Deck 25: Administering Medications
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Deck 25: Administering Medications
1
The primary care provider orders peak and trough levels for a patient who is receiving intravenous vancomycin every 12 hours.When should the nurse obtain a blood specimen to measure the trough?
A) With the morning routine laboratory studies
B) Approximately 30 minutes before the next dose
C) Two hours after the next dose infuses
D) While the drug infuses
A) With the morning routine laboratory studies
B) Approximately 30 minutes before the next dose
C) Two hours after the next dose infuses
D) While the drug infuses
Approximately 30 minutes before the next dose
2
A patient who just returned from the postanesthesia care unit is complaining of severe incision pain.Which drug contained in the medication administration record will offer the fastest relief?
A) Liquid acetaminophen with codeine
B) Intravenous morphine sulfate
C) Intramuscular meperidine
D) Oral oxycodone tablets
A) Liquid acetaminophen with codeine
B) Intravenous morphine sulfate
C) Intramuscular meperidine
D) Oral oxycodone tablets
Intravenous morphine sulfate
3
A patient is given furosemide 40 mg orally at 0900.The duration of action for this drug is approximately 6 hours after oral administration.At which time in military hours should the nurse no longer expect to see the effects of this drug?
A) 0930
B) 1000
C) 1100
D) 1500
A) 0930
B) 1000
C) 1100
D) 1500
1500
4
A patient is prescribed fluoxetine 20 mg by mouth daily for treatment of depression.The nurse caring for the patient is unfamiliar with this drug.Which action should the nurse take before administering the medication?
A) Inform the prescriber that she is not comfortable administering the drug.
B) Ask a nursing colleague for relevant information about the drug.
C) Consult the drug formulary accessible to staff at the patient care unit.
D) Trust the prescriber who writes the dose and administer the drug as intended.
A) Inform the prescriber that she is not comfortable administering the drug.
B) Ask a nursing colleague for relevant information about the drug.
C) Consult the drug formulary accessible to staff at the patient care unit.
D) Trust the prescriber who writes the dose and administer the drug as intended.
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5
A patient develops urticaria and pruritus 5 days after beginning phenytoin for treatment of seizures.Which type of reaction is the patient most likely experiencing?
A) Mild adverse reaction
B) Dose-related adverse reaction
C) Toxic reaction
D) Anaphylactic reaction
A) Mild adverse reaction
B) Dose-related adverse reaction
C) Toxic reaction
D) Anaphylactic reaction
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6
Laboratory test results indicate that warfarin anticoagulant therapy is suddenly ineffective in a patient who has been taking the drug for an extended time.The nurse suspects an interaction with herbal medications.What type of interaction does the nurse suspect?
A) Antagonistic drug interaction
B) Synergistic drug interaction
C) Idiosyncratic reaction
D) Drug incompatibility
A) Antagonistic drug interaction
B) Synergistic drug interaction
C) Idiosyncratic reaction
D) Drug incompatibility
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7
Teratogenic drugs should be avoided in which patient population?
A) Pregnant women
B) Elderly
C) Children
D) Adolescents
A) Pregnant women
B) Elderly
C) Children
D) Adolescents
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8
After receiving diphenhydramine,a patient complains of having a dry mouth.Which drug effect is this patient experiencing?
A) Side effect
B) Adverse reaction
C) Toxic reaction
D) Supportive effect
A) Side effect
B) Adverse reaction
C) Toxic reaction
D) Supportive effect
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9
A patient's digoxin level is 1.2 ng/mL; the therapeutic range for this drug is 0.5 to 2.0 ng/mL.Which action should the nurse take?
A) Notify the prescriber to reduce the dose.
B) Withhold the next dose of digoxin.
C) Administer the next dose as prescribed.
D) Notify the prescribing healthcare provider to increase the dose.
A) Notify the prescriber to reduce the dose.
B) Withhold the next dose of digoxin.
C) Administer the next dose as prescribed.
D) Notify the prescribing healthcare provider to increase the dose.
