Deck 17: Administering Medications

Question 1

A registered nurse for more than 15 years was concerned when she learned that her hospital was going to let unlicensed nursing assistants start IVs on patients.The nurse knew this was in violation of the scope of nursing practice in her state.Which of the following organizations defines the scope of nursing's professional functions and responsibilities?

A) The US Food and Drug Administration (FDA)
B) The MedWatch program
C) Employee assistance programs (EAP)
D) State Nurse Practice Acts

Answer 1

State Nurse Practice Acts

Question 2

A patient has an order for a subcutaneous injection of insulin.The nurse will prepare to give this injection into which of the following tissues?

A) Into a large muscle
B) Into the connective tissue beneath the dermis
C) Into a vein using a pump
D) Between the epidermis and dermis

Answer 2

Into the connective tissue beneath the dermis

Question 3

A 34 year old has been on morphine for 6 months after back surgery and has gone to multiple health care providers to obtain prescriptions.Which term best describes this situation?

A) Medication dependence
B) Medication abuse
C) Medication misuse
D) Medication underuse

Answer 3

Medication abuse

Question 4

A postoperative patient is undergoing antibiotic therapy.She has never had any problems taking medications in the past.When the nurse hung the second dose of IV antibiotics,the patient suddenly developed shortness of breath and had difficulty breathing.The nurse recognized this was most likely a(n):

A) idiosyncratic reaction.
B) toxic effect.
C) side effect.
D) anaphylactic reaction.

Question 5

A patient states that aspirin upsets her stomach.This is known as a(n):

A) allergic response.
B) toxic effect.
C) idiosyncratic reaction.
D) side effect.

Question 6

Which of the following patients is most at risk for theophylline toxicity due to decreased biotransformation ability?

A) A 45-year-old man with renal insufficiency
B) A 59-year-old man with chronic obstructive airway disease
C) A 53-year-old woman who smokes and has asthma
D) A 49-year-old woman with chronic obstructive airway disease and hepatitis

Question 7

The nurse is preparing oral medications for a patient.In preparing these medications the nurse is aware of which of the following?

A) Acidic medications are absorbed slowly by the gastric mucosa.
B) Alkaline medications are absorbed rapidly by the gastric mucosa.
C) Solutions and suspensions are more difficult to absorb than capsules.
D) Alkaline medications are absorbed in the small intestine.

Question 8

The nurse is preparing to give an intramuscular (IM)injection of pain medication.The nurse prepares this medication knowing which of the following?

A) Intramuscular (IM) medications are absorbed faster than subcutaneous medications.
B) Medication absorption is faster with subcutaneous medications.
C) Blood supply to the subcutaneous tissue is richer than to muscle.
D) Muscle tissue has a less developed vascular system than subcutaneous tissue.

Question 9

A patient's health care provider wrote a prescription for an antibiotic for an upper respiratory infection.According to safe medication practice standards,the nurse should transcribe the order as which of the following?

A) .5 mg
B) 5.0 mg
C) mg
D) 0.5 mg

Question 10

A postoperative patient is receiving morphine sulfate from a patient-controlled analgesia device.On assessment,the nurse notes that the patient's respirations are depressed.The nurse realizes the effect of morphine sulfate infusion can be labeled as which of the following?

A) Toxic
B) Allergic
C) Therapeutic
D) Idiosyncratic

Question 11

A 12-year-old patient has undergone knee surgery.She has an order for pain medication,which can be given by several different routes.Which of the following routes of administration will provide the fastest pain relief?

A) Transcutaneous
B) Intravenous
C) Oral
D) Rectal

Question 12

A patient with a respiratory infection asks the nurse why some antibiotics are prescribed to be taken every 12 hours and some have to be taken 4 times a day.What is the nurse's best response?

A) "The time between doses changes because any medication's half-life varies so much."
B) "We need to vary the times to keep the blood values fluctuating."
C) "We try to give the next dose of medication only after the last dose is gone."
D) "Regular doses are given based on the half-life to maintain a therapeutic plateau."

Question 13

A patient is unable to swallow pain medication following oral surgery.What would be the appropriate form of the medication to use to administer the drug using the rectal route?

A) Tablet
B) Elixir
C) Capsule
D) Suppository

Question 14

A patient calls to say that he is unable to pay for the medication from a specific manufacturer that was prescribed.The health care provider gives another name for the medication and suggests the patient look for this name instead.The new name was probably which of the following?

