Essential-Safety-Medication Test (MSG)

57. A 3-year-old child is to receive an iron preparation orally. The nurse should: A. Use a straw B. Administer the medication by injection C. Mix the medication in water D. Ask the pharmacy to send up a pill for the child to swallow

57 ANS: A

58. The client has an order for 30 units of U-500 insulin. The nurse is using a U-100 syringe and will draw up and administer: A. 5 units B. 6 units C. 10 units D. 30 units

58 ANS: B

59. The nurse is preparing to administer 8 mg of a 10 mg dose of an intravenous narcotic. Which of the following statements made by the nurse best reflects an understanding of the appropriate manner to handle this situation? A. "I will sign out the narcotic before the end-of-shift count is completed." B. "I need to get another RN to witness the waste and sign the narcotic sheet." C. "Narcotics are expensive, so it makes sense to save the unused portion for the next time they need the drug." D. "I always make sure someone sees me place the unused portion on the narcotic in the sharps container."

59 ANS: B

6 The nurse is preparing to administer a medication to a 6-year-old. What is the nurse's priority action? A. Administer the exact dosage as ordered. B. Give the dosage supplied by the pharmacy. C. Verify that the dosage is within the safe range for this child. D. Administer no more than one-half of the safe adult dosage.

6 ANS: C

60. The nurse is caring for a client who is experiencing severe pain and is insistent about "getting some relief quickly." Which of the following prescriptions is most likely to produce the quickest pain relief? A. Percodan orally B. Lidocaine topically C. Demerol intramuscularly D. Morphine sulfate intravenously

60 ANS: D

62. The nurse is aware that which of the following clients is at greatest risk for developing medication toxicity? A. The 16-year-old anorexic B. The 35-year-old with liver cancer C. The 45-year-old chronic alcoholic D. The 73-year-old diagnosed with hepatitis B

62 ANS: D

96. A nurse is converting the dosage of a medication to a different unit in the metric system. The medication label specifies the drug as being 0.5 g per tablet. The order is for 500 mg. How many tablets will the nurse give? A) one B) two C) five D) ten

96. A

97. What factor is used to most accurately calculate drug dosages for a child? A) age B) developmental level C) weight D) body surface area (BSA)

97. D

100. A physician has ordered that a medication be given "stat" for a patient who is having an anaphylactic drug reaction. At what time would the nurse administer the medication? A) at the next scheduled medication time C) not until verifying it with the patient B) immediately after the order is noted D) never, this is not a legal type of order

100. B

11 At which point of preparing medication from an ampule does the nurse anticipate using a filter needle? A. Filter needles are not used for this preparation. B. When drawing the medication from the ampule. C. When administering the medication to the client. D. Both for drawing up the medication and for administering the medication

11 ANS: B

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1 The nurse is preparing to administer a medication that the agency designates as "high alert." What action should the nurse take? A. Ask another registered nurse to verify the medication. B. Call the pharmacist to check the efficacy of the medication. C. Decline to administer the medication unless there is a physician present. D. Request that the nursing supervisor administer the medication

1 ANS: A

98. A nurse is conducting an interview with a patient to collect a medication history. Which of the following questions would be used to ensure safe medication administration? A) "Have you noticed any change in your bowel habits?" B) "How do you feel about taking medications?" C) "Do you have any allergies to medications?" D) "At what times do you take your medications?"

98. C

99. A hospitalized patient asks the nurse for "some aspirin for my headache." There is no order for aspirin for this patient. What will the nurse do? A) go ahead and give the patient aspirin, a common self-prescribed drug B) ask the patient's visitors if they have any aspirin for the patient C) ask the patient's family to bring some aspirin from home D) tell the patient an order from the doctor is legally required

99. D

45. The most effective way in the acute care environment to determine the client's identity before administering medications is to: A. Ask the client's name B. Check the name on the chart C. Ask the other caregivers D. Check the client's name band

45 ANS: D

4 The nurse identifies that the ordered dose for a medication is twice the amount generally administered. What action should the nurse take? A. Administer the medication as it was ordered. B. Check to see if previous shift nurses gave the medication. C. Collaborate with the prescriber about the order. D. Administer only the standard dose of the medication.