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10
A surgeon prescribes potassium chloride 20 mEq by mouth for a patient with a nasogastric (NG)tube for gastric drainage.How should the nurse proceed?
A) Seek clarification from the surgeon about the medication order.
B) Clamp the NG tube while administering the dose by mouth.
C) Instill the medication through the NG tube.
D) Withhold the oral potassium chloride elixir.
A) Seek clarification from the surgeon about the medication order.
B) Clamp the NG tube while administering the dose by mouth.
C) Instill the medication through the NG tube.
D) Withhold the oral potassium chloride elixir.
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11
A patient with end-stage cancer is prescribed morphine sulfate to reduce pain.For which effect is this medication prescribed?
A) Supportive
B) Restorative
C) Substitutive
D) Palliative
A) Supportive
B) Restorative
C) Substitutive
D) Palliative
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12
Which term refers to the movement of a drug from the site of administration to the bloodstream?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
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13
The primary care provider prescribes furosemide 40 mg IV for a patient with heart failure.Which drug name is used in this prescription?
A) Chemical
B) Brand
C) Trade
D) Generic
A) Chemical
B) Brand
C) Trade
D) Generic
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14
A patient with terminal cancer requires increasing doses of an opioid pain medication to obtain relief from pain.This patient is exhibiting signs of drug:
A) Abuse
B) Misuse
C) Tolerance
D) Dependence
A) Abuse
B) Misuse
C) Tolerance
D) Dependence
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15
What term is used to describe the time it takes for drug concentration to reach a therapeutic level in the blood?
A) Peak action
B) Duration of action
C) Onset of action
D) Half-life
A) Peak action
B) Duration of action
C) Onset of action
D) Half-life
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16
Which expected outcome is best for a patient with a nursing diagnosis of Deficient Knowledge related to new drug treatment regimen?
A) After an explanation and written materials,describes the expected actions and adverse reactions of his medication
B) In 1 week after instructional session,describes the expected actions and adverse reactions of his medications
C) Follows the treatment plan as prescribed
D) Experiences no adverse effect from his prescribed treatment plan
A) After an explanation and written materials,describes the expected actions and adverse reactions of his medication
B) In 1 week after instructional session,describes the expected actions and adverse reactions of his medications
C) Follows the treatment plan as prescribed
D) Experiences no adverse effect from his prescribed treatment plan
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17
While receiving an intravenous dose of an antibiotic,levofloxacin,a patient develops severe shortness of breath,wheezing,and severe hypotension.Which action should the nurse take first?
A) Administer epinephrine IM.
B) Give bolus dose of intravenous fluids.
C) Stop the infusion of medication.
D) Prepare for endotracheal intubation.
A) Administer epinephrine IM.
B) Give bolus dose of intravenous fluids.
C) Stop the infusion of medication.
D) Prepare for endotracheal intubation.
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18
Which are the rights of medication administration?
A) right patient,right room,right drug,right route,right dose,and right time.
B) right drug,right dose,right route,right time,right physician,and right documentation.
C) right patient,right drug,right route,right time,right documentation,and right equipment.
D) right patient,right drug,right dose,right route,right time,and right documentation.
A) right patient,right room,right drug,right route,right dose,and right time.
B) right drug,right dose,right route,right time,right physician,and right documentation.
C) right patient,right drug,right route,right time,right documentation,and right equipment.
D) right patient,right drug,right dose,right route,right time,and right documentation.
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19
A patient is prescribed the narcotic hydromorphone (Dilaudid).Where should the nurse expect to retrieve this drug for administration?
A) Cabinet in the patient's room
B) Double-locked medication drawer
C) Stock supply cabinet
D) Portable medication cart
A) Cabinet in the patient's room
B) Double-locked medication drawer
C) Stock supply cabinet
D) Portable medication cart
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20
Which factor in a patient's medical history is most likely to prolong the half-life of certain drugs?
A) Heart disease
B) Liver disease
C) Rheumatoid arthritis
D) Tobacco use
A) Heart disease
B) Liver disease
C) Rheumatoid arthritis
D) Tobacco use
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21
The healthcare provider telephones the care area to provide a verbal medication prescription for a client.What action should the nurse take? Select all that apply.
