Which medication order is written appropriately?
Metformin 0.5 g PO
Methotrexate 15.0 mg PO
Meropenem 1.0 g IV
None of the above
The Correct Answer is C
Choice A rationale:
Incorrect dosage form: Metformin is typically administered orally as a tablet or liquid suspension, not as a powder for reconstitution (PO).
Missing route of administration: The medication order does not specify the route of administration, such as oral (PO), intravenous (IV), or intramuscular (IM).
Potential for medication errors: The lack of clarity in the medication order could lead to errors in administration, such as giving the wrong dose or administering the medication by the wrong route.
Choice B rationale:
Incorrect dosage unit: Methotrexate is typically administered in milligrams (mg), not grams (g).
Potential for overdose: The order for 15.0 g of methotrexate is a very high dose that could lead to serious adverse effects, including toxicity and death.
Choice C rationale:
Correctly written: The medication order specifies the drug name (meropenem), the dose (1.0 g), the dosage form (IV), and the route of administration (IV).
Appropriate dosage range: The dose of 1.0 g of meropenem is within the typical dosage range for this antibiotic.
Clear and concise: The medication order is clear, concise, and easy to understand, which helps to reduce the risk of medication errors.
Choice D rationale:
Incorrect: While choices A and B are both incorrect, choice C is a correctly written medication order.
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Correct Answer is C
Explanation
Choice A rationale:
Intravenous (IV) administration delivers medication directly into the bloodstream. This route is not appropriate for insulin because it would result in a rapid and potentially dangerous drop in blood glucose levels. Insulin needs to be absorbed more slowly to mimic the natural release of insulin from the pancreas.
IV administration also requires sterile technique and specialized equipment, making it more complex and time-consuming than subcutaneous injection.
Additionally, there is a higher risk of infection and other complications with IV administration.
Choice B rationale:
The vastus lateralis is a muscle in the thigh that is commonly used for intramuscular (IM) injections. However, IM injections are not typically used for insulin administration because they can be more painful and have a slower absorption rate than subcutaneous injections.
IM injections also carry a higher risk of hitting a blood vessel, which could lead to erratic absorption of insulin.
Choice D rationale:
The deltoid is a muscle in the upper arm that can be used for subcutaneous injections. However, the abdomen is generally the preferred site for insulin injection because it has a greater amount of subcutaneous fat, which helps to slow the absorption of insulin and provide a more consistent effect.
The abdomen is also a more convenient site for self-injection, as it is easily accessible.
Choice C rationale:
The fatty tissue of the abdomen is the ideal site for subcutaneous insulin injection because it provides slow and consistent absorption of insulin.
The abdomen has a rich blood supply, which helps to distribute the insulin throughout the body.
The subcutaneous tissue in the abdomen is relatively thin, which makes it easy to inject insulin without causing pain or discomfort.
The abdomen is also a large area, which allows for multiple injection sites to be used and rotated to prevent lipohypertrophy (thickening of the subcutaneous tissue).
Correct Answer is B
Explanation
Choice A rationale:
A superficial abrasion heals by secondary intention, not primary intention.
In secondary intention healing, the wound is left open to heal from the inside out. This type of healing is typically slower and results in more scar tissue formation.
The absence of active bleeding, drainage, or debris is a positive sign, but it does not guarantee that the wound is healing by primary intention.
Choice C rationale:
The presence of thick yellow slough indicates that the wound is infected and not healing properly. This is a sign of delayed healing, not primary intention healing.
Choice D rationale:
The presence of granulation tissue is a sign of healing, but it does not indicate whether the wound is healing by primary or secondary intention.
Granulation tissue is a type of new tissue that forms during the healing process. It is composed of blood vessels, collagen, and fibroblasts.
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