When carrying out the order for morphine 2 mg IV every 3 hours prn, the nurse recognizes that which intervention is most appropriate?
1. The nurse should wait until the previous dose of morphine has worn off before administering more.
2. For best results, the patient should receive the morphine every 3 hours.
3. The nurse should assess pain every hour and routinely offer the drug.
4. The nurse should wait until the patient requests the morphine to administer the drug.
3
Rationale 1: Waiting for a previous dose of medication to wear off will reduce the blood level of analgesic; the patient may then need more than the ordered amount to regain control over pain.
Rationale 2: Administering the medication every 3 hours around the clock circumvents the nurse's responsibility to assess the pain and administer medication when the patient needs it.
Rationale 3: While around-the-clock dosing has been proven more effective than as-needed (prn) dosing, the nurse should educate the patient about the medication, assess pain frequently, and offer the drug every 3 hours. If the patient is experiencing breakthrough pain, the nurse should contact the prescriber.
Rationale 4: Waiting for the patient to request the drug may allow too much time to elapse, resulting in severe pain that will require more than the ordered amount to relieve.
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A person in the community asks the nurse, "People with mental illnesses went to state hospitals in earlier times. Why has that changed?" Select the nurse's accurate response(s). (Select all that apply.)
a. "Science has made significant improvements in drugs for mental illness, so now many persons may live in their communities." b. "There's now a better selection of less restrictive treatment options available in communities to care for people with mental illness." c. "National rates of mental illness have declined significantly. There actually is not a need for state institutions anymore." d. "Most psychiatric institutions were closed because of serious violations of patients' rights and unsafe conditions." e. "Federal legislation and payment for treatment of mental illness has shifted the focus to community rather than institutional settings."
In 2005, the World Health Organization (WHO) declared the need for the health care workforce to:
a. reduce medical errors. b. organize care around the patient. c. provide a service-oriented delivery. d. remain in individual scopes of practice.
Which of the following would be the first action that a foreign nurse should take to practice in the United States?
a. Apply for a hospital job in the personal desired state to practice in. b. Enroll in a community college to study "American" nursing. c. Contact NCLEX to set up a testing time. d. Contact the board of nursing in the per-sonal desired state to practice nursing in.
A nurse manager is educating staff on how to give effective presentations. Which statement indicates an understanding of this?
a. "To give an effective presentation, you should always maintain a positive atti-tude.". b. "You should avoid planning and should create the presentation as you go.". c. "Give the same presentation regardless of the audience.". d. "To reduce anxiety, avoid making eye contact with the audience.".