ATI: medication calculation exam
what are the two most common types of isotonic solutions?
0.9% sodium chloride Lactaded Ringers
how many mL are in 1 tablespoon?
15 mL
how many mL are in 1 cup?
240 mL
how many teaspoons are in 1 tablespoon?
3 tsp
what are two examples of hypertonic solutions?
3% sodium chloride dextrose 10% in water
how many mL are in 1 ounce?
30 mL
how many mL are in 1 teaspoon?
5 mL
what is a PRN prescription?
A prescription that stipulates at what dosage, what frequency, and under what conditions a med may be given.
a nurse is administering lactated ringers which contains lactate. LR is used to treat a client who has which of the following disorders? A.) acidosis B.) alkalosis C.) Caloric excess
CORRECT- A acidosis
a nurse is monitoring a client who is receiving an IV medication. the client reports dizziness and a feeling of chest tightness. the nurse notes that the clients face is flushed. these findings indicate which of the following systematic complications of IV therapy? A.) speed shock B.) anaphylactic shock C.) extravasation D.) fluid overload
CORRECT- A speed shock
a nurse is caring for a client who has fluid overload following continuous IV infusion of 200 mL/hr. which of the following actions by the nurse is appropriate? A.) Reduce the IV fluid rate B.) place the client in the orthopneic position C.) remove the IV catheter D.) place the client in modified trendelenburg position
CORRECT- A Reduce the IV fluid rate
A nurse is reviewing a client's prescriptions. The nurse should contact the provider to clarify which of the following prescriptions? A.)Phenytoin 100 mg PO every 8 hr B.)Morphine 2.5 mg IV bolus PRN for incisional pain C.)Regular insulin 7 units subcutaneous 30 min before breakfast and dinner D.)Lisinopril 20 mg PO every 12 hr. Hold for systolic BP less than 110 mm Hg
CORRECT: B Morphine 2.5 mg IV bolus PRN for incisional pain WHY: This prescription requires clarification because it is missing the frequency of medication administration
A nurse is transcribing medication for a group of clients. Which of the following is the appropriate way for the nurse to record medications that require the use of a decimal point? A.) .4mL B.) 0.6mL C.) 8.0mL D.) 125.0mL
CORRECT: B WHY: The nurse should place a leading zero to the left of the decimal point when the dose is less than 1 and should not use a trailing 0 at then of the number. This ensures the number is read as "six tenths" of a milliliter.
what is a stat prescription?
It is a prescription given only once, and given immediately.
what is a routine prescription?
a prescription carried out until provider changes or discontinues
what is PC an abbreviation for?
after meals
what are the important facts to know about placement of zeros in dosage?
always use a leading 0 before a decimal, to trailing 0 after the integer after the decimal
what is PRN an abbreviation for?
as needed
what is AC an abbreviation for?
before meals
what is PO an abbreviation for?
by mouth
what are the 6 rights of medication administration?
right client right medication right route right time right dose right documentation
how are large volumes IV infusions administered?
continuously
what does this error prone abbreviation mean?: DC
discharge the medication or discontinue it
what is GTT an abbreviation for?
drop
what is QID an abbreviation for?
four times a day
what is h an abbreviation for?
hour
after dextrose is metabolized what type of solution is it?
hypotonic
hemolysis can occur with the administration of which type of solutions?
hypotonic
what STAT an abbreviation for?
immediately
what is secondary tubing?
includes a drip chamber and a roller clamp, used to administer small IV bag or a bottle of medication
what is ID an abbreviation for?
intradermal
what is IM an abbreviation for?
intramuscular
what is IV an abbreviation for?
intravenous
why don't we use expired medication?
it does not have the right therapeutic effect that the drug would normally have
what is primary tubing?
it includes a drip chamber, an injection port, and a roller clamp, usually used to administer continuous IV infusion
what Is a standing prescription?
it is protocol based, contains a list of directives to implement in specific situations
What is "Tall Man Lettering"?
