A nurse is transcribing a telephone prescription for acetaminophen 650 mg by mouth daily at bedtime. The nurse should identify that which of the following abbreviations are acceptable to use when transcribing the prescription?
Abbreviate "daily" as "QD"
Abbreviate "by mouth" as "PO"
Abbreviate "acetaminophen" as "APAP"
Abbreviate "at bedtime" as "qhs"
The Correct Answer is B
Rationale:
A. Abbreviate "daily" as "QD": The abbreviation "QD" is no longer recommended because it can be confused with "QID" (four times daily), potentially leading to dangerous medication errors.
B. Abbreviate "by mouth" as "PO": "PO" is the standard and accepted abbreviation for "by mouth," and it is widely used in medical documentation without ambiguity.
C. Abbreviate "acetaminophen" as "APAP": "APAP" is not universally recognized and may lead to confusion. Using the full name of the drug "acetaminophen" is safer and clearer.
D. Abbreviate "at bedtime" as "qhs": "Qhs" is discouraged as it can be easily misinterpreted. Writing "at bedtime" without abbreviations is the recommended practice to avoid errors.
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Correct Answer is A
Explanation
Rationale:
A. The pharmacist typically restocks the medication drawer each day to ensure that medications are available and up-to-date. This is an essential component of the unit-dose medication system.
B. The nursing supervisor does not usually unlock the medication drawer; this is typically done by the nurse in charge or the individual administering the medications.
C. While it is important to limit the number of controlled substances, the medication drawer is usually stocked in a manner that allows for easy access to necessary medications, and there are regulations that govern this process.
D. Opened medications should not necessarily be disposed of at the end of each shift; they may be retained if they are still within their stability period and are properly stored according to protocols.
Correct Answer is D
Explanation
Rationale:
A. Verapamil is a calcium channel blocker that typically decreases heart rate rather than increases it. Therefore, an increased heart rate would not be a therapeutic response to this medication.
B. Verapamil works to lower blood pressure by inhibiting calcium influx into the vascular smooth muscle. An increase in blood pressure would not be an expected therapeutic outcome.
C. While verapamil may help with heart function, the primary therapeutic response is not specifically measured by decreased pulmonary congestion. This outcome may not be directly observable in the early treatment phases post-myocardial infarction.
D. Verapamil is effective in reducing anginal pain by decreasing myocardial oxygen demand through lowering heart rate and contractility. Thus, a decrease in anginal pain would be a direct therapeutic response to the medication.