4 ANS: C

40. The student nurse reads the order to give a 1-year-old client an intramuscular injection. The appropriate and preferred muscle to select for a child is the: A. Deltoid B. Dorsogluteal C. Ventrogluteal D. Vastus lateralis

40 ANS: C

41. The nurse administers the intramuscular medication of iron by the Z-track method. The medication was administered by this method to: A. Provide faster absorption of the medication B. Reduce discomfort from the needle C. Provide more even absorption of the drug D. Prevent the drug from irritating sensitive tissue

41 ANS: D

2 Hospital regulations now require that the nurse write out the name of the drug morphine sulfate instead of using the abbreviation MS. What is the best rationale for this requirement? A. The hospital has placed MS on its list of do not use abbreviations. B. JCAHO requires that the abbreviation MS not be used. C. Using the abbreviation MS puts the client at risk of medication error. D. Computerized charting systems will not accept the abbreviation MS.

2 ANS: C

42. The client is ordered to have eye drops administered daily to both eyes. Eye drops should be instilled on the: A. Cornea B. Outer canthus C. Lower conjunctival sac D. Opening of the lacrimal duct

42 ANS: C

43. Following the administration of ear drops to the left ear, the client should be positioned: A. Prone B. Upright C. Right lateral D. Dorsal recumbent with hyperextension of the neck.

43 ANS: C

44. The order is for eye medication, ii gtt OD. The nurse administers: A. 2 mL to the right eye B. 2 drops to the left eye C. 2 drops to the right eye D. 2 drops to both eyes

44 ANS: C

20 While preparing to administer an eye ointment, the nurse inadvertently squeezes the tube, discarding the first bead of medication. What action should the nurse take at this point? A. Administer the eye ointment as ordered, as the first bead of ointment should be discarded anyway. B. Notify the pharmacy and request a new, unopened tube of ointment. C. Have a second licensed nurse witness the waste and sign the chart. D. Continue to squeeze the tube until a clear line of ointment has been discarded from the tip.

20 ANS: A

21 The nurse is preparing to administer eardrops to a 6-year-old. What nursing action is correct? A. Pull the earlobe down and back to straighten the ear canal. B. Insert the tip of the applicator into the ear canal. C. Put the eardrops in the refrigerator for 10 minutes prior to administration. D. Press gently on the tragus of the ear a few times after administration

21 ANS: D

38. The nurse is teaching the client how to prepare 10 units of regular insulin and 5 units of NPH insulin for injection. The nurse instructs the client to: A. Inject air into the regular insulin and then into the NPH insulin B. Withdraw the regular insulin first C. Inject air into and withdraw the NPH insulin immediately D. Inject air into both vials and withdraw the regular insulin first

38 ANS: D

10 The nurse is to administer four oral medications to the client via a nasogastric tube. One of the medications is a tablet that has been crushed, one is a capsule that has been opened and the powder removed, and two are supplied in liquid form. How should the nurse administer these medications? A. Flush the tube, mix the crushed tablet and the capsule powder into the two liquids for administration, and follow by flushing the tube. B. Mix the crushed tablet and capsule powder in warm water and administer. Flush the tube and administer the mixed liquids. C. Flush the tube with the mixed liquids first, then administer the crushed tablet and capsule powder mixed in cold water. D. Mix the crushed tablet and capsule powder individually in warm water. Administer each medication separately, flushing the tube before and after each administration.

10 ANS: D

12 The nurse has discontinued suction to a nasogastric tube to administer medication. For how long should the nurse plan to leave this suction discontinued?