practice of writing part of a drug's name in upper case letters to help distinguish sound-alike, look-alike drugs from one another in order to AVOID MEDICATION ERRORS.
what are the two types of IV tubing?
primary tubing secondary tubing
what is SL an abbreviation for?
sublingually
what are electronic fluid devices?
these are infusion or IV pumps that deliver an accurate rate of fluid infusion in a specific amount of time
what are volume controlled administration sets?
they are small fluid containers that attach below the primary infusion bag, used in situations where the volume has to be carefully controlled
what is a single prescription?
this prescription is implemented once
what is TID an abbreviation for?
three times a day
when do we use hypotonic solutions?
to treat a fluid or electrolyte imbalance by moving water into the cells
what is BID an abbreviation for?
twice a day
when do we use hypertonic solutions?
used to correct fluid and electrolyte imbalances
when do we use isotonic solutions?
when we need to maintain or increase the volume of the vascular system
how do you label IV tubing?
with the time and date of the first use and the nurses initials
when a medication error occurs, what should you always do?
you should immediately file an incident report, make sure to use great detail and turn it into the risk manager
which patients are at highest risk for adverse effects?
-older adults -pediatric patients -patients taking multiple medications -ill patients
what are the components that should be written on the prescription?
-route -date and time it was written -cautions -the name of medication -the clients name -the physicians signature -the dose, frequency, and strength
how many calories does 1 L of 5% dextrose in water provide?
170 cal.
how many tablespoons are in 1 ounce?
2 tbsp
how many pounds are in 1 kg
2.2 lbs
A nurse on a medical unit is assisting with the orientation of a newly licensed nurse. The nurse should remind the newly licensed nurse to have a second nurse review the dosage of which of the following medications prior to administration? A.) Heparin B.) Acetaminophen C.) Acetylcysteine D.) Hydroxychloroquine
CORRECT: A WHY: The nurse should have a second nurse check the dosage of high-alert medications, such as heparin, because serious client harm can occur if the dosage is excessive. High-alert medication classes include central nervous system drugs, chemotherapy agents, and anticoagulants.
A nurse is preparing to administer medication to a client who has a prescription for decussate sodium 50 mg capsule PO twice daily. The client refuses to take the medication because of nausea. Which of the following actions should the nurse take? A.) Administer a decussate sodium capsule rectally B.) Withhold the medication C.) Administer 100 mg decussate sodium with the next scheduled administration D.) Encourage the client to take the medication as the provider prescribed
CORRECT: B WHY: The nurse should withhold the medication due to the client's nausea and notify the provider. If nausea persists, the nurse should contact the provider to prescribe an antiemetic.
A nurse working in a medical-surgical unit is preparing to administer medications to a client. The nurse plans to use two forms of identification to verify that she has the right client. Which of the following actions can the nurse use to identify the client? (select all that apply) 1.) Compare the name on the clients wristband with the name in the medication administration record 2.) Ask the client to state his date of birth 3.) Check the room number in the medication administration record with room number of the client 4.) Ask the client to state his name 5.) Use the bar code to scan to identify the client
CORRECT: 1,2,4,5 WHY IS 3 WRONG: The client's room number is not an acceptable identifier. The client could have moved to a different room since the MAR was printed, or he could share the room with another client.
A nurse is preparing to administer a medication to a newly admitted client. The nurse should identify which of the following actions as a part of the assessment phase of the nursing process? A.)Asking the client about a history of medication allergies B.)Instructing the client about the medications adverse effects C.)Determining whether the medication should be administered with or without meals D.)
