Which of the following drug orders will provide the fastest pain relief for the patient?

Fentanyl transdermal 25 mcg/hour

Morphine 30 mg

Acetaminophen with oxycodone 10 mg/325 mg

Hydromorphone 1 mg IV

Answer and Explanation

The Correct Answer is D

Choice A reason: Fentanyl transdermal releases slowly over hours; its onset of 12-24 hours is too delayed for rapid pain relief, suiting chronic, not acute, pain management.

Choice B reason: Oral morphine (assuming PO) takes 30-60 minutes for onset; its slower absorption via the gut delays relief compared to faster intravenous routes.

Choice C reason: Acetaminophen with oxycodone (PO) has a 30-60 minute onset; gastrointestinal absorption limits speed, making it less rapid than IV administration for acute pain.

Choice D reason: Hydromorphone IV acts within 5-10 minutes; direct bloodstream delivery bypasses digestion, providing the fastest opioid receptor activation for immediate pain relief.

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Correct Answer is D

Explanation

Choice A reason: Withholding delays treatment; nausea may persist, risking vomiting of the dose if given later, reducing bioavailability and therapeutic effect over time.

Choice B reason: Sips of water won’t prevent vomiting; with ongoing nausea, the oral dose is likely expelled, decreasing absorption and failing to deliver the medication effectively.

Choice C reason: Crackers may worsen nausea or fail to retain the dose; vomiting risks remain high, compromising oral administration’s reliability in this acute condition.

Choice D reason: Rectal or parenteral routes bypass the stomach, ensuring delivery despite vomiting; this maintains therapeutic levels, critical for efficacy in a nauseated patient.

A. Wait until the prescriber makes rounds again to clarify the order. B. Contact the prescriber to clarify the order. C. Ask a colleague what the order says. D. Ask the patient what medications he takes at home.

Correct Answer is B

Explanation

Choice A reason: Waiting delays care; illegible orders risk errors, and timely clarification ensures the patient receives accurate treatment without unnecessary postponement.

Choice B reason: Direct prescriber contact resolves ambiguity; it ensures the order’s intent, aligning with safety protocols to prevent misinterpretation or harm.

Choice C reason: Colleagues may guess incorrectly; peer opinion lacks authority, risking errors in dosage or drug, compromising patient safety over prescriber intent.

Choice D reason: Patient recall is unreliable; home meds may differ from admission orders, and this doesn’t clarify the prescriber’s handwritten instruction accurately.

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Which of the following drug orders will provide the fastest pain relief for the patient?

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Naxlex Comprehensive Predictor Exams

A patient who is to receive a daily medication by the oral route has had nausea and vomiting for the last 24 hours. The best action to ensure that the patient receives the scheduled dose is to:

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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