The nurse is reviewing new medication orders for a patient who has an epidural catheter for pain relief. One of the orders is for enoxaparin (Lovenox), a low“molecular-weight heparin (LMWH). What is the nurse™s priority action?

Correct Answer: C

Rationale: The priority action for the nurse in this situation is to contact the prescriber because the administration of LMWH (such as enoxaparin) is contraindicated in patients with epidural catheters due to the increased risk of spinal or epidural hematoma formation. Spinal or epidural hematoma can lead to serious neurologic complications, including paralysis. Therefore, it is crucial for the nurse to verify the order with the prescriber and explore alternative anticoagulant options that are safe to use in patients with epidural catheters. Giving the LMWH as ordered without addressing this contraindication could result in harm to the patient.

Correct Answer: D

Rationale: Diphenhydramine with MAOIs risks hypertensive crisis due to norepinephrine excess, a life-threatening interaction. Depression , seizures , and allergy control are secondary. D prioritizes urgent assessment, making it the best focus.

Correct Answer: C

Rationale: Morphine is a potent opioid analgesic that is commonly used for pain management, but it is not typically used to treat diarrhea and dysentery. Instead, medications such as loperamide or diphenoxylate/atropine are more commonly employed for managing diarrhea. Morphine can actually cause constipation as a side effect due to its action on opioid receptors in the gut. Therefore, the statement that morphine is used to treat diarrhea and dysentery is false.

Correct Answer: D

Rationale: Enteric-coated medications are designed to resist dissolution in the stomach and release the active ingredient in the intestines. Chewing or crushing the tablet can compromise the coating, leading to premature drug release and potential irritation of the stomach lining. Therefore, the nurse should instruct the patient to swallow the tablet whole without chewing. Taking the tablet with orange juice or avoiding other medications is not necessary, and crushing the tablet is contraindicated. Proper administration ensures the medication's effectiveness and minimizes the risk of adverse effects.

Correct Answer: A

Rationale: A. Hypoglycemia is a major adverse effect of regular insulin. This occurs when insulin lowers blood glucose levels too much, causing symptoms such as sweating, shaking, confusion, and even loss of consciousness if severe.