Medication and I.V. Administration
A client has developed hospital-acquired pneumonia. When preparing to administer cephalexin 500 mg, the nurse notices that the pharmacy sent cefazolin. What should the nurse do? Select all that apply. Administer the cefazolin. Verify the medication prescription as written by the health care provider. (HCP). Contact the pharmacy and speak to a pharmacist. Request that cephalexin be sent promptly. Return the cefazolin to the pharmacy.
Verify the medication prescription as written by the health care provider. (HCP). Contact the pharmacy and speak to a pharmacist. Request that cephalexin be sent promptly. Return the cefazolin to the pharmacy.
The client visits the health care provider reporting a red, swollen, and painful right great toe and is subsequently diagnosed with gouty arthritis. Which drug does the nurse anticipate the healthcare provider to order? furosemide metolazone phenytoin allopurinol
allopurinol
The nurse prepares a teaching plan for a client who is to start clozapine. Which information is crucial to include? the importance of reporting insomnia an emphasis on the need for weekly blood tests measures to relieve episodes of diarrhea description of akathisia and drug-induced parkinsonism
an emphasis on the need for weekly blood tests due to the risk for agranulocytosis
Which type of solution raises serum osmolarity and pulls fluid from the intracellular and intrastitial compartments into the intravascular compartment? isotonic hypertonic electrotonic hypotonic
hypertonic
Which type of solution, when administered I.V., would cause fluid to shift from body tissues to the bloodstream? hypotonic isotonic sodium chloride hypertonic
hypertonic
A child with type 1 diabetes develops diabetic ketoacidosis and receives a continuous insulin infusion. Which condition represents the greatest risk to this child? hypercalcemia hyperphosphatemia hypokalemia hypernatremia
hypokalemia
A client's serum ammonia level is elevated, and the health care provider prescribes 30 mL of lactulose. The nurse should assess the client for which expected effect of this drug? increased urine output improved level of consciousness increased bowel movements absence of nausea and vomiting
increased bowel movements
The health care provider (HCP) has prescribed nitroglycerin to a client with angina. The client also has closed-angle glaucoma. The nurse should contact the HCP to discuss the potential for which drug interaction? decreased intraocular pressure increased intraocular pressure hypotension hypertension
increased intraocular pressure
The sudden onset of which sign indicates a potentially serious complication for the client receiving an IV infusion? noisy respirations pupillary constriction halitosis moist skin
noisy respirations
A client is scheduled for surgery at 8 a.m.(0800). While completing the preoperative checklist, the nurse sees that the surgical consent form isn't signed. It's time to administer the preoperative analgesic. Which nursing action takes the highest priority in this situation? giving the client the preoperative analgesic at the scheduled time asking the client to sign the consent form notifying the surgeon that the client hasn't signed the consent form canceling the surgery
notifying the surgeon that the client hasn't signed the consent form
A client is to receive intravascular chemotherapy for 10 days. Which equipment should the nurse use for this procedure? short peripheral catheter central venous access in the femoral vein intravenous catheter insertion device peripherally inserted central catheter (PICC)
peripherally inserted central catheter (PICC)
Which laboratory test should the nurse monitor when the client is receiving warfarin sodium therapy? partial thromboplastin time (PTT) serum potassium arterial blood gas (ABG) values prothrombin time (PT)
prothrombin time (PT)
Which is most critical for the nurse to communicate to the health care provider (HCP) prior to placing an epidural analgesia catheter? The client: consumed 240 mL of beef broth 4 hours prior. has had an indwelling urinary catheter in place for 2 days. received enoxaparin 40 mg subcutaneously 1 hour ago. has an albumin level of 3.5 g/dL.
received enoxaparin 40 mg subcutaneously 1 hour ago.
An elderly client who experiences several adverse drug reactions may benefit from reduced drug dosages. nursing home placement. increased drug doses at longer intervals. frequent visits to the physician.
reduced drug dosages.
During gentamicin therapy, the nurse should monitor a client's serum potassium level. serum glucose level. partial thromboplastin time (PTT). serum creatinine level.
serum creatinine level.
