Fundys Medication Administration

A bedridden client is scheduled to receive subcutaneous injections of heparin at 8:00 a.m. and 8:00 p.m. each day. The client's medication administration record would present these times as

0800 and 2000

A nurse has administered one unit of glucose to the client as per order. What is the correct documentation of this information?

1 Unit of glucose

The nurse is teaching a client about using topical gentamicin sulfate. Which comment by the client indicates the need for additional teaching?

"I should apply it to large open areas."

Gentamicin sulfate 25 mg IM has been ordered every 6 hours. Gentamicin sulfate 40 mg/mL is available. How many milliliters (to the nearest tenth of a mL) should the nurse administer in each dose?

0.6

What is the maximum amount of medication (in milliliters) that can be administered into the deltoid muscle? Record your answer using a whole number.

2

A client complains of difficulty swallowing when the nurse tries to administer a medication in capsule form. What action should the nurse take next?

Check for availability of a liquid preparation.

The nurse is preparing to administer furosemide to a 3-year-old with a heart defect. After verifying the arm band, which is the most appropriate second identifier for the nurse to use?

Ask the parent the child's name.

The nurse gave the client the wrong medication. It is 2 hours later when the nurse realizes the error. What should the nurse do first?

Assess the client's condition.

The nurse manager on a pediatric floor is updating safety recommendations for the unit. Which strategy would help reduce pediatric medication errors? Select all that apply.

Avoid using parenteral syringes when administering liquid oral medications. Limit the size of IV fluid bags that can be hung on small children. Reduce the available concentrations or dose strengths of high-alert medications to the minimum.

To give a Z-track injection, a nurse measures the correct medication dose and then changes the needle on the syringe. What is the rationale for this action?

Changing the needle makes the injection less painful

The nurse is using the Z-track method of intramuscular (IM) injection to administer iron dextran to a client with iron-deficiency anemia. Which techniques should the nurse use to give this injection? Select all that apply.

Confirm the client's identity before administering the iron dextran. Change the needle after drawing up the iron dextran. Before inserting the needle, displace the skin laterally by pulling it away from the injection site. Inject the iron dextran after aspirating for a blood return.

The nurse in the emergency department is administering a prescription for 20 mg intravenous furosemide, which is to be given immediately. The nurse scans the client's identification band and the medication barcode. The medication administration system does not verify that furosemide is prescribed for this client; however, the furosemide is prepared in the accurate unit dose for intravenous infusion. What should the nurse do next?

Contact the pharmacist immediately to check the order and the barcode label for accuracy.

It is acceptable for the nurse to accept a verbal order from the physician in which of these situations?

During a medical emergency.

The nurse is preparing to administer 4 units of regular insulin to a client with type 1 diabetes mellitus. Which equipment does the nurse need to perform the injection? Select all that apply.

Medication administration record 27-gauge, ½" needle

An adolescent in the terminal stage of leukemia cries out for more pain medicine. What is the best action for a nurse to take in caring for this dying adolescent?

Give the adolescent more pain medication to control pain and suffering.

The unit secretary who transcribes the health care provider's (HCP's) prescriptions asks the nurse to interpret an illegible prescription. The nurse should clarify the prescription with the:

HCP

As a nurse-manager of a medical-surgical unit reviews the month's risk-management data, she notices that a number of incident reports were completed because 6 p.m.(1800) medications were administered late. Dinner is served between 5:30 p.m. (1730) and 6 p.m. (1800). Staff take their dinner breaks between 5 p.m. (1700) and 6:30 p.m.(1830). Based on this information, which is the most appropriate action for the nurse-manager to take?

Investigate when medications are given, staff and client dinner times, the number of medications that must be given at 6 p.m. (1800), and staff availability between 5 p.m. (1700) and 6 p.m. (1800).

What is one disadvantage of using the rectal route?

It can result in incomplete drug absorption.

What is the priority action that a nurse should take after omitting an ordered medication?

Notify the prescriber.

An infant received the wrong medication dose. What is the charge nurse's role in following up on the incident?

Objectively assess the circumstances surrounding the error.

Which technique is correct when the nurse is inserting a rectal suppository for an adult client?

Position the suppository along the rectal wall.

