The practical nurse (PN) is administering the 0900 medications to a client who was admitted during the night. Which client statement indicates that the PN should further assess the prescription?

Choice A reason: Explaining the medication’s purpose is important but does not address the inappropriate bedtime dosing. Diuretics increase urination, causing nocturia and sleep disruption. Administering as scheduled without review risks client discomfort, making this choice less appropriate than verifying timing.

Choice B reason: Reviewing the prescription with the charge nurse is critical, as bedtime diuretic administration causes nocturia, disrupting sleep. Diuretics, like hydrochlorothiazide, increase urine production, and morning dosing aligns with daily activity, minimizing nighttime disturbance, ensuring safe and effective administration timing.

Choice C reason: Withholding the medication until the next day delays treatment, risking conditions like edema or hypertension. Consulting the charge nurse allows timely clarification of dosing time, ensuring therapeutic benefits without sleep disruption, making this choice overly cautious and unnecessary.

Choice D reason: Administering the diuretic early without confirmation violates protocol, as the prescription specifies bedtime. Unilateral changes risk errors, and morning dosing requires provider approval. Reviewing with the charge nurse is safer, ensuring alignment with clinical intent while addressing sleep concerns.

Choice A reason: Reassuring that neutropenia causes bone pain is incorrect, as the pain is a side effect of filgrastim, not neutropenia. Filgrastim stimulates bone marrow, causing medullary expansion and pain. Misattributing the cause fails to address the drug’s effect, making this choice inappropriate.

Choice B reason: Preparing a variance report is unnecessary, as bone pain is a known filgrastim side effect, not an error. Filgrastim increases neutrophil production, stressing bone marrow and causing pain. Reporting is not the priority; managing the client’s discomfort is more immediate and appropriate.

Choice C reason: Changing the injection site does not alleviate bone pain, as it results from filgrastim’s systemic effect on bone marrow stimulation, not local irritation. Pain is due to increased hematopoiesis in marrow, not the injection itself, making this choice ineffective for addressing the symptom.

Choice D reason: Offering a PRN analgesic addresses bone pain, a common filgrastim side effect caused by bone marrow expansion from stimulated neutrophil production. Analgesics relieve discomfort without altering the drug’s therapeutic effect, making this the most appropriate action to improve client comfort and adherence.