The nurse is caring for a client who has a new prescription for amitriptyline for depression and is preparing to be discharged. What assessment is the nurse's priority? orthostatic hypotension constipation and dry mouth suicidal ideation extrapyramidal effects
suicidal ideation
A nurse is administering two drugs to a client at the same time. The nurse knows the most probable reason for giving the drugs together is tolerance. antagonism. hyporeactivity. synergism.
synergism.
Which I.M. injection site is appropriate for a 6-month-old infant? vastus lateralis muscle ventrogluteal area deltoid muscle gluteus maximus muscle
vastus lateralis muscle
A client is receiving magnesium sulfate at 3 g/hr intravenously. The bag of 1000 mL of normal saline contains 20 g of magnesium sulfate. How many mL/hr should the nurse set the IV pump rate in order to deliver 3 g/hr?
150 mL
Small air bubbles adhering to the interior surface of the syringe might have which effect on parenteral administration? altered onset of action altered duration altered drug absorption altered drug dose
altered drug dose
Which drug delivery system most effectively reduces the likelihood of medication errors? floor stock unit-dose individual prescription automated
automated
When positioned properly, the tip of a central venous catheter should lie in the superior vena cava. basilic vein. jugular vein. subclavian vein.
superior vena cava.
After knee replacement surgery, a client is being discharged with acetaminophen with codeine 30 mg tablets for pain. During discharge preparation, the nurse should include which instruction? "Avoid driving a car while taking this medication." "Decrease your fluid intake to two glasses daily." "Take the medication on an empty stomach." "Report any fine motor tremors to your physician."
"Avoid driving a car while taking this medication."
A client is to be discharged with a prescription for an analgesic that is a controlled substance. Which comment by the client indicates to the nurse that further teaching is needed? "I will avoid sharp objects." "I will keep the medication in a safe place." "I know I can titrate the dose according to the pain level." "I will avoid operating a motor vehicle."
"I know I can titrate the dose according to the pain level."
The nurse is preparing a client for a cardiac catheterization. Which client statement would the nurse need to report to the healthcare provider immediately? "I am allergic to penicillin and midazolam." "I have not been able to eat since yesterday." "I took my metformin this morning." "I am very claustrophobic in small spaces."
"I took my metformin this morning."
Which statement made by a client who is taking misoprostol indicates a therapeutic outcome of therapy? "My stomach feels better." "My heart doesn't beat as fast now." "I can breathe easier." "My blood pressure is normal."
"My stomach feels better."
A client states, "I have never taken a yellow pill before for my blood pressure. Why are you giving me this pill?" After verifying that the nurse has prepared the correct medication, which statement by the nurse would be accurate? "This is the same medication that you take at home but in generic form." "We use all kinds of brands at the hospital so I am sure it is correct." "You can refuse to take this medication if you wish." "I think you must be confused; this is the right medication."
"This is the same medication that you take at home but in generic form."
A nurse needs to give a pediatric client furosemide orally before one unit of packed red blood cells. How many mL should the nurse give? Record the answer using a whole number. Order: Furosemide 3 mg/kg/dose orally Dose on hand: Furosemide 40 mg/5 mL Client's weight: 40 kg
15
The nurse is preparing to administer a flu shot to an adult client. How would the nurse proceed? Place the steps in sequential order. All options must be used. Clean the injection site with an alcohol pad. Gently stretch the skin taut at the site. Locate the deltoid muscle. Wait 10 seconds before removing needle. Inject it into the muscle at a 90-degree angle. Put gloves on.
1Put gloves on. 2Locate the deltoid muscle. 3Clean the injection site with an alcohol pad. 4Gently stretch the skin taut at the site. 5Inject it into the muscle at a 90-degree angle. 6Wait 10 seconds before removing needle.
A child with a body surface area (BSA) of 0.82 m2 has been prescribed actinomycin 2.5 mg/m2 intravenously. What is the correct amount to be given? Record your answer using two decimal places.
2.05
The physician prescribes acetaminophen 650 mg by mouth every 4 hours for a client with a temperature of 102° F (38.8° C) who has a feeding tube in place. The nurse has acetaminophen solution on hand containing 160 mg/5 ml. How many milliliters of solution should the nurse administer? Record your answer using one decimal place.sm.
