Quote from adam_racine
I took a pre-emploment test and I don't know how I did. Here were a couple questions. What do you think the right answers were?
1) John smith always asks for his ativan which is ordered for 1mg po pen every 6 hours what does the nurse do?
a)give him the med and notify the psych nurse if he continues to request the ativan around the clock
b)tell the resident you don't see any signs of anxiety and hold the medication
2) John smith takes morphine pen. She has colon cancer and a history of substance abuse. She asks for this med all the time and says she is in pain even though you just gave her medication what do you do?
a) administer this med as ordered and notify the director of nursing and doctor for correct pain management . The resident needs more medication
b)Give her as little as possible since she has a history of substance abuse
c) she is lying she just says she is in pain because she wants more medication.
I think number one was b and two was a
do you guys think I was right?
IMO, you scored a 50%.
1: If the patient has the Ativan ordered, it's been 6 hours since their last dose and isn't heavily sedated (e.g., RASS 0 or higher), give it to them. It is not your place to decide what meds they can and can't have--that is up to the doctor. However notify the MD if the patient continually requests Ativan--they may decide to make it scheduled instead of PRN, they may switch him to a new medication, they may decide he's a seeker and discontinue it, etc. That's up to the doctor.
Also, reread the question: nowhere does it say that the patient isn't anxious.
In fact, that question says precious little about the patient's condition or why he's getting the Ativan in the first place.
2. Pain is whatever the patient says it is. And again, it's not up to you to decide what meds the patient can and can't have, even if they have a known CD history--that is the doctor's call. If you can administer it, administer it and notify the MD that the patient has been requesting it.