Chapter 31 MEDICATION ADMINISTRATION (exam 3)

7. A nurse is administering an MDI with a spacer to a patient with COPD. Place the steps of the procedure in the correct order. 1. Insert MDI into end of spacer. 2. Perform a respiratory assessment. 3. Remove mouthpiece from MDI and spacer device. 4. Place the spacer mouthpiece into patient's mouth and instruct patient to close lips around the mouthpiece. 5. Depress medication canister, spraying 1 puff into spacer device. 6. Shake inhaler for 2 to 5 seconds. 7. Instruct patient to hold breath for 10 seconds. 8. Instruct patient to breathe in slowly through mouth for 3 to 5 seconds.

2,3,6,1,4,5,8,7

Which blood product places a patient at a higher risk of fluid overload after transfusion? A. Whole blood. B. Red blood cells (RBCs). C. Platelets. D. Leukocyte-poor RBCs. E. Cryoprecipitate.

A

Identify the IV catheter gauge typically recommended to infuse blood products in an adult. A. 16 gauge. B. 18 gauge. C. 22 gauge. D. 24 gauge.

B

which statement by the student nurse indicates the need for further education about medication administration? A. "I should set up and prepare medications in distraction-free areas." B. "i should advise the certified medical assistant to administer IV medication." C. "i should be vigilant during the entire process of medication administration." D. "I should identify each client using at least two identifiers before administering medications."

B

The registered nurse is teaching a nursing student about the process of medication reconciliation for a client who was admitted in a health care setting. Which statement made by the nursing student indicates the need for further teaching? A. "I would check the new medication prescription against the current list of medicines." B. " I would avoid asking about the client's over-the-counter medications." C. "I would obtain a comprehensive and current list of the client's medications." D. "I would avoid distractions and go slowly when reconciling the client's medications."

B. "I would avoid asking about the client's over-the-counter medications."

A nurse is preparing to administer a unit of packed red blood cells. The patient has an IV of D5½NS infusing. What IV solution should the nurse use to infuse the unit of packed RBCs? A. D5½NS. B. D5W. C. Normal saline. D. Lactated Ringer's.

C

The nurse finds that a visually impaired client is having difficulty in determining which medications to take after being discharged from the hospital. which intervention would be best in this situation? A. filling and labeling the medication bottles for the client B. Advising the caregiver to administer the client's medication C. recommending that the client's pharmacy relabel the medication in large letters D. showing the client examples of pill organizers that will help them sort the medication

C. recommending that the client's pharmacy relabel the medication in large letters

What are the initial infusion rate and total infusion time for blood products? A. 5 mL/min; 30 minutes. B. 10 mL/min; 2 hours. C. 30 mL/min; 4 hours. D. 2 mL/min; 4 hours.

D

Which information must be clearly described in the medication administration record (MAR) before administering a medication, select all that apply -Dosage and route -Client's full name -Time to be administered -Frequency of administration -Full name of prescribed medication

all are correct

4. Which of the following guidelines must a nurse use for taking verbal or telephone orders? (Select all that apply). 1. Follow the health care agency guidelines regarding authorized staff who may receive and record verbal or telephone orders. 2. Clearly identify patient's name, room number, and diagnosis. 3. Read back all orders to health care provider. 4. Use clarification questions to avoid misunderstandings. 5. Write "VO" (verbal order) or "TO" (telephone order), including date and time, name of patient, and complete order; sign the name of the health care provider and nurse.

1,2,3,4,5

An older adult states that she cannot see her medication bottles clearly to determine when to take her prescription. What actions should the nurse take to help the older adult patient? (Select all that apply.) 1. Provide a dispensing system for each day of the week. 2. Provide larger, easier-to-read labels. 3. Tell the patient what is in each container. 4. Have a family caregiver administer the medication. 5. Use teach-back to ensure that the patient knows what medication to take and when

1,2,5

When the nurse arrived at 8:00 AM D5W is infusing at 100 mL per hour. At 11:00 AM the HCP changes the order for the IV solution to 0.9% sodium chloride to be administered at 75mL per hour and changes the dietary order from NPO to clear liquids. from 1:00 PM to 8:00 PM, the client has 4 oz of apple juice, 4 oz of tea, 4 oz of gelatin, and 6 oz of water. How many mL would the nurse document as the client's TOTAL FLUID INTAKE for the shift? Record your answer using a whole number in mL

1515 mL 2 hours(75 mL) 7 hours(4 ounces + 4 ounces + 4 ounces + 6 ounces) 1 oz=30 mL *the answer is right, but if you know how to solve this please text me*

1. A nurse is administering an oral tablet to a patient. Which of the following steps is the second check for accuracy in determining the patient is receiving the right medication? 1. Logging on to AMDS or unlocking medicine drawer or cart. 2. Before going to patient's room, comparing patient's name and name of medication on label of prepared drugs with MAR. 3. Selecting correct medication from ADMS, unit-dose drawer, or stock supply and comparing name of medication on label with MAR or computer printout. 4. Comparing MAR or computer printout with names of medications on medication labels and patient name at patient's bedside.

2

8. A patient is to receive medications through a small-bore nasogastric feeding. Which nursing actions are appropriate? (Select all that apply.) 1. Verifying tube placement after medications are given 2. Mixing all medications together to give all at once 3. Using an enteral tube syringe to administer medications 4. Flushing tube with 30 to 60 mL of water after the last dose of medication 5. Checking for gastric residual before giving the medications 6. Keeping the head of the bed elevated for 30 to 60 minutes after the medications are given

3,4,5,6

9. Place the steps of administering an intradermal injection in the correct order. 1. Inject medication slowly. 2. Note the presence of a bleb. 3. Advance needle through epidermis to 3 mm. 4. Using nondominant hand, stretch skin over site with forefinger. 5. Insert needle at a 5- to 15-degree angle into the skin until resistance is felt. 6. Cleanse site with antiseptic swab.