20.3
A nurse is preparing to give an average-size 9-year-old child a preoperative I.M. injection. Which size needle should the nurse use? 20G, 1″ 20G, 1½″ 22G, 1″ 22G, 1½″
22G, 1″
A client is receiving an intravenous (IV) infusion of heparin sodium at 1200 units per hour. The dilution is 25,000 units per 500 mL. How many milliliters per hour will this client receive? Round your answer to a whole number.
24 mL/hr
The maximum transfusion time for a unit of packed red blood cells (RBCs) is 1 hour. 2 hours. 4 hours. 6 hours.
4 hours.
After undergoing small-bowel resection, a client is prescribed metronidazole 500 mg intravenously. The mixed solution is 100 ml. The nurse is to administer the drug over 30 minutes. The drop factor of the available intravenous tubing is 15 gtt/ml. What is the drip rate in drops per minute? Record your answer using a whole number.
50
The client is admitted to the medical/surgical unit for treatment of acute thrombophlebitis of the right calf. The client is administered 5000 units of heparin IV, followed by 1000 units of IV heparin per hour. Which action by the nurse is most appropriate if the client receives too much heparin? Have vitamin K readily available. Administer protamine sulfate. Administer calcium gluconate. Have warfarin sodium readily available.
Administer protamine sulfate.
A client reports pain in the right heel and is requesting medication. The nurse assesses the client and administers an analgesic. The client experiences no pain relief and states that the heel pain is worse. What is an appropriate intervention by the nurse? Repeat the dose of analgesic every hour. Call the physician to report the finding. Massage the client's foot in a circular motion. Apply warm, moist heat to the right ankle area.
Call the physician to report the finding.
A graduate nurse is reviewing the procedure for removing a peripherally inserted central catheter (PICC) with the preceptor. Which planned action by the graduate nurse should the preceptor correct? Measuring the length of the removed catheter and comparing it with the documented length of the inserted catheter Discarding the catheter in a trash container Flushing the PICC with 0.9% sodium chloride before removing it Applying a dressing over the site and leaving it in place for 24 hours
Discarding the catheter in a trash container
A client is using patient-controlled analgesia (PCA) to manage postoperative pain. What should the nurse do when assisting the client with the PCA? Reassure the client that pain will be relieved. Document the client's response to pain medication. Instruct the client to continue pressing the system's button whenever pain occurs. Titrate pain medication until the client is free from pain.
Document the client's response to pain medication.
The nurse is caring for a child who has an order for penicillin. The parents ask the nurse about penicillin allergies. Which information should be included when teaching the parents about penicillin allergies? Select all that apply. Hives may develop 1 to 72 hours after initiation of the drug. Wheezing and trouble breathing indicate a severe allergy. Allergies to penicillin will cause high fevers and seizures. If a rash develops, it is safe to switch to a cephalosporin. Children outgrow penicillin allergies and can take the drug in the future.
Hives may develop 1 to 72 hours after initiation of the drug. Wheezing and trouble breathing indicate a severe allergy.
A nurse is monitoring the effectiveness of a client's drug therapy. When should the nurse obtain a blood sample to measure the trough drug level? 1 hour before administering the next dose Immediately before administering the next dose Immediately after administering the next dose 30 minutes after administering the next dose
Immediately before administering the next dose
A nurse is caring for a client with a history of GI bleeding, sickle cell anemia, and a platelet count of 22,000 mm3. The client, who is dehydrated and receiving dextrose 5% in half-normal saline solution at 150 ml/hour, reports having severe bone pain and is scheduled to receive a dose of morphine sulfate. For which administration route should the nurse question an order? Oral Intravenous (IV) Intramuscular (IM) Subcutaneous (s.q.)
Intramuscular (IM)
The nurse learns that a client who is scheduled for a tonsillectomy has been taking 40 mg of oral prednisone daily for the last week for poison ivy on the leg. What should the nurse do first? Document the prednisone with current medications. Notify the surgeon of the poison ivy. Notify the anesthesiologist of the prednisone administration. Withhold all preoperative medications.
Notify the anesthesiologist of the prednisone administration.
