence.

D. Delaying scheduled dosing until nausea starts is less effective. Nausea prevention is more effective than treatment after it occurs. Scheduled dosing should begin before or at the start of chemotherapy, not after symptoms develop.

A. A positive Kernig’s sign (pain and resistance when attempting to extend the knee with the hip flexed) is a classic indicator of meningeal irritation, which, in the presence of fever, headache, neck stiffness, photophobia, and lethargy, strongly suggests meningitis. This finding requires immediate attention because bacterial meningitis can progress rapidly and become life-threatening.

B. While a petechial or purpuric rash may be seen in meningococcal meningitis, a general red raised rash is nonspecific and not the most urgent additional finding compared with a positive Kernig’s sign. Its absence does not rule out meningitis.

C. A negative Brudzinski’s sign (no involuntary hip/knee flexion when the neck is flexed) does not rule out meningitis, especially in early or mild cases. A positive Kernig’s sign is a more sensitive early indicator in this scenario.

D. A negative Babinski’s sign is normal and does not indicate neurological compromise in this context. Its presence or absence is not immediately relevant to the acute presentation of suspected meningitis.