The nurse must monitor the trough level of medication.
When would the nurse order the trough level?

Choice A rationale

Documenting the error and notifying the supervisor are necessary steps, but they are not the most immediate or comprehensive actions. The priority in a medication error is patient safety, which requires immediate medical assessment and intervention. This step follows after direct patient care and notification of the physician.

Choice B rationale

Administering the original drug and observing for adverse reactions addresses part of the problem, but it does not prioritize immediate medical consultation regarding the mistakenly administered drug. The focus should be on the potential effects of the incorrect medication and timely intervention to mitigate harm.

Choice C rationale

The most appropriate and immediate action is to call the physician to inform them of the medication error. This allows the physician to assess the potential harm to the patient based on the specific drug, dosage, and patient's condition, and to order appropriate interventions. An incident report is crucial for organizational learning and quality improvement.

Choice D rationale

Deciding not to act based on a quick check of allergies or contraindications is highly negligent and unsafe. Even if there are no apparent immediate contraindications, any medication error carries inherent risks and requires a thorough medical evaluation by the physician. This approach prioritizes patient safety over documentation and investigation.

Choice A rationale

Reading newsprint at 20 inches assesses near vision, but it is not the standard clinical method for comprehensive visual acuity assessment. While it can provide some insight into the patient's functional near vision, a more precise and standardized tool like a Jaeger card or specific near vision charts are preferred for accurate diagnostic evaluation.

Choice B rationale

The Jaeger card is specifically designed to assess near visual acuity, typically held at 14 inches (35 cm) from the eye. While useful for evaluating reading vision, it does not provide information about distance visual acuity, which is a primary component of a comprehensive eye examination and is assessed using a Snellen chart.

Choice C rationale

The confrontation test assesses peripheral vision, not central visual acuity. It involves the examiner bringing fingers or objects into the patient's field of vision from various directions. While an important part of a complete eye examination to detect visual field defects, it does not quantify the sharpness of central vision.

Choice D rationale

The Snellen chart is the gold standard for assessing distance visual acuity. Positioning it 20 feet away standardizes the testing distance, allowing for accurate measurement of visual acuity as a fraction (e.g., 20/20). This provides a reliable and reproducible measure of central vision, critical for diagnosing and monitoring visual impairments.