CORRECT: A WHY: The nurse should identify that data collection is part of the assessment phase of the nursing process. The nurse should collect data regarding the client's prior adverse reactions to medication, laboratory data, use of other mediations, and pertinent vital signs as part of the assessment phase to ensure safe medication administration
A nurse is assessing a client following administration of an antibiotic. The nurse should identify that which of the following findings is a manifestation of an anaphylactic reaction to the medication? A.) Swollen lips B.) Hypertension C.) Low heart rate D.) Constipation
CORRECT: A WHY: The nurse should identify that swollen lips is a manifestation of an anaphylactic reaction. Other manifestations include stridor, dyspnea, wheezing, urticaria, and pruritus. The nurse should notify the rapid response team, elevate the client's head off the bed, apply high-flow oxygen, and prepare to administer epinephrine.
What is a now prescription?
similar to stat, but it is not as urgent, needs to be given within 90 minutes of being ordered
what is an intermittent IV bolus?
used to administer smaller volumes of IV solution, it piggybacks with the primary infusion bag. it sits above this bag and drips, once it is finished it immediately starts infusing the primary bag again
what is an IV bolus?
using a syringe to slowly administer medications straight into the IV
a nurse is caring for a client who is receiving antibiotics via IV therapy. the client reports feeling short of breath and is wheezing. what actions should the nurse take next? (select all that apply) A.) remove the IV catheter B.) call the rapid response team C.) administer O2 D.) sit the client up at a 45 degree angle E.) prepare to administer acetylcysteine
CORRECT- B, C, D call the rapid response team administer O2 sit the client up at a 45 degree angle
a nurse is planning care for a patient who is receiving IV therapy. which of the following measures should the nurse include to prevent phlebitis? A.) change IV site weekly B.) hold warm compress to IV site C.) use clean technique when placing the transparent dressing over the IV D.) use a small gauge catheter when initiating IV therapy
CORRECT- D use a small gauge catheter when initiating IV therapy
A nurse is caring for a client who is to receive XR 100 mg PO daily. The client tells the nurse that the capsule is too hard to swallow. Which fo the following actions should the nurse take? A.) Crush the contents of the capsule to administer in a small amount of pudding B.) Request extended-release sprinkles from the pharmacy C.) Ask the charge nurse to clarify the prescription with the provider D.) Withhold the medication until the time for the next dose
CORRECT: B WHY: The nurse can administer topiramate XR in sprinkle form, if available. This is not changing the route of the medication. The sprinkle capsules can be opened and mixed with food for ease of swallowing while still remaining extended release.
A nurse is caring for a client who reports severe back pain at 1400. The client's prescriptions include Oxycodone extended-release 20 mg PO every 12 hr (last dose received at 0600) and oxycodone immediate-release 5mg PO every 4 hr PRN (last dose received at 2300 the day before). Which of the following actions should the nurse take? A.)Contact the provider to request an order for a different pain medication B.)Administer oxycodone immediate-release 5 mg PO at 1600 C.)Administer oxycodone immediate-release 5mg PO now D.)Contact the provider to request an increase in the oxycodone extended-release dose
CORRECT: C WHY: It has been 15 hr since the previous dose of oxycodone immediate-release, and the medication is prescribed every 4 hr as needed, so the nurse should prepare to administer a dose now to treat the client's pain
A nurse discovers a medication error in which the client received the prescribed amount of medication. Which of the following actions should the nurse take first? A.) Notify the provider B.) Complete an incident report C.) Assess the client D.) Report the error to the nurse manager
CORRECT: C WHY: When using the nursing process framework, the first action the nurse should take after discovering a medication error is to assess the client's status. This ensures that any adverse effects of the medication error are identified and that relevant interventions are implemented.
A charge nurse is reviewing the types of prescriptions with a newly licensed nurse. Which of the following prescriptions should the nurse include as an example of a standing prescription? A.) Oxycodone 5mg by mouth every 4hr as needed for pain B.) Furosemide 20mg IV stat C.) Acetaminophen 650 mg by mouth every 6hr for temperature greater than 38.4 C (101.2 F) D.) Diazepam 10 mg IV 30 min prior to procedure
CORRECT: C WHY: A standing prescription is protocol-based and contains directions for administration based upon specific situations, such as the development of a fever.