The nurse is preparing to administer a flu shot to an elderly client. How should the nurse proceed? Place the steps in sequential order. Use all the options.

Put gloves on. Locate the deltoid muscle. Clean the injection site with an alcohol pad. Expel air bubbles from the syringe. Gently stretch the skin taut at the sites. Inject it into the muscle at a 90-degree angle.

A registered nurse (RN) and licensed practical nurse (LPN) are administering medications on the neurologic floor. The LPN prepares to administer phenytoin to a client with a history of seizures. The LPN walks into the room and hands the medication to a nursing assistant. The LPN asks the nursing assistant to give the client the medication after completing the client's morning care. What should the registered nurse do?

Remind the LPN that it is the LPN's duty to administer the medications.

A nurse is preparing to administer cardiac medications to two clients with the same last name. The nurse checks the medication three times before entering the room to administer medications to the first client. While leaving the room, the nurse realizes they didn't check the client's identification before administering the medication. Which action should the nurse take first?

Return to the room, check the client's identification against the medication administration record, and complete a variance report if needed.

The nurse notes that a client's blood glucose level is increased. The nurse plans to inform the physician by phone. Which technique should the nurse use to communicate verbally to the physician?

SBAR

Eardrops have been prescribed to be instilled in the adult client's left ear to soften cerumen. To position the client, the nurse must do which of the following? Select all that apply.

Straighten the client's eustachian tube. Gently pull the auricle up and back.

The nurse is teaching the client how to use a metered-dose inhaler (MDI) to administer a corticosteroid. Which observations indicates that the client is using the MDI correctly? Select all that apply.

The inhaler is held upright. The client rinses the mouth with water following administration.

A medication order reads, "Meperidine 1 ml I.M. stat." A nurse responsible for administering the drug should base the next action on which understanding?

The nurse should clarify the order with the physician.

Which intervention is an example of primary prevention?

administering a measles, mumps, and rubella immunization to an infant

Which procedures can the nurse working on a pediatric floor safely delegate to the licensed practical/vocational nurse (LPN/VN)? Select all that apply.

administering gastrostomy tube feedings inserting hearing aids

When prioritizing a client's care plan based on Maslow's hierarchy of needs, a nurse's first priority would be

administering pain medication.

A nurse is developing a drug therapy regimen that won't interfere with a client's lifestyle. When doing this, the nurse must consider the drug's

adverse effects.

After receiving an I.M. injection, a client complains of burning pain at the injection site. Which nursing action would be most appropriate at this time?

applying a warm compress to dilate the blood vessels

Which drug delivery system most effectively reduces the likelihood of medication errors?

automated

A hospitalized client fell on the floor and sustained a small laceration on the hand that requires stitches. The intern will suture the client's hand at the client's bedside and asks for bupivacaine with epinephrine and a suture kit in order to suture the laceration. Which issue should be resolved before proceeding with suturing?

bupivacaine with epinephrine used as the local anesthetic.

When a nurse tries to administer medication, the client refuses it, saying, "I don't have to take those pills if I don't want to." What intervention by the nurse would have the highest priority?

exploring how the client's feelings affect the decision to refuse medication

A client requests medication at 9 p.m. (2100) instead of 10 p.m. (2200) so that the client can go to sleep earlier. Which type of nursing intervention is required?

independent

Which are appropriate identifiers to use when providing care or administering medications or treatments? Select all that apply.

medical record number name band

The nurse transcribes the physician's order onto the client's medication record:September 15, 2012Administer 10 gtt of timolol maleate ophthalmic solution AU daily.John Bloom, MDWhich components of the medication order should the nurse question? Select all that apply:

number of drops route

The charge nurse on a hematology/oncology unit is reviewing the policy for using abbreviations with the staff. The charge nurse should emphasize which information about why dangerous abbreviations need to be eliminated? Select all that apply.

to ensure efficient and accurate communication to prevent medication errors to ensure client safety

The nurse manager is developing a "read-back" procedure to reduce medication administration errors. What are purposes of the "read-back" requirement? Select all that apply.

to make sure that prescriptions and test results that are communicated verbally or by telephone are clear to the receiver of the information to make sure that prescriptions and test results that are communicated verbally or by telephone are confirmed by the individual giving the information