12 ANS: 20 to 30 minutes

13 The client is to receive an intramuscular injection of a medication that is supplied in a 2-mL cartridge and a second medication that is supplied in a vial. The total amount to be administered of these medications exceeds the volume of the cartridge by 0.5 mL. How should the nurse proceed? A. Administer the cartridge medication in one injection and the vial medication in a separate injection. B. Call the pharmacy for advice on administering these medications. C. Draw both of the medications up into a syringe for administration. D. Add as much of the vial medication to the cartridge as possible prior to injection, giving the balance in a separate injection.

13 ANS: C

14 During administration of an intradermal injection, the nurse notices that the outline of the needle bevel is visible under the client's skin. How should the nurse proceed? A. Recognize that this is an expected finding in a properly administered intradermal injection. B. Withdraw the needle, prepare a new injection, and start again. C. Insert the needle further into the skin at a deeper angle. D. Turn the needle so that the bevel is down and inject the medication slowly, looking for development of a bleb.

14 ANS: A

15 The nurse has just injected insulin subcutaneously into the client's abdomen. What action should the nurse take at this point? A. Massage the site to encourage absorption. B. Leave the needle embedded in the client's skin for 5 seconds after administration. C. Remove the needle rapidly by pulling it quickly from the skin. D. Cover the injection site with a pressure dressing for at least 15 minutes or until the bleb disappears.

15 ANS: B

16 The nurse who is to administer 2.5 mL of intramuscular pain medication to an adult client notes that the previous injection was administered in the right ventrogluteal site. In which site should the nurse plan to administer this injection? A. The same site B. The deltoid C. The left ventrogluteal D. The rectus femoris

16 ANS: C

17 While administering an intramuscular injection, the nurse notes blood return in the syringe barrel after aspirating. What action should the nurse take? A. Pull the needle out 1/4 inch and inject the medication. B. Inject the medication as planned. C. Notify the physician immediately. D. Discard the medication and start over.

17 ANS: D

18 The nurse is adding medication to an existing intravenous setup. Which nursing action is indicated? A. Close the infusion clamp. B. Ensure that the IV bag is full prior to adding medication. C. Do not remove the IV bag from the standard. D. Briskly shake the IV bag after injecting the medication.

18 ANS: A

19 Upon aspirating a saline lock prior to administering intravenous medication, the nurse notes that there is no blood return. What nursing action should be taken? A. Discontinue this infiltrated lock and restart another site for medication administration. B. Slowly infuse 1 mL of saline into the lock, assessing for infiltration. C. Reinsert the needle into the lock and aspirate using more pressure. D. Pull the intravenous catheter out 1/8 inch and attempt aspiration.

19 ANS: B

39. A client has a prescription for a medication that is administered via an inhaler. To determine if the client requires a spacer for the inhaler, the nurse will determine the: A. Dosage of medication required B. Coordination of the client C. Schedule of administration D. Use of a dry powder inhaler

39 ANS: B

22 While preparing to administer a transdermal estrogen patch, the nurse finds the previously applied patch in the client's bed linens. How can the nurse avoid this situation with the patch now being applied? A. Shave the area where the patch is being applied. B. Place a heating pad over the area where the patch is applied for 10 minutes after application. C. Run a finger around the adhesive edges of the new patch before placing it on the client's skin. D. Press firmly over the patch with the palm of the hand for about 10 seconds after applying it to the skin.

22 ANS: D

23 The nurse is preparing a small amount of medication for oral administration. Which nursing action is essential? A. Draw up the medication in a syringe with a large-gauge needle. B. Measure the medication at the top of the meniscus. C. Label the syringe with the medication name, amount, and route. D. Dilute the medication with water before measuring

23 ANS: C

24 The diabetic client asks the clinic nurse about the advisability of reusing insulin syringes. Assessment reveals that the client has poor personal hygiene and difficulty with fine motor skills. The nurse also knows the client has financial difficulties. What instruction should the nurse give this client? A. "The American Diabetes Association advises that syringes are single use only." B. "In order to save money, I advise you to reuse syringes up to three times or until the needle feels dull." C. "Only people who practice good personal hygiene can reuse syringes." D. "All clients are different, but I advise you to use a new syringe each injection."

