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A nurse is caring for a client who has a prescription for morphine 4 mg IM stat. The medication is dispensed in a 5 mg/mL prefilled syringe. Which of the following actions should the nurse take?
- A. Dispose of the excess medication in the sharps container.
- B. Give the full contents of the prefilled syringe.
- C. Discard the excess medication with a second nurse as a witness.
- D. Inject the prescribed dose and save the rest for a later use.
Correct Answer: C
Rationale: The correct answer is C: Discard the excess medication with a second nurse as a witness. The nurse should discard the excess medication in the presence of another nurse to ensure proper disposal and avoid any medication errors or potential harm to the patient. This action aligns with medication safety practices and helps prevent medication errors.
Choice A: Disposing of the excess medication in the sharps container is incorrect because it does not involve a witness for proper disposal and may not follow facility protocols.
Choice B: Giving the full contents of the prefilled syringe would result in administering more medication than prescribed, risking harm to the patient.
Choice D: Injecting the prescribed dose and saving the rest for later use is incorrect as it goes against safe medication practices and may lead to errors in dosing.
In summary, choice C is the correct action to ensure safe and appropriate disposal of excess medication, while the other choices may lead to potential errors and harm to the patient.
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A nurse is caring for a client who has hypertension and has been taking hydrochlorothiazide. Which of the following laboratory values should the nurse evaluate?
- A. Coagulation studies
- B. Thyroid levels
- C. Complete blood count
- D. Serum electrolyte levels
Correct Answer: D
Rationale: The correct answer is D: Serum electrolyte levels. Hydrochlorothiazide is a diuretic that can lead to electrolyte imbalances, such as hypokalemia and hyponatremia. Monitoring serum electrolyte levels is crucial to prevent complications like arrhythmias. Coagulation studies (A) are not typically affected by hydrochlorothiazide. Thyroid levels (B) are unrelated to this medication. Complete blood count (C) is not directly impacted by hydrochlorothiazide. Thus, evaluating serum electrolyte levels is the most relevant and essential assessment in this scenario.
A nurse is caring for a client who is receiving treatment for chronic alcohol use disorder. Which of the following medications should the nurse plan to administer to assist the client in maintaining abstinence by aversion therapy?
- A. Carbamazepine
- B. Disulfiram
- C. Atenolol
- D. Lorazepam
Correct Answer: B
Rationale: The correct answer is B: Disulfiram. Disulfiram is used in aversion therapy for alcohol use disorder by causing unpleasant effects like nausea, vomiting, and flushing when alcohol is consumed. This helps deter the client from drinking. Carbamazepine (A) is used for seizures, mood disorders, and neuropathic pain, not specifically for aversion therapy. Atenolol (C) is a beta-blocker used for hypertension and not for aversion therapy. Lorazepam (D) is a benzodiazepine used for anxiety and not for aversion therapy.
A nurse is reviewing the medical record of a client who has a new prescription for celecoxib to treat osteoarthritis. Which of the following should the nurse recognize as a contraindication for this medication?
- A. Concurrent use of chondroitin
- B. Concurrent use of calcium supplements
- C. Penicillin allergy
- D. Sulfonamide allergy
Correct Answer: D
Rationale: The correct answer is D: Sulfonamide allergy. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that belongs to the sulfonamide class of medications. Patients with a known allergy to sulfonamides are at an increased risk of developing an allergic reaction to celecoxib. It is important for the nurse to recognize this contraindication to prevent potential serious adverse reactions such as anaphylaxis.
A: Concurrent use of chondroitin - This is not a contraindication for celecoxib as there is no known significant interaction between chondroitin and celecoxib.
B: Concurrent use of calcium supplements - Calcium supplements do not interact with celecoxib and are not a contraindication for its use.
C: Penicillin allergy - Penicillin allergy is not related to celecoxib use as they are different classes of medications with distinct mechanisms of action.
In summary, the correct answer is D because
A nurse is collecting data from a client who has been taking carbamazepine. Which of the following is an adverse effect of carbamazepine and should be reported to the provider?
- A. Sore throat
- B. Increased salivation
- C. Urge incontinence
- D. Gingivitis
Correct Answer: A
Rationale: The correct answer is A: Sore throat. Carbamazepine can cause agranulocytosis, a serious condition characterized by a decrease in white blood cells, leading to symptoms like sore throat. This is a potentially life-threatening adverse effect that should be reported to the provider immediately. Increased salivation (choice B), urge incontinence (choice C), and gingivitis (choice D) are not common adverse effects of carbamazepine and do not require immediate reporting.
A nurse is reinforcing discharge teaching with a client who has a prescription for rifampin for the treatment of tuberculosis (TB). Which of the following instructions should the nurse include in the teaching?
- A. Take the medication on an empty stomach.
- B. Discontinue the medication if your saliva turns orange.
- C. Return for another TB skin test in 3 months.
- D. You will need to take this medication for 1 week.
Correct Answer: A
Rationale: The correct answer is A: Take the medication on an empty stomach. Rifampin is best absorbed when taken on an empty stomach, usually 1 hour before or 2 hours after meals. This maximizes its effectiveness in treating TB. Choice B is incorrect because discoloration of body fluids (including saliva) is a known side effect of rifampin and does not indicate the need to discontinue the medication. Choice C is incorrect because the client should not return for another TB skin test in 3 months unless specifically instructed by the healthcare provider. Choice D is incorrect because treatment for TB usually lasts for several months, not just 1 week.