Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is receiving a medication prescription by telephone from a provider. The provider states, “Administer 6 milligrams of morphine IV push every 3 hours as needed for acute pain.” How should the nurse transcribe the prescription in the client’s medical record?
A. Morphine 6 mg IV push every 3 hr PRN acute pain.
This is because it uses the full name of the drug, the exact dose, the route of administration, the frequency, and the indication for use. It also avoids any abbreviations that could be confused with other drugs or measurements.
B. MS6 mg IV push every 3 hr PRN acute pain.
Choice B is wrong because MS is an abbreviation for morphine sulfate that could be mistaken for magnesium sulfate.
C. MSO4 6 mg IV push every 3 hr PRN acute pain.
Choice C is wrong because MSO4 is an abbreviation for morphine sulfate that could be mistaken for magnesium sulfate.
D. Morphine 6.0 mg IV push every 3 hr PRN acute pain.
Choice D is wrong because 6.0 mg could be misread as 60 mg and lead to a tenfold overdose. Normal ranges for morphine dosage depend on the route of administration, the indication, and the patient’s tolerance and response. For acute pain, the usual oral dose is 10 to 30 mg every 4 hours as needed. For chronic pain, the usual oral dose is 15 to 30 mg every 8 to 12 hours as needed. For intravenous (IV) administration, the usual dose is 2.5 to 15 mg every 4 hours as needed. The morphine equivalent daily dose (MEDD) is a concept that attempts to establish an equivalency in terms of dose when comparing any opioid to morphine.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Pharmacology 2019 Proctored Exam. Take the full exam now
Full Explanation
This is because it uses the full name of the drug, the exact dose, the route of administration, the frequency, and the indication for use. It also avoids any abbreviations that could be confused with other drugs or measurements.
Choice B is wrong because MS is an abbreviation for morphine sulfate which could be mistaken for magnesium sulfate.
Choice C is wrong because MSO4 is an abbreviation for morphine sulfate that could be mistaken for magnesium sulfate.
Choice D is wrong because 6.0 mg could be misread as 60 mg and lead to a tenfold overdose.
Normal ranges for morphine dosage depend on the route of administration, the indication, and the patient’s tolerance and response.
For acute pain, the usual oral dose is 10 to 30 mg every 4 hours as needed. For chronic pain, the usual oral dose is 15 to 30 mg every 8 to 12 hours as needed.
For intravenous (IV) administration, the usual dose is 2.5 to 15 mg every 4 hours as needed.
The morphine equivalent daily dose (MEDD) is a concept that attempts to establish an equivalency in terms of dose when comparing any opioid to morphine.
Similar Questions
A nurse is teaching a client who has active pulmonary tuberculosis about management of medication for the disease.
Which of the following statements is appropriate for the nurse to make?
A. You should anticipate taking medication to treat your disease for at least the next 3 years.
Choice A is wrong because the duration of treatment for active TB is usually 6 to 9 months, not 3 years.
B. You will need to undergo tuberculin skin tests every 6 months while taking medication for your disease.
Choice B is wrong because tuberculin skin tests are not reliable indicators of disease activity or response to treatment, as they can remain positive for years after successful therapy.
C. You should report monthly to have your blood drawn to monitor kidney function while taking medication.
Choice C is wrong because blood tests to monitor kidney function are not routinely required for TB treatment, unless the client has a preexisting renal impairment or is taking drugs that are nephrotoxic.
D. You will need to take two or more medications to treat your disease.
This is because TB is caused by a bacterium that can develop resistance to single-drug therapy, so a combination of drugs is used to prevent or treat drug resistant strains. Some of the common drugs used for TB are isoniazid, rifampin, ethambutol, and pyrazinamide.
Full Explanation
This is because TB is caused by a bacterium that can develop resistance to single-drug therapy, so a combination of drugs is used to prevent or treat drug-resistant strains. Some of the common drugs used for TB are isoniazid, rifampin, ethambutol, and pyrazinamide.
Choice A is wrong because the duration of treatment for active TB is usually 6 to 9 months, not 3 years.
Choice B is wrong because tuberculin skin tests are not reliable indicators of disease activity or response to treatment, as they can remain positive for years after successful therapy.
