The electronic medication system alerts the nurse that the medication dose scanned for the client is two times higher than the dose prescribed. Which action should the nurse implement?

Report a mismatch of prescribed and available doses.

Calculate the dose on hand to match the prescribed dose.

Ask the pharmacist if another dose can be dispensed.

Withhold the medication until the exact dose is available.

Answer and Explanation

The Correct Answer is A

A.   This is a critical first step when a medication dose discrepancy is identified. Reporting the mismatch alerts the appropriate personnel (such as the pharmacy or healthcare provider) to investigate and resolve the issue. This ensures that the correct dose is administered and helps prevent potential medication errors.
B.   While calculating the dose on hand is important to ensure accurate dosing, this action should be secondary to reporting the issue first. Calculating the dose is part of the process to verify and adjust the dose if needed, but the primary concern is to report the discrepancy to get it addressed properly and safely.
C.   Asking the pharmacist for a different dose is a valid action, but it should come after reporting the discrepancy. The pharmacist can provide guidance on whether a different dose can be dispensed and help clarify any issues with the medication.
D.   Withholding the medication is an appropriate precaution if there is uncertainty about the dose, but it is not the first action to take. This step should follow the initial reporting of the discrepancy to ensure that the medication is correct and safe to administer.

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Correct Answer is B

Explanation

A. While providing practical advice is useful, this response does not directly address the client's current emotional state or frustration. The immediate need is to support the client emotionally rather than instructing them on dressing techniques. It may also come off as dismissive of the client’s feelings.
B. This response is the most appropriate because it acknowledges and validates the client’s emotional experience. By recognizing their frustration, the nurse shows empathy and understanding, which can help in building a therapeutic relationship. It also opens up a dialogue for the client to express their feelings and concerns, which can improve their overall comfort and cooperation.
C. While education on dressing techniques is beneficial, this response does not address the client's immediate frustration or emotional needs. It also postpones support and could make the client feel like their current struggles are not being adequately addressed in the moment.
D. This response is defensive and does not address the client’s immediate emotional needs. It may escalate the situation by making the client feel like they are being reprimanded for their behavior. It is important to handle such situations with empathy and support rather than focusing on institutional policies.

A. Obtain a clean, voided urine specimen for analysis. B. Evaluate the client's response to bladder training efforts. C. Place a protective undergarment on the client. D. Encourage increased fluid intake for 24 hours.

Correct Answer is A

Explanation

A. Urinary incontinence in an older adult can be a symptom of various underlying conditions, such as urinary tract infections, dehydration, or cognitive impairment. Obtaining a urine specimen for analysis can help to identify the underlying cause of the incontinence and guide appropriate treatment.
B. Bladder training is a technique used to improve bladder control and reduce incontinence. However, it's not appropriate to evaluate the client's response to bladder training efforts when they have suddenly become disoriented and developed incontinence. This suggests a potential underlying medical condition that needs to be addressed first.
C. While protective undergarments can be helpful in managing incontinence, they do not address the underlying cause of the problem. It's important to identify and treat the underlying condition to improve the client's quality of life and prevent complications.
D. While dehydration can sometimes contribute to incontinence, it's not appropriate to increase fluid intake in a client who has suddenly become disoriented. This could worsen their condition, especially if they have cognitive impairment or other underlying medical conditions.

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The electronic medication system alerts the nurse that the medication dose scanned for the client is two times higher than the dose prescribed. Which action should the nurse implement?

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