A nurse is caring for a client who is vomiting. The physician has ordered oral dimenhydrinate. What is the most appropriate action by the nurse to help the client? Administer the medication intravenously due to the vomiting. Notify the physician of the vomiting, and obtain a new medication order. Administer the oral medication, and monitor the client's emesis. Wait for the vomiting to cease, and then administer the oral medication.
Notify the physician of the vomiting, and obtain a new medication order.
A nurse fails to give the evening dose of an IV antibiotic that is to be administered every 12 hours. The evening dose was scheduled for 1800; it is now 2200. What should the nurse do next? Report the incident to the health care provider. Assess the client for increasing signs of infection. Administer the 1800 dosage now. Call the pharmacist for instructions.
Report the incident to the health care provider.
A physician writes a medication order for meperidine 500 mg. The nurse's appropriate action would be to give the medication as ordered. clarify the order with the pharmacy. clarify the order with the physician. clarify the order with another nurse on the unit.
clarify the order with the physician.
A client is asking about dietary modifications to counteract the long-term effects of prednisone. What is the most appropriate information for the nurse to give the client? "Increase your intake of calcium and vitamin D." "Increase your intake of complex carbohydrates." "Increase your intake of polyunsaturated fats." "Increase your intake of dietary sodium."
"Increase your intake of calcium and vitamin D."
An older adult who experienced a brief delirium realizes that the condition was caused by prescription medication intoxication. Which statement indicates the need for further education? "I never realized that taking a little extra medication now and then could cause such a problem." "I get medicines from three different doctors and they don't all know what I'm taking." "I thought that the herbal medicines would help me. I never realized they would make me sick." "I didn't know that cold and flu medicines might not mix with my regular medicines."
"I get medicines from three different doctors and they don't all know what I'm taking."
The home care nurse is conducting a follow-up visit to a client who was recently discharged to home with intermittent total parental nutrition (TPN) therapy. What statement by the client leads the nurse to determine that additional teaching is needed? "I will change the I.V. administration tubing every week." "If the catheter dressing becomes loose, I will change the dressing." "I will wash my hands prior to initiating my nightly TPN." "I will avoid catheter contact with lint-producing materials."
"I will change the I.V. administration tubing every week."
Propranolol is ordered for a client that has Type 1 diabetes mellitus. Which client statement indicates understanding of a common side effect of this therapy? "I will check my blood glucose at least twice a day." "I will check my weight every month." "I will use nasal spray if my nose gets stuffy." "I will carry tissues because my eyes will water."
"I will check my blood glucose at least twice a day."
An adolescent with cystic fibrosis has been placed on ciprofloxacin for a lung infection. Which statement from the client indicates the need for more teaching? "I won't take this drug with any dairy products." "I'll need to have drug levels drawn while I'm on this medication." "I should immediately report any muscle or joint pain." "If I miss a dose, I should take it as soon as I remember."
"I'll need to have drug levels drawn while I'm on this medication."
The nurse is caring for a client who has been prescribed a benzodiazepine medication for acute anxiety. What information is most important for the nurse to include when teaching the client about the medication? "Take the medication as prescribed as there is risk for addiction." "You can only take this medication for a few days due to the side effects." "This medication may keep you awake, so plan to take it in the morning." "This medication should be taken with food for best absorption."
"Take the medication as prescribed as there is risk for addiction."
The client was recently diagnosed with a hiatal hernia. The healthcare provider orders an antacid that has reduced adverse effects. What should the nurse include in the client's teaching about the side effects of antacids? "A side effect of an antacid is fast breathing." "The major side effect of an antacid is diarrhea." "A side effect of an antacid is a decreased urge to urinate." "The major side effect of an antacid is profuse sweating."
"The major side effect of an antacid is diarrhea."
Three days after surgery, a client continues to take hydrocodone 7.5 mg and acetaminophen 500 mg for postoperative pain. What should the nurse ask the client before administering the pain medication? "When did you last have a bowel movement?" "Have you emptied your bladder?" "How long has it been since your last dose?" "Is your pain better than before you had surgery?"
"When did you last have a bowel movement?"