6, 4, 5, 3, 1, 2

What may happen if lactated Ringer's, electrolytes, or other calcium-containing solutions are administered concurrently with blood products? A. Calcium binds to citrate resulting in hypocalcemia. B. Electrolyte imbalance occurs as a result of upsetting the sodium-to-calcium balance. C. Serum protein concentrations reduce. D. Hyperchloremic metabolic acidosis occurs.

A

A trauma patient has received 6 units of red blood cells. Plasma and platelets are now prescribed. What is the primary reason the nurse changes the blood administration tubing between packed RBCs (PRBCs), platelets, and/or plasma? A. Blood tubing must be changed every 6 units. B. Plasma is unable to pass through tubing that has previously filtered red blood cells. C. Platelets should run through tubing different than tubing used for RBCs. D. Blood tubing must be changed every hour.

C

A postoperative patient is receiving a unit of packed red blood cells and requests pain medication for a pain level of 8. Upon review, the nurse sees the patient may have 3 mg of morphine sulfate IV push. What is the nurse's best action? A. Inform the patient he will have to wait until his blood transfusion is complete and provide non-pharmacological methods of pain relief. B. Stop the blood transfusion, flush the port closes to the insertion site with normal saline, administer the morphine, flush with normal saline, and restart the blood infusion. C. Administer the morphine sulfate intramuscularly this one time. D. Initiate a second VAD and administer the morphine sulfate.

D

It is acceptable practice to place blood into refrigerators or freezers located in patient care areas. True False

False

the nurse is preparing to administer an ophthalmic medication to a client. which steps would the nurse include for this procedure? select all that apply -Clean the eyelid and eyelashes -Place the dropper against the eyelid -Apply clean gloves before beginning the procedure -Instill the solution directly onto the cornea -Press on the naso-lacrimal duct after instilling the solution

-Clean the eyelid and eyelashes -Apply clean gloves before beginning the procedure -Press on the naso-lacrimal duct after instilling the solution

The nurse is teaching a client about safe insulin administration. which statement made by the client indicates the need for further education? -"I should see whether the insulin is expired." -"I should keep a daily logbook of times of insulin injection." -"I should keep my medication in its original labeled container." -"I should administer insulin only if there are any symptoms."

"I should administer insulin only if there are any symptoms."

An older client asks, "How do i know that the medications that I take are safe?" Which response by the nurse is correct?" select all that apply -"Ask your health care provider how and when you should be taking your medications." -"Stop taking a prescribed medication if you are not feeling better in a few days." -"discard medications into the toilet that have exceeded the expiration date on the bottle." -"check the name, dose, and instructions about administration of medications each time before leaving the pharmacy." -"Inform your health care provider of the over-the-counter medications, recreational drugs, and amount of alcohol you ingest."

-"Ask your health care provider how and when you should be taking your medications." -"check the name, dose, and instructions about administration of medications each time before leaving the pharmacy." -"Inform your health care provider of the over-the-counter medications, recreational drugs, and amount of alcohol you ingest."

10. After receiving an IM injection in the deltoid, a patient states, "My arm really hurts. It's burning and tingling where I got my injection." What should the nurse do next? (Select all that apply.) 1. Assess the injection site. 2. Administer an oral medication for pain. 3. Notify the patient's health care provider of assessment findings. 4. Document assessment findings and related interventions in the patient's medical record. 5. This is a normal finding, so nothing needs to be done. 6. Apply ice to the site for relief of burning pain.

1,3,4

5. Which aspects of the patient's care related to the administration of heparin can the nurse delegate to the nursing AP? (Select all that apply): 1. Notify the nurse if there are any signs of bleeding. 2. Assess the vital signs for possible symptoms of bleeding. 3. Assess bleeding sites and apply appropriate pressure to the sites. 4. Notify the nurse if there is blood noted in the patient's urine. 5. Notify the nurse if there is oozing from any puncture sites.

1,4,5

6. The nurse is administering an IV push medication to a patient who has a compatible IV fluid running through IV tubing. Place the following steps in the appropriate order. 1. Release tubing and inject medication within amount of time recommended by agency policy, pharmacist, or medication reference manual. Use watch to time administration. 2. Select injection port of IV tubing closest to patient. Whenever possible, injection port should accept a needleless syringe. Use IV filter if required by medication reference or agency policy. 3. After injecting medication, release tubing, withdraw syringe, and recheck fluid infusion rate. 4. Connect syringe to port of IV line. Insert needleless tip or small-gauge needle of syringe containing prepared drug through center of injection port. 5. Clean injection port with antiseptic swab. Allow to dry. 6. Occlude IV line by pinching tubing just above injection port. Pull back gently on syringe plunger to aspirate blood return.

2,5,4,6,1,3

What is the benefit of using a large-bore intravenous (IV) catheter for administering blood products? A. Large-bore IV catheters promote rapid flow of blood components. B. Large-bore IV catheters allow a more consistent rate of administration than smaller catheters. C. Large-bore IV catheters are necessary when a pressure bag is being used. D. Large-bore IV catheters are used so that flushing the line before and after blood product infusion is easier.

A

Why is warming a unit of blood products in a microwave or under hot water from the tap contraindicated? A. It destroys the blood product. B. It makes the blood product too hot to infuse and as it cools it coagulates. C. Preparation of blood products is the blood bank's responsibility. D. It can create a leak in the blood packaging.

A

Why might dysrhythmias and a reduction in core body temperature occur in a recently transfused patient? A. An air embolism. B. Volume overload. C. Hypocalcemia. D. Rapid administration of nonwarmed blood products.

D