When given a scheduled morning medication, the patient states, “I haven’t seen that pill before.
Are you sure it’s correct?” The nurse checks the medication administration record and verifies that it is listed.
Which is the nurse’s best response?
“Go ahead and take it and then I’ll check with your doctor about it.”
“It wouldn’t be listed here if it were not ordered for you.”
“Let me check on the order first before you take it.”
“It’s listed here on the medication sheet, so you should take it.”
The Correct Answer is C
Choice A rationale:
This choice suggests that the nurse is advising the patient to take the medication first and then check with the doctor. This is not a safe practice. The nurse should always verify any doubts or concerns before administering the medication. Administering an unfamiliar medication can lead to adverse effects if it turns out to be incorrect.
Choice B rationale:
This choice implies that if a medication is listed on the medication administration record (MAR), it must be correct. However, errors can occur when transcribing medication orders onto the MAR. Therefore, it’s crucial for the nurse to verify any concerns or doubts before administering the medication.
Choice C rationale:
This is the correct choice. If a patient expresses concern about a medication, the nurse should always check the order before administering it. This is a fundamental aspect of patient safety and medication administration. It ensures that the right patient receives the right medication at the right dose via the right route at the right time.
Choice D rationale:
This choice suggests that because the medication is listed on the medication sheet, the patient should take it. However, this does not address the patient’s concern about the unfamiliar medication. It’s important for the nurse to validate the patient’s concern and verify the medication order before administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Phenytoin is an anticonvulsant drug used in the prophylaxis and control of various types of seizures. It has a narrow therapeutic index, which means that the safe and toxic plasma levels of the drug are very close to each other. This characteristic makes the dosing of phenytoin challenging, as even small deviations from the recommended therapeutic range can lead to suboptimal treatment or adverse effects. Therapeutic effect without clinical signs of toxicity occurs more often with serum total concentrations between 10 and 20 mcg/mL34. Therefore, clinicians are advised to initiate therapeutic drug monitoring in patients who require phenytoin.
Choice B rationale:
The statement that phenytoin has a low chance of being effective is incorrect. Phenytoin is a widely used and effective anticonvulsant. It works by slowing down impulses in the brain that cause seizures. It is used to control seizures but does not treat all types of seizures. The effectiveness of phenytoin is not determined by its narrow therapeutic index but by its pharmacological action in the brain.
Choice C rationale:
The assertion that there is no difference between safe and toxic plasma levels of phenytoin is incorrect. There is indeed a difference between the safe (therapeutic) and toxic levels of phenytoin. The therapeutic range for phenytoin is typically between 10 and 20 mcg/mL34. Levels above this range can lead to toxicity, while levels below this range may not provide the desired therapeutic effect.
Choice D rationale:
The statement that a very small dosage of phenytoin can result in the desired therapeutic effect is not entirely accurate. While it’s true that phenytoin is effective in controlling seizures, the dosage required to achieve this effect is not necessarily “very small”. The usual adult dose for seizures is 100 mg orally 3 times a day. The dosage may need to be adjusted based on individual patient factors and response to therapy. Therefore, it’s not accurate to generalize that a “very small” dosage will result in the desired therapeutic effect for all patients.
Correct Answer is C
Explanation
Choice A rationale:
Erythromycin Erythromycin is a macrolide antibiotic that is often used as an alternative to penicillin. It is generally safe for use in patients with a penicillin allergy. It works by inhibiting bacterial protein synthesis and is effective against a wide range of bacteria.
Choice B rationale:
Amphotericin B Amphotericin B is an antifungal medication, not an antibiotic. It is used to treat serious, systemic fungal infections. It has no cross-reactivity with penicillin, so it would not be a concern for a patient with a penicillin allergy.
Choice C rationale:
Amoxicillin-clavulanate Amoxicillin-clavulanate is a type of penicillin antibiotic. Patients with a known penicillin allergy should avoid this medication, as they may have a cross-reactivity to it. This is why the nurse should verify this prescription with the provider.
Choice D rationale:
Gentamicin Gentamicin is an aminoglycoside antibiotic used to treat serious bacterial infections caused by gram-negative bacteria. It is not related to penicillin and would be safe for a patient with a penicillin allergy.
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