Examkin

Question

Difficulty: MediumPharmacological Therapies

A practical nurse (PN) receives the shift report and begins medication administration for a group of assigned clients. Which of the following actions demonstrate adherence to safe pharmacological principles and the practical nurse scope of practice? (Select all that apply.)

  1. Asking the client to state their full name and date of birth while verifying their identification band before giving an oral antihypertensive.Answer
  2. B
    Proceeding to administer subcutaneous enoxaparin to a client who has a morning platelet count of 38,000/mm338,000/\text{mm}^3 without alerting the registered nurse.
  3. C
    Accepting a delegated task from the registered nurse to administer an intravenous (IV) push dose of furosemide to a client with fluid volume overload.
  4. Withholding a scheduled dose of oral potassium chloride for a client whose laboratory report shows a serum potassium level of 6.2 mEq/L6.2\text{ mEq/L} and notifying the charge nurse.Answer
  5. Documenting the administration of an oral analgesic in the electronic health record immediately after observing the client swallow the medication.Answer
  6. F
    Bypassing a broken barcode scanner and identifying a sleeping client by confirming the room number matches the medication record before giving oral levothyroxine.

Answer

The correct actions include verifying two unique client identifiers (name and date of birth), withholding potassium for a hyperkalemic client (6.2 mEq/L6.2\text{ mEq/L}) while notifying the charge nurse, and documenting medication administration immediately after it is swallowed.
The correct actions align with the fundamental rights of medication safety and the boundaries of the practical nurse's scope of practice. Using two valid identifiers (name, date of birth) guarantees the right client receives the medication. Withholding potassium in the presence of an elevated serum level (6.2 mEq/L6.2\text{ mEq/L}) and immediately notifying the charge nurse demonstrates appropriate clinical vigilance and escalation. Finally, documenting medications immediately after administration prevents accidental double-dosing by other staff.

Step-by-Step Solution

1
Evaluate the principles of medication safety and client identification.
Safe practice requires the use of two unique identifiers (e.g., name and date of birth) and immediate documentation after administration.
These steps are foundational to the 'rights' of medication administration to prevent wrong-client errors and duplicate dosing.
2
Analyze the clinical data and laboratory values presented in the scenarios.
A potassium level of 6.2 mEq/L6.2\text{ mEq/L} (hyperkalemia) and a platelet count of 38,000/mm338,000/\text{mm}^3 (severe thrombocytopenia) are critical laboratory abnormalities.
Administering potassium to a hyperkalemic client or an anticoagulant to a severely thrombocytopenic client can precipitate life-threatening complications.
3
Apply the practical nurse (PN) scope of practice to the scenarios.
The PN correctly withholds contraindicated medications and reports critical findings, but must refuse to administer medications via the intravenous (IV) push route.
IV push administration requires complex assessment and rapid clinical judgment that belongs within the registered nurse's scope of practice.

Key Concept

Safe Medication Administration and Scope of Practice
Rate this question

Topics

Pharmacological Therapies

More questions from this topic