24 ANS: D

25 The client who regularly uses a metered-dose inhaler four times a day tells the nurse that it is difficult to tell when the canister is empty. What instruction should the nurse give this client? A. Place the canister in a bowl of water. If the canister floats, it is not empty. B. When you get a new canister, divide the number of puffs that is listed on the label by four. That will tell you how many days the canister will last. C. You can tell that the canister is empty when you can no longer smell the medication when you activate the plunger. D. When you feel like you are no longer getting maximum effect from the medication, your canister is empty.

25 ANS: B

26 The nurse is providing discharge teaching for a client who is being dismissed with prescriptions for a bronchodilator inhaler and a corticosteroid inhaler. What information should the nurse provide regarding the dosage schedule for these two medications? A. Always use the corticosteroid inhaler first. B. Use the bronchodilator first. C. It makes no difference which inhaler is used first. D. Use the inhalers on alternate days, not on the same day.

26 ANS: B

27 The nurse is planning to administer medications to a new client. What is the nurse's greatest priority in administering these medications? A. Be certain the medications are given within 15 minutes of the time they are scheduled. B. Before giving the medications, know what the intended effects are for this client. C. Assess the client's knowledge of the action of the medications. D. Document the administration accurately so the reimbursement is correct

27 ANS: B

28. A client is nauseated, has been vomiting for several hours, and needs to receive an antiemetic (antinausea) medication. The nurse recognizes that which of the following is accurate? A. An enteric-coated medication should be given. B. Medication will not be absorbed as easily because of the nausea. C. A parenteral route is the route of choice. D. A rectal suppository must be administered.

28 ANS: C

29. The client receiving an intravenous infusion of morphine sulfate begins to experience respiratory depression and decreased urine output. This effect is described as: A. Therapeutic B. Toxic C. Idiosyncratic D. Allergic

29 ANS: B

3 The hospitalized client has an order for Tylenol 325 mg 2 tablets every 4 hours prn temperature over 101°F. The client complains of a headache. Can the nurse legally administer Tylenol to treat the headache? A. Yes, since Tylenol is used both for fever and headache. B. No, not unless the client also has a temperature over 101°F. C. Yes, but the nurse should document the reason why the medication was administered as a temperature elevation. D. Yes, since the medication is available over the counter, an order is not required

3 ANS: B

30. The client is to receive a medication via the buccal route. The nurse plans to implement which of the following actions? A. Place the medication inside the cheek. B. Crush the medication before administration. C. Offer the client a glass of orange juice after administration. D. Use sterile technique to administer the medication

30 ANS: A

31. The physician orders a grain and a half of Seconal to help a client sleep. The label on the medication bottle reads Seconal 100 mg. How many capsules should the nurse give the client? A. 1/2 B. 1 C. 1/2 D. 2

32 ANS: B

33. The physician has ordered 6 mg of morphine sulfate every 3 to 4 hours prn for a client's postoperative pain. The unit dose in the medication dispenser has 15 mg in 1 mL. How much solution should the nurse give? A. 1/5 mL B. 1/3 mL C. 2/5 mL D. 1/4 mL

33 ANS: C

34. To determine proper drug dosages for children, calculations are most precisely made on the basis of the child's: A. Weight B. Height C. Age D. Body surface area

34 ANS: D

35. The nurse is documenting administration of a medication that is given at 10:00 AM, 2:00 PM, and 6:00 PM. The medication that the nurse is documenting is: A. Morphine sulfate 10 mg q4h prn B. Inderal 10 mg PO bid C. Diazepam 5 mg PO tid D. Keflex 500 mg PO q8h

35 ANS: C

36. The nurse is working on the pediatric unit. In preparing to give medications to a preschool-age child, an appropriate interaction by the nurse is: A. "Do you want to take your medication now?" B. "Would you like the medication with water or juice?" C. "Let me explain about the injection that you will be getting." D. "If you don't take the medication now, you will not get better."