A) Repeat the prescription to the provider.
B) Tell the provider that verbal orders are not permitted.
C) Ask the unit secretary to write the prescription in the medical record.
D) Remind the provider that verbal orders need to be signed within 1 week.
E) Sign the prescription with the provider's name followed by the nurse's name.
A) Repeat the prescription to the provider.
B) Tell the provider that verbal orders are not permitted.
C) Ask the unit secretary to write the prescription in the medical record.
D) Remind the provider that verbal orders need to be signed within 1 week.
E) Sign the prescription with the provider's name followed by the nurse's name.
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22
The nurse accidentally provides a patient with 10 mg of warfarin instead of 5 mg as prescribed.Which action should the nurse take?
A) No action is necessary because an extra 5 mg of warfarin is not harmful.
B) Call the prescriber and ask her to change the order to 10 mg.
C) Document on the chart that the drug was given and indicate the drug was given in error.
D) Complete an incident report according to the facility's policy.
A) No action is necessary because an extra 5 mg of warfarin is not harmful.
B) Call the prescriber and ask her to change the order to 10 mg.
C) Document on the chart that the drug was given and indicate the drug was given in error.
D) Complete an incident report according to the facility's policy.
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23
The nurse needs to provide a medication to a child.What should the nurse recall when calculating the dosage of this medication? Select all that apply.
A) Use Clark's rule.
B) Convert mg to mEq.
C) Refer to a nomogram.
D) Recall that 1 mL is equal to 100 units.
E) Convert the child's weight to kilograms.
A) Use Clark's rule.
B) Convert mg to mEq.
C) Refer to a nomogram.
D) Recall that 1 mL is equal to 100 units.
E) Convert the child's weight to kilograms.
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24
How should the nurse dispose of a contaminated needle after administering an injection?
A) Place the needle in a specially marked,puncture-proof container.
B) Recap the needle,and carefully place it in the trash can.
C) Recap the needle,and place it in a puncture-proof container.
D) Place the needle in a biohazard bag with other contaminated supplies.
A) Place the needle in a specially marked,puncture-proof container.
B) Recap the needle,and carefully place it in the trash can.
C) Recap the needle,and place it in a puncture-proof container.
D) Place the needle in a biohazard bag with other contaminated supplies.
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25
The nurse must administer eardrops to an infant.How should this medication be given?
A) Pull the pinna down and back before instilling the drops.
B) Pull the pinna upward and outward before instilling the drops.
C) Instill the drops directly; no special positioning is necessary.
D) Position the patient supine with the head of the bed elevated 30°.
A) Pull the pinna down and back before instilling the drops.
B) Pull the pinna upward and outward before instilling the drops.
C) Instill the drops directly; no special positioning is necessary.
D) Position the patient supine with the head of the bed elevated 30°.
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26
Which action should the nurse take immediately after administering a medication through a nasogastric tube?
A) Verify correct nasogastric tube placement in the stomach.
B) Auscultate the abdomen for presence of bowel sounds.
C) Immediately administer the next prescribed medication.
D) Flush the tube with water using a needleless syringe.
A) Verify correct nasogastric tube placement in the stomach.
B) Auscultate the abdomen for presence of bowel sounds.
C) Immediately administer the next prescribed medication.
D) Flush the tube with water using a needleless syringe.
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27
An adult patient is prescribed a unit of packed red blood cells.Which gauge needle should be inserted to administer this blood product?
A) 18 gauge
B) 22 gauge
C) 24 gauge
D) 26 gauge
A) 18 gauge
B) 22 gauge
C) 24 gauge
D) 26 gauge
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28
Which documentation entry related to PRN medication administration is complete?