A) Generic
B) Trade
C) Chemical
D) Proprietary

Question 15

A patient is hospitalized with a central nervous system infection that needs to be treated with water-soluble antibiotics.The medications will be instilled into the subarachnoid space via an epidural catheter.Why is this the best route of administration for this patient?

A) Intravenous water-soluble antibiotics cannot pass through the blood-brain barrier.
B) Only water-soluble medications can pass into the brain and cerebrospinal fluid.
C) Older patients better tolerate lipid soluble medications than younger patients.
D) Lipid soluble medications are safer for patients who are pregnant.

Question 16

Which of the following patients is most at risk for digoxin toxicity resulting from impaired excretion?

A) A 56-year-old man with coronary artery disease
B) A 24-year-old woman with cystic fibrosis
C) A 53-year-old woman with renal disease
D) A 57-year-old man with a hemorrhagic stroke

Question 17

A nurse is working with the pharmacist to determine when a patient's medications should be given.Several medications are due to be given in the morning.What is the most important reason to appropriately schedule the patient's medications?

A) Some medications are absorbed more quickly on an empty stomach.
B) All medications are hindered by the presence of gastric contents.
C) If given at the same time, all medications will be absorbed at the same rate.
D) The nurse must schedule medications to fit the pharmacy's schedule.

Question 18

The nurse is medicating the patient daily with warfarin (Coumadin).The patient is having blood levels drawn daily to determine the dose needed.The nurse realizes that the goal is to reach which of the following?

A) The minimum effect concentration (MEC) in the plasma
B) Reach the peak concentration level of the medication
C) The level that falls between the MEC and toxic level
D) An adequate trough level in the plasma

Question 19

A woman has been prescribed a daily iron supplement by her health care provider.She recently became constipated,most likely related to the iron supplement.Which of the following best describes this response?

A) Therapeutic effect
B) Adverse reaction
C) Side effect
D) Toxicity

Question 20

A nurse is caring for a patient with kidney disease.The nurse needs to make more focused assessments when administering medications to this patient because the patient may experience problems with the process of:

A) excretion.
B) absorption.
C) distribution.
D) metabolism.

Question 21

Allergic symptoms vary,depending on an individual and the medication; they range from mild to severe.Sudden constriction of bronchiolar muscles,edema of the pharynx and larynx,and severe wheezing and shortness of breath are characteristics of a(n):

A) medication allergy.
B) anaphylactic reaction.
C) medication interaction.
D) idiosyncratic reaction.

Question 22

A nurse is working in a newborn special care unit that has numerous premature infants.She recently transferred to this unit from an adult intensive care unit.The nurse is very cautious in administering medications because premature newborns are especially vulnerable to medication errors.Why is this true?

A) Premature infants excrete urine more quickly than older infants.
B) Premature infants metabolize medications more quickly than older children.
C) Premature infants require more frequent dosing to achieve desired effects.
D) Premature infants have less mature livers and kidneys.

Question 23

Unpredictable effects of some medications in which a patient overreacts or underreacts to a medication or has a reaction different from what is expected are known as:

A) medication allergies.
B) anaphylactic reactions.
C) medication interactions.
D) idiosyncratic reactions.

Question 24

A patient is to receive two different kinds of insulin.What is the nurse's most appropriate action?

A) Prepare the regular (clear) insulin first.
B) Mix Lantus and Lente insulin in the same syringe.
C) Administer the rapid-acting insulin within 30 minutes of a meal.
D) Verify insulin dosage with another nurse after administration.

Question 25

Nurses are legally required to document medications administered to patients.The nurse is mandated to document which of the following?

A) Medication after administration
B) Medication before administration
C) Rationale for giving a questionable incorrect dosage
D) Concerns about giving the medication

Question 26

A(n)_______ occurs when one medication modifies the action of another medication.

A) medication allergy
B) anaphylactic reaction
C) medication interaction
D) idiosyncratic reaction

Question 27

When the effect of two medications combined is greater than the effects of the medications when given separately,the two medications are said to have a(n):

A) synergistic effect.
B) anaphylactic reaction.
C) medication interaction.
D) idiosyncratic reaction.

