Walkthrough: Pharmacological and Parenteral Therapies Q10 – NCLEX-RN®

00:01 A postoperative client is requesting pain medication after receiving morphine, two hours prior.

00:07 The nurse reads the prescription "morphine intravenous 4 milligrams PRN every 6 hours for severe pain." Which response by the nurse is most accurate? All right, let's break it down. Let's look at the first sentence.

00:21 So this is a post op client.

00:23 That's what's particular about them.

00:25 They're requesting pain medication. They got morphine two hours prior.

00:30 Okay, so, post op client, having pain.

00:33 We got morphine two hours prior.

00:36 The nurse looks at the prescription, or we would also call that in order.

00:40 Now, here's what it says, "morphine intravenous 4 milligrams PRN every 6 hours for severe pain." Okay, which response by the nurse is most accurate? So now I have to think through the order.

00:56 I know of a patient who got pain medication, two hours prior.

01:00 They got morphine two hours before.

01:03 Now they're asking for morphine.

01:05 The order reads every 6 hours PRN for severe pain.

01:10 So you're going to look through the answer choices and decide which response by the nurse is most accurate? All right. Run through your answer choices.

01:20 Quickly, write down 1, 2, 3, and 4. Just the numbers on your sheet.

01:24 Work through the answer choices, then come back.

01:27 We'll go through them together.

01:36 Welcome back.

01:37 Now did you do the work? Have you committed to your answer? Good job, if you have.

01:43 That's the way you get the most out of studying with us.

01:46 Okay, so let's look at these again.

01:48 Number one, "I can only administer the medication if your pain is severe." Well, the order does say for severe pain.

01:58 I'm not ready to let that go.

02:00 Number two.

02:01 "I am concerned you're experiencing a side effect." Okay. After surgery, if a client is having pain, that could be a side effect.

02:12 What about number three? "Let me talk to your healthcare provider since your dose is early." Well, is it early? It is. The order says PRN every six hours.

02:25 And we know that this patient is asking for it just two hours after they receive morphine.

02:30 So that one's definitely in.

02:32 What about number four? "Your order is as needed. I will get the medication." No, that one I can immediately take out.

02:41 Because the order doesn't mean as often as you want it.

02:44 It says PRN every six hours.

02:47 Now here's a special tip for NCLEX and real life.

02:51 As a nurse, we can't alter that order in any way.

02:56 So I can only give 4 milligrams every 6 hours PRN.

03:02 I can't adjust the dosage, and I cannot adjust the time.

03:06 So number four, I can cross off.

03:09 We're left with number one, two, and three.

03:12 Which one keeps this particular patient in this particular setting, the safest? Well, number one is true.

03:21 But is it better than two and three? No, it doesn't keep the patient the safest.

03:27 Number two.

03:28 "I'm concerned you're experiencing a side effect." A side effect of morphine? What are they talking about? Now you may have read that is adverse effect.

03:38 But that's not what the answer choice says.

03:40 It says, "I am concerned you may be experiencing a side effect." So more pain is not a side effect of morphine.

03:49 We're rid of number two.

03:51 Number three.

03:53 "Let me talk to your healthcare provider.

03:55 Your HCP sent your doses early." Does that make sense? Sure does.

03:59 Because the order says, "morphine IV 4 milligrams, PRN every 6 hours." This client is requesting it at two hours.

04:10 So the dose is early.

04:13 So this may not be your first statement that you make to a patient.

04:16 But keep in mind, the answer choices on an exam are not meant to be a script on how to take care of patients.

04:23 What they're asking you is of these four choices, which one keeps this particular patient in this particular setting, the safest.