A nurse is reviewing new prescriptions for several clients. Which of the following prescriptions should the nurse clarify with the provider?
Temazepam 15 mg PO at bedtime PRN sleep
Adderall XR 10 mg PO hs.
Fluoxetine 20 mg PO every a.m.
Guanfacine 1 mg PO daily
The Correct Answer is B
A. Temazepam 15 mg PO at bedtime PRN sleep: This prescription is clear, as it specifies the medication, dosage, route, and that it is for as-needed use at bedtime. This is an appropriate use of a sedative-hypnotic medication for sleep issues.
B. Adderall XR 10 mg PO hs: The abbreviation "hs" typically means "at bedtime," but in the context of Adderall, which is a stimulant, this usage may raise concerns about inappropriate timing. Stimulants are usually prescribed in the morning to avoid insomnia and potential side effects, so clarifying this prescription is necessary to ensure safe and effective use.
C. Fluoxetine 20 mg PO every a.m.: This prescription is clearly stated, with an appropriate dosage and frequency. Fluoxetine is commonly prescribed for depression and can be taken in the morning, making this prescription acceptable.
D. Guanfacine 1 mg PO daily: The prescription is straightforward and appropriate, as guanfacine is often used for attention deficit hyperactivity disorder (ADHD) or hypertension and can be taken daily. There are no concerns that require clarification with this prescription.
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Correct Answer is B
Explanation
A. Medication: The prescription specifies escitalopram, which is a well-known selective serotonin reuptake inhibitor (SSRI) used to treat depression. There is no ambiguity regarding the medication itself, making this aspect clear.
B. Time: While escitalopram can be taken at any time of day, it is important to clarify whether it should be taken in the morning or evening, especially if the client has a history of sleep disturbances. This timing can impact the client's daily routine and overall treatment effectiveness, so confirming the preferred time for administration is essential.
C. Dose: The prescribed dose of 10 mg daily falls within the typical therapeutic range for escitalopram. This dosage is standard for initiating treatment, so there is no need for clarification on this point.
D. Route: The prescription states that the medication is to be taken orally, which is the standard route for escitalopram. There is no confusion regarding the route of administration, making this aspect clear as well.
Correct Answer is C
Explanation
A. Albuterol metered dose inhaler 2 inhalations every 4 to 6 hr PRN for bronchospasm: This prescription is appropriate for managing acute bronchospasm. Albuterol is commonly used as a rescue inhaler, and the frequency aligns with standard practice for its use.
B. Clozapine 25 mg PO daily: This dosage is appropriate for initiating treatment with clozapine, which often starts at a low dose due to the risk of agranulocytosis. Regular monitoring of blood counts is required but the prescription itself is clear.
C. Haloperidol 0.5 mg PO 2 times each day: This prescription raises a concern due to the formatting error (there is a missing space after "Haloperidol"). The clarity of the dose is crucial, especially with potent medications like haloperidol, and the nurse should confirm the intended dosage to avoid medication errors.
D. Flunisolide 80 mcg inhalation twice daily: This is a standard prescription for a corticosteroid inhaler, used for long-term control of asthma or COPD. The dosage and frequency are appropriate, requiring no further clarification.