36 ANS: B

37. In preparing two different medications from two vials, the nurse must: A. Inject fluid from one vial into the other B. Uncap the syringe and wipe the needle with an alcohol preparation before inserting into either vial C. Discard the medication from vial number 2 if medication from vial number 1 is pushed into it D. Insert air into the first vial, but not the second vial

37 ANS: C

46. An order is written for Demerol 500 mg IM q3-4h prn for pain. The nurse recognizes that this is significantly more than the usual therapeutic dose. The nurse should: A. Give 50 mg IM as it was probably intended to be written B. Refuse to give the medication and notify the nurse manager C. Administer the medication and watch the client carefully D. Call the prescriber to clarify the order

46 ANS: D

47. An order is written for 80 mg of a medication in elixir form. The medication is available in 80 mg/tsp strength. The nurse prepares to administer: A. 2 mL B. 5 mL C. 10 mL D. 15 mL

47 ANS: B

48. The client is to receive a Mantoux test for tuberculosis. This test is administered via an intradermal injection. The nurse recognizes that the angle of injection that is used for an intradermal injection is: A. 15 degrees B. 30 degrees C. 45 degrees D. 90 degrees

48 ANS: A

49. The nurse prepares to administer an intradermal injection for the administration of medication for: A. Pain B. Allergy sensitivity C. Anticoagulant therapy D. Low-dose insulin requirements

49 ANS: B

5 The client has required 2 sublingual nitroglycerine tablets that are gr 1/150 per tablet. How many mg of nitroglycerine did the client receive?

5 ANS: 48 mg

50. The nurse is evaluating the integrity of the ventrogluteal injection site. The nurse finds the site by locating the: A. Middle third of the lateral thigh B. Greater trochanter, anterior iliac spine, and iliac crest C. Anterior aspect of the upper thigh D. Acromion process and axilla

50 ANS: B

51. The client is to receive heparin by injection. The nurse prepares to inject this medication in the client's: A. Scapular region B. Vastus lateralis C. Posterior gluteal D. Abdome

51 ANS: D

52. A medication is prescribed for the client and is to be administered by IV bolus injection. A priority for the nurse before the administration of medication via this route is to: A. Set the rate of the IV infusion B. Check the client's mental alertness C. Confirm placement of the IV line D. Determine the amount of IV fluid to be administere

52 ANS: C

53. A client on the medical unit receives regular insulin at 7:00 AM. The nurse is alert to a possible hypoglycemic reaction by: A. 7:30 AM B. 10:00 AM C. 4:00 PM D. 8:00 PM

53 ANS: B

54. A priority for the nurse in the administration of oral medications and prevention of aspiration is: A. Checking for a gag reflex B. Allowing the client to self-administer C. Assessing the ability to cough D. Using straws and extra water for administration

54 ANS: A

55. The nurse is to administer several medications to the client via the N/G tube. The nurse's first action is to: A. Add the medication to the tube feeding being given B. Crush all tablets and capsules before administration C. Administer all of the medications mixed together D. Check for placement of the nasogastric tube

55 ANS: D

56. The nurse is administering an injection at the ventrogluteal site. On aspiration, the nurse notices that there is blood in the syringe. The nurse should: A. Inject the medication B. Pull the needle back slightly and inject the medication C. Move the skin to the side and inject the medication slowly D. Discontinue the injection and prepare the medication again

56 ANS: D

61. A 78-year-old client with congestive heart failure (CHF) is reporting vascular pain in his lower legs and requests his oral narcotic analgesic. The nurse recognizes that the client's pain relief will be negatively affected primarily because of: A. The client's age B. The systemic effects of CHF C. The route of administration D. The status of the peripheral vessels