A) 6/5/14 0900 morphine 4 mg IV given in right antecubetal fossa for pain rated 8 on a 1-10 scale,J.Williams RN
B) 0600 famotidine 20 mg IV given in right hand,S.Abraham RN
C) 9/2/14 0900 levothyroxine 50 mcg PO given
D) 1/16/14 furosemide 40 mg PO given,J.Smith RN
A) 6/5/14 0900 morphine 4 mg IV given in right antecubetal fossa for pain rated 8 on a 1-10 scale,J.Williams RN
B) 0600 famotidine 20 mg IV given in right hand,S.Abraham RN
C) 9/2/14 0900 levothyroxine 50 mcg PO given
D) 1/16/14 furosemide 40 mg PO given,J.Smith RN
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29
The nurse manager wants to reduce the number of medication errors made on a care area.What can be implemented to improve the safety of medication administration? Select all that apply.
A) Smart pumps
B) Automated dispensing cabinets
C) Unit dose administration system
D) Bar code medication administration
E) Computerized prescriber order entry (CPOE)
A) Smart pumps
B) Automated dispensing cabinets
C) Unit dose administration system
D) Bar code medication administration
E) Computerized prescriber order entry (CPOE)
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30
The primary care provider prescribes nitroglycerin 1/150 g SL for a patient experiencing chest pain.How should the nurse administer the drug?
A) Place the drug in the cheek and allow it to dissolve.
B) Place the drug under the tongue and allow it to dissolve.
C) Inject the drug superficially into the subcutaneous tissue.
D) Give the pill and water to the patient for him to swallow the tablet.
A) Place the drug in the cheek and allow it to dissolve.
B) Place the drug under the tongue and allow it to dissolve.
C) Inject the drug superficially into the subcutaneous tissue.
D) Give the pill and water to the patient for him to swallow the tablet.
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31
The nurse is teaching parents ways to give oral medication to their child.Which action would they implement to improve compliance?
A) Crush time-release capsules to put in his favorite food.
B) Give medication quickly before he knows what is happening.
C) Allow the child to eat a frozen pop before receiving the medication.
D) Mask the flavor of medication in a toddler cup with orange juice.
A) Crush time-release capsules to put in his favorite food.
B) Give medication quickly before he knows what is happening.
C) Allow the child to eat a frozen pop before receiving the medication.
D) Mask the flavor of medication in a toddler cup with orange juice.
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32
A patient is in the bathroom and asks the nurse to leave medications on the bedside table.What should the nurse do?
A) Inform the patient that she will return when he is finished in the bathroom.
B) Wait outside the bathroom door until the patient is ready for the dose.
C) Withhold the dose until the next administration time later in the day.
D) Document that the dose was omitted in the medication administration record.
A) Inform the patient that she will return when he is finished in the bathroom.
B) Wait outside the bathroom door until the patient is ready for the dose.
C) Withhold the dose until the next administration time later in the day.
D) Document that the dose was omitted in the medication administration record.
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33
A patient has difficulty taking liquid medications from a cup.How should the nurse administer the medications?
A) Request that the prescriber change the order to the IV route.
B) Administer the medication by the IM route.
C) Use a needleless syringe to place the medication in the side of the mouth.
D) Add the dose to a small amount of food or beverage to facilitate swallowing.
A) Request that the prescriber change the order to the IV route.
B) Administer the medication by the IM route.
C) Use a needleless syringe to place the medication in the side of the mouth.
D) Add the dose to a small amount of food or beverage to facilitate swallowing.
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34
Which action should the nurse take to relax the vastus lateralis muscle before administering an intramuscular injection into the site?
A) Apply a warm compress.
B) Massage the site in a circular motion.
C) Apply a soothing lotion.
D) Have the client assume a sitting position.
A) Apply a warm compress.
B) Massage the site in a circular motion.
C) Apply a soothing lotion.
D) Have the client assume a sitting position.
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35
The nurse must administer hepatitis B immunoglobulin 0.5 mL intramuscularly to a 3-day-old infant.Which injection site should the nurse choose to administer this injection?
A) Ventrogluteal
B) Vastus lateralis
C) Deltoid
D) Dorsogluteal
A) Ventrogluteal
B) Vastus lateralis
C) Deltoid
D) Dorsogluteal
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