A client who has been taking flunisolide nasal spray, two inhalations a day, for treatment of asthma has painful, white patches in the mouth. What should the nurse tell the client? "This is an anticipated adverse effect of your medication. It should go away in a couple of weeks." "You are using your inhaler too much and it has irritated your mouth." "You have developed a fungal infection from your medication. It will need to be treated with an antifungal agent." "Be sure to brush your teeth and floss daily. Good oral hygiene will treat this problem."
"You have developed a fungal infection from your medication. It will need to be treated with an antifungal agent."
A nurse working in a blood conservation program is being mentored by a supervising nurse. A client asks for information about iron supplements and epoetin alfa as alternatives to a blood transfusion. Which response by the nurse causes the supervising nurse to plan a review of professional and ethical standards? "You should take the unit of blood. It will help you feel better." "Do you have all the information you need for informed consent?" "Do you have any questions that I can clarify for you?" "Tell me how the nurse educator explained the procedure."
"You should take the unit of blood. It will help you feel better."
Because of a shortage of IV infusion pumps, a nurse must regulate a client's IV by gravity flow. The client has a prescription for 1000 mL of 0.9 normal saline to infuse at 100 mL/hr. The tubing drop factor is 10 drops/mL. At what drip rate should the nurse set the infusion? 17 drops per minute 6 drops per minute 60 drops per minute 10 drops per minute
17 drops per minute
A client is to receive 1 unit of packed red blood cells over 2 hours. There are 250 mL in the infusion bag. The IV administration infusion set delivers 10 gtt/mL. At what flow rate (in drops per minute) should the nurse run the infusion? Record your answer using a whole number.
21 gtt/min
A client who is experiencing an exacerbation of ulcerative colitis is receiving IV fluids that are to be infused at 125 mL per hour. The IV tubing delivers 15 gtt/mL. How quickly should the nurse infuse the fluids in drops per minute to infuse the fluids at the prescribed rate? Record your answer using a whole number.
31 gtt/min 125 mL/60 min × 15 gtt/1 mL = 31 gtt/min.
Two days after a client undergoes repair of a ruptured cerebral aneurysm, a physician orders mannitol, 0.5 g/kg to be infused over 60 minutes. The client weighs 175 lb. The nurse should administer how many grams of mannitol? Record your answer using a whole number.
40 g
The emergency department nurse is caring for a client having a STEMI. The health care provider has prescribed a weight-based heparin bolus of 40 units/kg, with a maximum dose of 4000 units. The client weighs 250 lb (113.64 kg). How many units of heparin will the nurse give?
4000 units
A client who underwent surgery had this intake on the day of the procedure: Day shift: 500 mL packed blood cells and 236 mL platelets in additive solution; 750 mL normal saline solution; 1 L dextrose 5% in normal saline solution Evening shift: 250 mL normal saline solution; 1 L dextrose 5% in normal saline solution Night shift: 1 L dextrose 5% in normal saline solution. How many milliliters of solution should the nurse document as the client's 24-hour intake? Record your answer using a whole number.
4736 mL
The nurse must administer ferrous sulfate to an infant who weighs 8 lb 13 oz (4.00 kg). The dosage prescribed is 6 mg/kg/day to be given in three doses. What would be the correct amount to be administered for each dose? Record your answer using a whole number.
8
A client in the intensive care unit has a critically low potassium level of 1.9 mEq/l (mmol/l). What would be the best way to replace this client's potassium? Administer two potassium chloride 10 mEq (10 mmol) in 100 ml 0.9% sodium chloride IVPB, over 1 hour each Administer 20 mEq (20 mmol) potassium chloride by mouth once Administer sodium polystyrene 30 g PO once Administer 20 mEq (10 mmol) potassium chloride in 100 ml 0.9% sodium chloride IV as a rapid free-flowing bolus
Administer two potassium chloride 10 mEq (10 mmol) in 100 ml 0.9% sodium chloride IVPB, over 1 hour each
The nurse is obtaining blood from a central venous access device (CVAD) using aseptic technique and during the procedure soils the CVAD dressing with blood. After the sample is obtained and sent to the laboratory, what should the nurse do next? Redraw the specimen from the CVAD using sterile technique. Call the health care provider regarding contamination of the CVAD dressing. Reinforce the CVAD dressing. Change the soiled dressing per facility policy.