Choice C is wrong because blood tests to monitor kidney function are not routinely required for TB treatment unless the client has a preexisting renal impairment or is taking drugs that are nephrotoxic.
A nurse is caring for a client who has diabetes mellitus and is taking pioglitazone. The nurse should plan to monitor the client for which of the following adverse effects?
A. Tinnitus.
Choice A is wrong because tinnitus, which is ringing or buzzing in the ears, is not a known side effect of pioglitazone.
B. Insomnia.
Choice B is wrong because insomnia, which is difficulty falling or staying asleep, is not a known side effect of pioglitazone.
C. Orthostatic hypotension.
Choice C is wrong because orthostatic hypotension, which is a drop in blood pressure when standing up from a sitting or lying position, is not a known side effect of pioglitazone. In fact, pioglitazone may cause low blood sugar (hypoglycemia) when used with other diabetes medications, which can cause symptoms such as dizziness, sweating, and confusion. Answer and explanation
D. Fluid retention.
Pioglitazone is a medication that belongs to a class of drugs called thiazolidinediones, which are used to treat type 2 diabetes by improving insulin sensitivity. One of the common side effects of pioglitazone is edema, which is swelling caused by excess fluid in the body tissues. This can lead to fluid retention and weight gain, and may worsen heart failure in some patients.
Full Explanation
Pioglitazone is a medication that belongs to a class of drugs called thiazolidinediones, which are used to treat type 2 diabetes by improving insulin sensitivity. One of the common side effects of pioglitazone is edema, which is swelling caused by excess fluid in the body tissues. This can lead to fluid retention and weight gain and may worsen heart failure in some patients.
Choice A is wrong because tinnitus, which is ringing or buzzing in the ears, is not a known side effect of pioglitazone.
Choice B is wrong because insomnia, which is difficulty falling or staying asleep, is not a known side effect of pioglitazone.
Choice C is wrong because orthostatic hypotension, which is a drop in blood pressure when standing up from a sitting or lying position, is not a known side effect of pioglitazone.
In fact, pioglitazone may cause low blood sugar (hypoglycemia) when used with other diabetes medications, which can cause symptoms such as dizziness, sweating, and confusion.
A nurse is teaching a client who has a new prescription for a nitroglycerin transdermal patch.
Which of the following instructions should the nurse include?
A. Apply a new patch if you have chest pain.
Choice A is wrong because nitroglycerin transdermal patches cannot be used to treat an attack of angina once it has begun. They can only be used to prevent attacks of angina. If you have chest pain, you should use another form of nitroglycerin, such as sublingual tablets or spray.
B. Discontinue the patch if you experience a headache.
Choice B is wrong because headache is a common side effect of nitroglycerin transdermal patches and does not mean that you should stop using them. However, you should tell your doctor if the headaches are severe or do not go away. You may also take acetaminophen to relieve the headache.
C. Remove the patch prior to going to bed.
Nitroglycerin transdermal patches are used to prevent episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart). They work by relaxing the blood vessels so that the heart does not need to work as hard and therefore does not need as much oxygen.
D. Cover the patch with dry gauze when taking a shower.
Choice D is wrong because you do not need to cover the patch with dry gauze when taking a shower. You may shower while you are wearing a nitroglycerin skin patch. If a patch loosens or falls off, replace it with a fresh one.
Full Explanation
Nitroglycerin transdermal patches are used to prevent episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart). They work by relaxing the blood vessels so that the heart does not need to work as hard and therefore does not need as much oxygen.
Choice A is wrong because nitroglycerin transdermal patches cannot be used to treat an attack of angina once it has begun. They can only be used to prevent attacks of angina. If you have chest pain, you should use another form of nitroglycerin, such as sublingual tablets or spray.
Choice B is wrong because headache is a common side effect of nitroglycerin transdermal patches and does not mean that you should stop using them. However, you should tell your doctor if the headaches are severe or do not go away. You may also take acetaminophen to relieve the headache.
Choice D is wrong because you do not need to cover the patch with dry gauze when taking a shower. You may shower while you are wearing a nitroglycerin skin patch. If a patch loosens or falls off, replace it with a fresh one.