61 ANS: B

63. A 20-year-old diagnosed with Crohn's disease is experiencing severe pain and is requesting the prescribed morphine as often as it can be administered. The nurse is particularly concerned about opioid toxicity because of: A. The client's frequent requests for the narcotic B. The client's compromised bowel absorption C. The drug's seeming inability to control the client's pain D. The drug's ability to produce marked respiratory depression

63 ANS: B

64. The nurse recognizes which of the following clients as being at greatest risk for anaphylactic shock? A. A 69-year-old client receiving an antibiotic for a respiratory tract infection B. A 45-year-old prescribed a decongestant as needed for seasonal allergies C. A 50-year-old client prescribed a therapeutic dose of an antihypertensive medication D. A 26-year-old receiving intravenous steroids for the initial flare-up of rheumatoid arthritis

64 ANS: A

65. During the admission interview a client shares with the nurse that she is allergic to latex. The nurse's immediate response is to: A. Place an allergic to latex sticker on the client's Kardex B. Verbally notify the staff of the client's allergy to latex C. Notify the client's health care provider of the client's allergy to latex D. Place an identification bracelet on the client that identifies the latex allergy

65 ANS: D

66. A client is observed swallowing a chewable form of aspirin. Which of the following statements made by the nurse shows the best understanding of the educational reinforcement needed by this client? A. "This aspirin is designed to be chewed, not swallowed." B. "This aspirin will not give you the desired effects if it's swallowed." C. "I realize that you usually swallow aspirin, but this form only works if it's chewed." D. "I can see if your health care provider will order your aspirin in a form that can be swallowed."

66 ANS: C

67. To minimize the risk for injury to the oral mucosa, a client ordered a buccally administered medication is instructed to: A. Alternate cheeks with each subsequent dose B. Swallow the medication with a full glass of liquid C. Chew the medication thoroughly before swallowing D. Avoid allowing the medication to dissolve on the tongue

67 ANS: A

68. To best prevent a systemic effect from a topically applied medication patch, the nurse must: A. Alternate application sites regularly B. Avoid applying the medication to broken skin C. Monitor the client for signs of an irritating rash D. Remove residual medication with mild soap and water

68 ANS: B

69. The nurse assigns ancillary personnel the task of giving a client a pre-procedure enema. Which of the following statements made by the personnel requires immediate follow-up by the nurse? A. "I use all of the soap provided in the kit." B. "The soapy water just came right back out." C. "An enema is intended to clean out the rectum." D. "The client was able to hold the enema for 5 minutes."

69 ANS: B

7 During the process of administering medications, the nurse checks the name band for the client's name. What should be this nurse's next action? A. Administer the medication as ordered. B. Initial the MAR that the medication will be given. C. Double-check the client's identification using a second method. D. Educate the client regarding the medication to be given.

7 ANS: C

70. Research has shown that the primary reason nurses make medication errors is related to: A. The complexity of making accurate drug calculations B. Events that distract the nurse during the administration process C. The presence of multiple drugs with similar generic and trade names D. Heavy client assignments that require massive medication administrations

70 ANS: B

71. The nurse has taken a verbal order for a narcotic medication to be given to a client experiencing severe pain related to metastatic cancer of the bone. The nurse's initial action regarding the order is to: A. Prepare the medication for administration to the client B. Properly sign for the narcotic analgesic in the narcotic records C. Notify the client that a verbal order for a narcotic pain medication has been received D. Write and then sign the complete order in the appropriate location in the client's chart

71 ANS: D

72. During the admission interview the client reports to the nurse that she is "a little allergic to penicillin." Which of the following questions asked by the nurse is most likely to provide the most relevant information regarding the client's possible allergy to penicillin? A. "Who told you that you are allergic to penicillin?" B. "What makes you think you are allergic to penicillin?" C. "Can you describe what happens when you take penicillin?" D. "What do you take for an infection since you are allergic to penicillin?"