A day-shift nurse gives a client an injection of pain medication. The nurse forgets to document the injection on the medication administration record (MAR). The day-shift nurse tells the evening-shift nurse that she gave the client 4 mg of morphine at 2 p.m. for postoperative pain but didn't document the injection. The evening-shift nurse puts the day-shift nurse's initials and the date and time the dose was administered in the appropriate area of the MAR. The evening-shift nurse's action is considered to be which type of documentation error?

unauthorized entry

A client reports being allergic to amoxicillin even though the medication administration record and armband do not indicate medication allergies. What should the nurse do about administering the drug to the client?

Withhold the medication.

A physician's order for a client states the administration of a medication "b.i.d." How many times should the nurse administer the medication to the client?

Twice a Day

During the preoperative interview, the nurse obtains information about the client's medication history. Which information is not necessary to record about the client?

use of all drugs taken in the last 18 months

The nurse is preparing to give an IM injection. to an underweight client. Which site is the safest because it has the fewest amount of blood vessels and major nerves located in the area?

vastus lateralis

A client's diagnosis of pneumonia requires treatment with antibiotics. The corresponding order in the client's chart should be written as

moxifloxacin 400 mg daily

A nurse who fails to check a client's armband before administering medications is:

negligent.

Which type of medication order might read "Vitamin K 10 mg I.M. daily × 3 days?"

standing order

An adolescent client who has been taking an antidepressant for 6 weeks has returned to the clinic for a medication check. When the nurse talks with the client and her parent, the mother reports that she has to remind the client to take her antidepressant every day. The client says, "Yeah, I'm pretty bad about remembering to take my meds, but I never miss a dose because Mom always bugs me about taking it." Which response would be effective for the nurse to make to the client?

"It seems there are some difficulties with being responsible for your medications that we need to address".

A physician writes an order for a client that says: "Digoxin .125 mg P.O. once daily." To prevent a dosage error, how should the nurse transcribe this order onto the medication administration record?

Digoxin 0.125 mg P.O. once daily"

A nurse needs to enter into the computer the time the client took medication. However, the time is written in the military format, and the computer accepts only the traditional format. How should the nurse enter the time in the computer if the client took medication at 1530 hrs?

03:30 p.m.

The nurse is preparing to administer ear drops to a 2-year-old client with an infection of the external auditory canal. The order reads, "2 drops in the right ear three times per day." Which steps should the nurse take to administer this medication? Select all that apply.

Wash hands and arrange supplies at the bedside. Warm the medication to the body temperature. Examine the ear canal for drainage.

A nurse preparing to administer medications on the respiratory floor is using the computerized medication-dispensing system. Her password isn't working. The nurse should:

ask computer support to reset her password.

A nurse realizes that the dosage of the medication administered to the client has been entered incorrectly into the client records. Which would be the most appropriate action for the nurse?

strike out with a single line and place initials

A nurse inadvertently gives a client a double dose of an ordered medication. After discovering the error, whom should the nurse notify first?

the prescriber

Which intramuscular (IM) sites are appropriate for the nurse to use in an adult client? Select all that apply.

dorsogluteal muscle deltoid muscle vastus lateralis muscle rectus femoris muscle

The nurse is preparing to administer the last dose of ceftriaxone before discharge to a 1-year-old but finds the IV has occluded. What should the nurse do/?

Contact the prescriber to request a prescription change.

A nurse on the gynecologic surgery unit observes a respiratory therapist (RT) take a medication cup with pills that was sitting in the medication room. What course of action should the nurse take?

Report the situation to the nursing supervisor.

A client on the genitourinary floor has refused all medications for 3 days. A nurse caring for this client asks why he isn't complying with his medication. The client states, "I don't want to take those pills anymore." The nurse informs the client that he must take all the medication the physician orders. With this statement, the nurse has violated the:

client's right to refuse medication.

The nurse is observing a new graduate nurse instill eyedrops into a client's eyes. The nurse evaluates that the new graduate is using appropriate technique when which step is incorporated into the procedure?

The nurse's hand is stabilized on the client's forehead while instilling the drops.