Change the soiled dressing per facility policy.
A client who is 1 day postoperative is using a morphine patient-controlled analgesia (PCA) pump. The client is confused and disoriented. What is the priority intervention by the nurse? Check respiratory rate and depth as well as oxygen saturation levels. Check the pulse rate and blood pressure. Check whether the client is self-administering a bolus too frequently. Check for shortness of breath, signifying a pulmonary embolism.
Check respiratory rate and depth as well as oxygen saturation levels.
Before administering an opioid prescribed for pain management, the nurse assesses a client using the Pasero Opioid-Induced Sedation Scale (POSS) (see chart). The nurse assigns a score of 3 based on the assessment criteria for the scale. What should the nurse do next? Continue to administer the medication because the client is well sedated. Increase the dose if the client becomes restless. Contact the health care provider (HCP) to request a decreased dose of the medication. Prepare to administer a reversal agent.
Contact the health care provider (HCP) to request a decreased dose of the medication.
A client is receiving spironolactone for treatment of bilateral lower extremity edema. The nurse should instruct the client to make which nutritional modification to prevent an electrolyte imbalance? Increase intake of milk and milk products. Restrict fluid intake to 1,000 mL/day. Decrease foods high in potassium. Increase foods high in sodium.
Decrease foods high in potassium.
A client with hyperthyroidism is to take saturated solution of potassium iodide (SSKI). What should the nurse do when administering this drug? Pour the solution over ice chips. Mix the solution with an antacid. Dilute the solution with water or juice. Mix the solution in pureed fruit.
Dilute the solution with water or juice.
While making rounds, the nurse observes that a client's primary bag of intravenous (IV) solution is light yellow. The label on the IV bag says the solution is dextrose 5% in water (D5W). What should the nurse do first? Continue to monitor the bag of IV solution. Ask another nurse to look at the solution. Notify the health care provider (HCP). Hang a new bag of D5W, and complete an incident report.
Hang a new bag of D5W, and complete an incident report.
The client who is just starting to wake up from a moderate sedation procedure repeatedly asks the nurse, "Where am I? What happened to me?" What action does the nurse take in response to the client's condition? No action is required based on the client's condition. Assess the client for signs of an acute head injury. Request a reversal agent for the medications administered. Assess the client for evidence of acute stroke.
No action is required based on the client's condition.
The nurse should dispose of a used needle and syringe by: Cutting the needle at the hilt in a needle cutter before disposing of it in the universal precaution container in the client's room. Placing uncapped, used needles and syringes immediately in the universal precaution container in the client's room. Recapping the needle and placing the needle and syringe in the universal precaution container in the client's room. Separating the needle and syringe and placing both in the precaution container in the client's room.
Placing uncapped, used needles and syringes immediately in the universal precaution container in the client's room.
A health care provider prescribes gentamicin for a client with peritonitis. The client has preexisting impaired vision and hearing. What should the nurse do? Give the drug as prescribed. Question whether the drug is appropriate for treatment of peritonitis. Question the prescription because gentamicin could cause further hearing impairment. Question the prescription because gentamicin could cause further visual impairment.
Question the prescription because gentamicin could cause further hearing impairment.
A client is receiving vincristine. What should the nurse instruct the client to do when taking this drug? Use loperamide for diarrhea. Restrict fluids to 6 cups (about 1½ L) a day. Follow a low-fiber, bland diet. Take a stool softener daily.
Take a stool softener daily.
A female client is treated for trichomoniasis with metronidazole. What should the nurse tell the client about this medication? The medication should not alter the color of the urine. The client should discontinue oral contraceptive use during this treatment. The client should avoid alcohol during treatment and for 24 hours after completion of the drug. The client's partner does not need treatment.
The client should avoid alcohol during treatment and for 24 hours after completion of the drug.
A client is taking iron supplements. What information should the nurse give the client? Iron supplements should be taken on an empty stomach. Do not use a bulk laxative. The stools will become darker. Liquid iron supplements will not discolor teeth.
The stools will become darker.