72 ANS: C

73. Policies for the proper storage and distribution of narcotics within a health care organization are written by: A. Federal government B. State government C. Local governmental bodies D. Health care organization

73 ANS: D

74. The nurse is administering morphine sulfate to a client for pain. The order has been written so that the nurse can chose from several routes of administration. The nurse knows that the morphine sulfate be most rapidly absorbed by which of the following routes? A. Oral B. IV C. IM D. Rectal

74 ANS: B

75. On beginning the administration of 500 mg of aztreonam IV to a client with a urinary tract infection, the client complains of difficulty breathing. The nurse quickly identifies this as a symptom of a(n): A. Therapeutic effect B. Anaphylactic reaction C. Idiosyncratic reaction D. Medication interaction

75 ANS: B

76. In the event of a medication error, the nurse's first responsibility is to: A. Contact the physician B. Fill out an incident report C. Notify their supervisor D. Ensure the client's safety

76 ANS: D

77. The nurse prepares to administer a table to a client who has difficulty swallowing pills. The nurse decides to crush the tablet and mix it with food. The nurse should mix the crushed medication: A. In a large amount of food to mask the taste B. With the client's favorite food C. With grapefruit juice D. In a very small amount of food

77 ANS: D

78. The nurse prepares to administer a prn pain medication by IM injection. The client refuses the injection stating that "I don't like shots." The best reaction by the nurse is to: A. Contact the physician for pain medication to be given by a different route B. Instruct the client that he or she needs to be brave and take the shot C. Contact the nursing supervisor to talk with the client D. Inform the client that the injection is the only route that the pain medication is ordered

78 ANS: A

79. When teaching a pediatric client's parents about administering his medication at home, the nurse states that the most accurate device for measuring the liquid medication is: A. Cup B. Teaspoon C. Oral plastic disposable syringe D. Dropper

79 ANS: C

8 The nurse is planning to administer a bitter-tasting oral medication to a 4-year-old. What strategy should this nurse plan? A. Give the medication in orange juice or milk to mask the taste. B. Tell the child that the medication tastes good. C. Ask the parents how they give medications at home. D. Get another nurse to assist by holding the client down.

8 ANS: C

80. The nurse is preparing to administer a nasal instillation of medication to a client. The best position for accessing the posterior pharynx is to place the client in a supine position and tilt the client's head: A. Backward B. Over the edge of the bed with the head to one side C. Over a small pillow and back D. In a chin-down position

80 ANS: A

81. The nurse has an order for 325 mg acetaminophen p.r. q4h prn for pain for a 7-year-old client who has had surgery. In preparing the client for insertion of the suppository, the client states that she feels the need to have a bowel movement. The nurse's best response is to: A. Insert the suppository, knowing that it will dissolve quickly B. Allow the client to defecate first to clear the rectum of stool C. Explain to the client that it is normal to feel the urge to defecate when a suppository is inserted into the rectum, but the urge will pass D. Hold the medication and contact the physician for a p.o. order

81 ANS: B

82. The nurse plays a major role in which of the following aspects of medication therapy? (Select all that apply.) A. Determining the necessity of a particular medication B. Discontinuing prescribed medications when appropriate C. Preparation of the client's prescribed dose of medication D. Monitoring the pharmacological effects of the prescribed medication E. Delivering the medication in accordance with the prescriber's directions F. Instructing the client regarding the pharmacological effects of the medication

82 ANS C,D,E,F

83. The home health nurse is preparing to educate a client on his or her newly prescribed medications. Which of the following nursing statements are appropriate to be included in this discussion? (Select all that apply.) A. "This medication is designed to lower your blood pressure." B. "Do you have medical insurance that covers the cost of medication?" C. "The medication can make you dizzy especially if you stand up quickly." D. "What do you think will be the most difficult thing about taking this medication?" E. "You will need to take this medication once a day; with breakfast seems to work best for most people." F. "It is important that you don't miss taking the medication, If you do, take it when you remember but never take two at a time."

