Zerwekh-Claborn NCLEX-RN Exam Practice questions

[2bRNot2b]

I had included an actual practice question (Mosby) about medication dosage here but realized it could be construed as violating copyright laws, so I am going to try to ask my question without including the actual practice question:

The doctor orders a medication that falls below the therapeutic dosage range for a person. The question's answer says to go ahead and administer the medication, the rationale being that the order given is within the therapeutic dosage range but the author only takes into account the "highest safe dose," ignoring the lowest amount within the therapeutic dosage range. Should that medication be administered or should the order be clarified with the doctor?

What is the point of giving not enough medication to be therapeutic?

Please can someone explain this rationale to me. What am I missing? I would hate to get this sort of question wrong in the NCLEX-RN because I didn't understand semantics or reasoning. Or am I correct?

[caliotter3]

Confusing to me the way you have written it, but in real life one always clarifies an order that they are unsure of.

[2bRNot2b]

Confusing to me the way you have written it, but in real life one always clarifies an order that they are unsure of.

Thanks for your response. Sorry, it was hard to explain without including the actual question. I agree that if I was unsure, I would question - in real life. However, that doesn't help with NCLEX-RN exam questions which apparently aren't based on real life as much as ideal life...

Multiple choice: The practice question asked what a nurse would do about a specific medication order, giving the person's weight, the dosage ordered, and the therapeutic dosage range.

One possible answer was to administer the dosage because it was within the parameters of the therapeutic dosage range. A second possible answer was to contact the doctor because it was outside the therapeutic dosage range.

The amounts given for the specific person's weight would have made the dosage below the therapeutic dosage range, yet the correct answer was supposedly the first response - to administer the dosage. My question is, if the dosage ordered is below the therapeutic dosage range, and therefore limited in effectiveness, does an NCLEX nurse ask for clarification, or is it only if the dosage is above the therapeutic dosage range, and therefore unsafe?

Does that make it clearer? I am a foreign trained nurse, and it would be tragic if I failed my NCLEX exam because I answered questions based on logically and mathematically correct answers rather than according to what is the practice in this country...

[kraymundo]

this question was asked in one of our classes. the teacher explained that sometimes if the medication is to be given to get the levels started but it also needs to be brought to the dr.'s attention or the pharmacist that the amount is not sufficient.

[quinnie]

I have always been taught in my nursing school that if a medication order is outside of the therapeutic range, whether that be too low or too high we always clarify the order with the doctor (and sometimes use the pharmacist as a resource). The answer that the book gave sounds very strange to me.