Which factors influence safe and effective medication administration for elderly clients? There is a lower risk of drug interactions. There is more likelihood of taking medications on time. There is an increase in lipid solubility and distribution throughout the body. There is less efficient absorption, detoxification, and elimination.
There is less efficient absorption, detoxification, and elimination.
The pediatric nurse is preparing to administer ibuprofen to an 8-month-old infant. The infant's weight is listed in the computer as 15 kg (33 lb) and the medication is prescribed to be given 10 mg/kg. The nurse notices that the dose of 150 mg seems high for an infant. The nurse clarifies the prescription with the healthcare provider, who states that it is the correct dose. What should the nurse do? Administer the medication as prescribed because the healthcare provider said it is correct. Verify child's weight is accurate and, if it is correct, give the medication. Notify the healthcare provider's superior about the medication prescription. Document the healthcare provider's response on the medical record.
Verify child's weight is accurate and, if it is correct, give the medication.
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. Lie the child on the right side with the left ear facing up. Examine the ear canal for drainage. Gently pull the pinna up and back and instill the drops into the external ear canal.
Wash hands and arrange supplies at the bedside. Warm the medication to the body temperature. Examine the ear canal for drainage.
The health care provider prescribes an intramuscular injection of vitamin K for a term neonate. The nurse explains to the parent that this medication is used to prevent which problem? hypoglycemia hyperbilirubinemia hemorrhage polycythemia
hemorrhage
Which type of solution, when administered I.V., would cause fluid to shift from body tissues to the bloodstream? hypotonic isotonic sodium chloride hypertonic
hypertonic
A client has been given propofol for a moderate sedation procedure for the reduction of a dislocated shoulder. The nurse notifies the health care provider that the client is having a serious adverse reaction to the propofol based on what findings? hypotension and apneic episodes abnormal urine color and dry mouth nausea and vomiting headache and redness at injection site
hypotension and apneic episodes
The client is having mild pain and inquires about what medications they can use. Which analgesic will the nurse teach the client to use for mild pain? Select all that apply. ibuprofen fentanyl acetaminophen hydrocodone naproxen
ibuprofen acetaminophen naproxen
A client who has been taking furosemide has a serum potassium level of 3.2 mEq/L. Which assessment findings by the nurse would confirm an electrolyte imbalance? muscle weakness and a weak, irregular pulse diarrhea and cramps tetany and tremors mental status changes and poor tissue turgor
muscle weakness and a weak, irregular pulse
The nurse has administered aminophylline to a client with emphysema. Which indicates the medication has been effective? relief from spasms of the diaphragm relaxation of smooth muscles in the bronchioles efficient pulmonary circulation stimulation of the medullary respiratory center
relaxation of smooth muscles in the bronchioles
A client is refusing to take the prescribed oral medication. Which measure by the nurse can be used to get the client to take the medication? Select all that apply. crushing the medication and hiding it in apple sauce suggesting a liquid form of the medication instead of a pill asking the client the reason for not taking the medication explaining the purpose of the medication to the client having a family member give the medication
suggesting a liquid form of the medication instead of a pill asking the client the reason for not taking the medication explaining the purpose of the medication to the client
A client with heart failure is given a prescription for torsemide. Two days after the drug therapy is started, which sign indicates the drug is having the intended outcome? The client: has an improved appetite and is eating better. weighs 7 lb (3 kg) less than the client did 2 days ago. is less thirsty than before the drug therapy. has clearer urine since starting torsemide.
weighs 7 lb (3 kg) less than the client did 2 days ago.
When administering an IM injection, when should the nurse use the Z-track technique? when the medication has a long absorption time when the medication takes effect very quickly when the medication is irritating to tissues when the medication has a viscous consistency
when the medication is irritating to tissues
A nurse overhears the following conversation between coworkers: "Older people have lost many friends and family and also have health problems. Their anxiety and worries can be so severe that they need higher doses of benzodiazepines than most people." What is the most appropriate response for the nurse to make to the coworkers? "You're right. Many older adults have had anxiety for so long that it's more difficult to treat." "That's not right. Older people need lower doses than most people because of reduced liver and kidney function." "You're wrong. It's not safe to use benzodiazepines at all in older adults because of the side effects." "Older people should get the same dose as any other adult. It doesn't make any difference."