Question 28

______ effect(s)is/are capable of causing injury or death.They often develop after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion.

A) An adverse
B) A side
C) Therapeutic
D) Toxic

Question 29

The patient is vomiting and complaining of severe chest discomfort.The nurse calls the health care provider in an attempt to obtain which of the following type of order?

A) PRN
B) Standing
C) One-time
D) STAT

Question 30

The patient is admitted to the cardiac unit.Everyone admitted to the cardiac unit will have an EKG done unless otherwise ordered.This is an example of which type of order?

A) PRN
B) Standing
C) One-time
D) STAT

Question 31

A nurse is assigned to care for a pediatric patient.The most common method for calculating pediatric medication dosage is based on the child's:

A) age.
B) height.
C) weight.
D) body surface area.

Question 32

A(n)______ effect is a predictable and often unavoidable adverse effect produced at a usual therapeutic dose.

A) adverse
B) side
C) therapeutic
D) toxic

Question 33

A nurse working in a clinic is teaching a patient how much cough syrup to take.The cough syrup comes in a 250-mL bottle,and the dosage is 10 mL every 4 hours.How many teaspoons should she instruct the patient to take?

A) 1
B) 2
C) 3
D) 4

Question 34

Pharmacokinetics is the study of which of the following? (Select all that apply.)

A) Absorption
B) Distribution
C) Metabolism
D) Excretion
E) Serious harm to patients

Question 35

Undesired,unintended,and often unpredictable responses to medication are referred to as _____ effects.

A) Adverse
B) Side
C) Therapeutic
D) Toxic

Question 36

The intended or desired physiological response of a medication is known as a(n)_____ effect.

A) adverse
B) side
C) therapeutic
D) toxic

Question 37

When a patient's immune system causes abnormal reactions to a medication,the patient has a(n):

A) medication allergy.
B) anaphylactic reaction.
C) medication interaction.
D) idiosyncratic reaction.

Question 38

The health care provider orders pain medication to be given to a patient when the patient needs it to control pain.What is this called?

A) PRN order
B) Standing order
C) One-time order
D) STAT order

Question 39

A nurse is caring for a patient who is to be discharged with a prescription for eye drops.The nurse knows that the patient understands how to administer eye drops correctly when the patient states that eye drops should be instilled on the:

A) sclera.
B) cornea.
C) conjunctival sac.
D) area between the iris and lower eyelid.

Question 40

A patient is to receive a medication that is irritating to muscle tissue.The most appropriate injection technique involves which of the following?

A) Z-track technique of injection
B) Subcutaneous technique of injection
C) Use of the vastus lateralis in adults
D) Use of the deltoid muscle in children less than 12 months old

Question 41

Which of the following are topical medications? (Select all that apply.)

A) Intradermal medications
B) Throat swabs and eye drops
C) Vaginal and rectal suppositories
D) Ear drops and bladder instillations
E) Nasal sprays

Question 42

Factors that influence medication absorption are known as which of the following? (Select all that apply.)

A) Ability of a medication to dissolve
B) Blood flow
C) Body surface area
D) Water solubility of a medication
E) Lipid solubility of a medication

Question 43

Which of the following are the basic units of measurement in the metric system? (Select all that apply.)

A) Meter
B) Teaspoon
C) Liter
D) Tablespoon
E) Gram

Question 44

The nurse is preparing to administer medications to a patient.In doing so the nurse should do which of the following? (Select all that apply.)

A) Monitor medication effects.
B) Assess the patient's ability to self-administer medications.
C) Determine if the patient should receive the medication.
D) Educate the patient and family about medication administration.
E) Delegate administration to nursing assistive personnel (NAP).

Question 45

A nurse is preparing to administer a medication by IV bolus through an existing IV line.What is the correct order for administering the medication? (Separate letters by a comma and space as follows: A,B,C,D.)

A) Perform hand hygiene and apply gloves.
B) Aspirate for blood return before injecting the medication.
C) Occlude the IV line by pinching the tubing just above the injection port.
D) Verify the specified time recommendation for administration of this medication.

Question 46

The passage of medication molecules from the site of administration into the blood is known as absorption.Factors that affect the rate of absorption include which of the following? (Select all that apply).

A) The ability of a medication to dissolve
B) Blood flow to the site of administration
C) Body surface area
D) Lipid solubility
E) The rate of distribution