The nurse notes these medications for a post-operative client. Which order would the nurse question?
Ceftriaxone 1 g IV q12h
Enoxaparin 40 mg daily
Rosuvastatin 10 mg po daily
Oxycodone 5 mg po q4h prn
The Correct Answer is B
A. Ceftriaxone 1 g IV q12h: This is a standard prophylactic or therapeutic dose for a third-generation cephalosporin in a surgical context. It targets common pathogens to prevent post-operative site infections. The frequency and route are consistent with established clinical guidelines for surgical patients.
B. Enoxaparin 40 mg daily: While the dose is correct for venous thromboembolism prophylaxis, the nurse must question the missing route of administration. Enoxaparin must be specified as a subcutaneous injection to ensure patient safety and legal compliance. Medication orders are incomplete and invalid without a designated route.
C. Rosuvastatin 10 mg po daily: Statins are frequently continued in the post-operative period for patients with established cardiovascular disease or hyperlipidemia. This order is complete, including dose, route, and frequency. It does not present an immediate clinical conflict in a standard post-operative care plan.
D. Oxycodone 5 mg po q4h prn: This is a standard order for moderate to severe post-operative pain management on an as-needed basis. The dosage is within safe starting ranges for opioid-naive or stable patients. It provides necessary analgesic flexibility for recovery without appearing excessive or dangerous.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The slough or eschar that covers the wound hides a stage 3 or 4 pressure injury: Clinical staging requires full visualization of the wound base to determine the depth of tissue involvement. Necrotic tissue like slough or eschar physically obstructs the view of the underlying anatomy. Until this debris is debrided, the true extent remains unknown.
B. The wound presents with various areas that are between stages of the healing process: Pressure injury staging is based on the maximum depth of anatomical damage observed at its worst point. Healing wounds are not "back-staged" but rather described by their current characteristics. Mixed presentation does not render a wound unstageable under standard protocols.
C. The pressure injury is so early in the tissue destruction process that staging cannot be determined: Early tissue destruction is actually easily staged as a Stage 1 injury if erythema is present. Unstageable refers to the inability to see the bottom of the wound, not a lack of progression. Even early injuries are classified by their clinical presentation.
D. There is persistent non-blanchable purple discoloration that makes it difficult to determine the correct stage: This specific description defines a deep tissue pressure injury (DTPI) rather than an unstageable one. DTPI involves intact skin with deep discoloration reflecting internal damage. Unstageable specifically requires the presence of obscuring material like slough or eschar.
Correct Answer is D
Explanation
A. Aspirin: Use of salicylates in children with viral infections like varicella or influenza is strictly contraindicated due to the risk of Reye's syndrome. This rare but fatal condition involves acute encephalopathy and fatty liver infiltration. Aspirin should never be suggested for pediatric viral fever management.
B. Tramadol: This is a potent centrally acting analgesic with opioid properties that is not indicated for simple fever reduction. It carries significant risks of respiratory depression and sedation in pediatric patients. It is inappropriate for treating the symptomatic hyperpyrexia associated with chicken pox.
C. Ketorolac: This non-steroidal anti-inflammatory drug is typically used for short-term management of moderate to severe pain, not routine fever. It has a high risk of gastrointestinal and renal side effects in children. It is not the primary agent for managing pediatric febrile episodes.
D. Acetaminophen: This is the safest and most appropriate antipyretic for treating fever in children with viral illnesses. It effectively reduces temperature by acting on the hypothalamic heat-regulating center. It does not carry the risk of Reye's syndrome associated with aspirin use in this population.
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