83 ANS: A, C, D, E, F

84. A nurse is accused of illegally abusing narcotic medications originally prescribed to clients. If found guilty this nurse is subject to: (Select all that apply.) A. Years of imprisonment in a federal prison B. Forced involvement in a drug rehabilitation program C. Inclusion on the State Board of Nursing Suspended license list D. Forfeiture of the professional license needed to practice nursing E. Monetary fines that can be in the hundreds of thousands of dollars F. Termination of employment from the institution where the abuse occur

84 ANS: A, C, D, E, F

85. Which of the following clients is likely to experience altered medication excretion with resulting possible toxicity? (Select all that apply.) A. A 16-year-old with asthma B. A 34-year-old with hepatitis B C. A 72-year-old with lung cancer D. A 20-year-old with Crohn's disease E. A 54-year-old in end-stage renal failure F. A 50-year-old with early Alzheimer's disease

85 ANS: A, B, D, E

86. The pharmacist provides collaboration to the acute care nursing staff in the form of: (Select all that apply.) A. Accurate dispersal of prescribed medications B. Information regarding medication side effects C. Appropriate labeling of prescribed medications D. Clarification regarding proper medication dosage E. Education of clients regarding the therapeutic value of drugs F. Answering questions related to potential drug incompatibilities

86. ANS: A, B, C, D, F

87. The nursing role regarding a medication error includes: (Select all that apply.) A. Immediate assessment of the client B. Notification of the health care provider C. Report the error to the appropriate institutional administrator D. Notify the client's family or medical power of attorney of the error E. Attach a written incident report to the client's chart within 24 hours F. Monitoring of the client as indicated by the potential effects of the medication

87 ANS: A, B, C, F

88. Which healthcare provider is legally responsible for prescribing medications? A) licensed practical nurse B) pharmacist C) physician D) social worker

88. C

89. What federal agency enforces the official standards for drugs in the United States? A) Centers for Disease Control and Prevention B) Judicial branch of the administration C) Controlled Substance Act D) Food and Drug Administration

89. D

9 The nurse is caring for a team of four clients who are seriously ill. One of the clients has just received a new cardiac medication. How should the nurse instruct the unlicensed assistive personnel (UAP) who is also caring for this client? A. Have the UAP assess for any unexpected effects from the medication. B. Tell the UAP to teach the client's family what to expect from the medication. C. Have the UAP look the medication up in a drug reference book to read about drug actions and possible side effects D. Give the UAP specific instructions regarding what drug actions or side effects to report to the nurse.

9 ANS: D

90. A patient who is taking Tylenol for a fever asks a nurse if there is a generic form that is less expensive. What would the nurse tell him? A) "No, Tylenol is all that is available." C) "Yes, and it is acetaminophen." B) "No, not that I am aware of." D) "Yes, and it is also called Tylenol

90. C

91. A nurse is administering a medication to a patient for acute pain. Of the various routes for drug administration, which would be chosen because it is absorbed more rapidly? A) injected medications C) topical skin medications B) liquid oral medications D) oral coated medications

91. A

92. A physician has ordered peak and trough levels of a medication. When would the nurse schedule the trough level specimen? A) before administering the first dose C) 30 minutes before the next dose B) immediately after the first dose D) 24 hours after the last dose

92. C

93. A patient who is taking an oral narcotic for pain relief tells the nurse he is constipated. What is this common response to narcotics called? A) therapeutic effect B) side effect C) toxic effect D) adverse effect

93. B

94. A nurse is conducting an interview for a health history. In addition to asking the patient about medications being taken, what else would be ask to assess the risk for drug interactions? A) the effects of prescribed medications C) daily amount of intake and output B) type and amount of foods eaten D) use of herbal supplements

94. D

95. A nurse is administering medications to a patient who emigrated from Asia. What should the nurse consider about the effects of the medications? A) unexpected side effects may occur as a result of slower metabolism B) expected side effects should be no different than in white patients C) the patient may require a larger-than-normal dose of a drug D) more rapid metabolism may interfere with drug absorption

95. A