"That's not right. Older people need lower doses than most people because of reduced liver and kidney function."
Which statement indicates that a new graduate nurse understands central venous pressure (CVP) measurement when used on a client? "The test accurately measures rate and rhythm of breathing patterns." "The test determines approximate blood pressure." "A high CVP leads to superior vena cava syndrome." "The test will assess pressure and volume changes in the right atrium."
"The test will assess pressure and volume changes in the right atrium."
A client with asthma has been prescribed fluticasone, one puff every 12 hours per inhaler. Place in correct order the nurse's statements when teaching the client how to properly use the inhaler with a spacer. "Hold your breath for at least 10 seconds, then breathe in and out slowly." "Take off the cap and shake the inhaler." "Press down on the inhaler once and breathe in slowly." "Rinse your mouth." "Attach the spacer." "Breathe out all of your air. Hold the mouthpiece of your inhaler and spacer between your teeth with your lips closed around it."
1"Take off the cap and shake the inhaler." 2"Attach the spacer." 3"Breathe out all of your air. Hold the mouthpiece of your inhaler and spacer between your teeth with your lips closed around it." 4"Press down on the inhaler once and breathe in slowly." 5"Hold your breath for at least 10 seconds, then breathe in and out slowly." 6"Rinse your mouth."
A client is upset to learn that corticosteroids need to be taken to control symptoms of systemic lupus erythematosus (SLE). While the nurse is preparing to administer medication, the client refuses to take it, stating, "This is turning me into an old woman before my time." What is the best response by the nurse? Explain that the symptoms of the disease are chronic and progressive and much worse than the side effects from the drugs. Ask about the medication side effects that are a concern and explain why suddenly stopping the drug can cause problems. Encourage the client to take the medication until able to consult with her physician regarding the side effects. Document the refusal to take the medication and notify the physician.
Ask about the medication side effects that are a concern and explain why suddenly stopping the drug can cause problems.
What assessment findings would lead the nurse to suspect that the client has an addiction to a pain medication? Select all that apply. Client tapers off pain medication. Client compulsively uses the pain medication. Client requests acetaminophen instead of the pain medication. Client loses control of use of pain medication. Client continues use of pain medication despite of risk of harm.
Client compulsively uses the pain medication. Client loses control of use of pain medication. Client continues use of pain medication despite of risk of harm.
A new nurse is preparing to dispense medications to the assigned clients. The medications are provided by the pharmacy in individualized single-dose packaging. Which step is most important to ensure that each client receives the correct medication? Ask the client if the medications are the same as those taken at home. Double check the medication in the package with a resource on the internet. Compare the prescriber's original order with the label on the pharmacy package. Have a second nurse verify the medications to be given.
Compare the prescriber's original order with the label on the pharmacy package.
The nurse is reviewing an order for sliding scale insulin for a client with diabetes. Which parts of the order should the nurse question? Select all that apply. For blood glucose of 1-145 mg/dL (0-8 mmol/L): Give 3 units of regular insulin. For blood glucose of 162-216 mg/dL (9-12 mmol/L): Give 5 units of NPH insulin. For blood glucose of 220-270 mg/dL (13-15 mmol/L): Give 8 units of regular insulin. For blood glucose of 288-360 mg/dL (16-20 mmol/L): Give 10 units of regular insulin. For blood glucose greater than 360 mg/dL (20 mmol/L): Give 12 units of insulin glargine.
For blood glucose of 1-145 mg/dL (0-8 mmol/L): Give 3 units of regular insulin. For blood glucose of 162-216 mg/dL (9-12 mmol/L): Give 5 units of NPH insulin. For blood glucose greater than 360 mg/dL (20 mmol/L): Give 12 units of insulin glargine.
A client taking furosemide and digoxin for exacerbation of heart failure reports weakness and heart fluttering. What would be the priority action by the nurse? Tell the client to rest more often to decrease symptoms. Tell the client to stop taking the digoxin and to stop all physical activity. Investigate the symptoms further with the client and suggest contacting the physician. Offer the client clear instructions about avoiding foods that contain caffeine.
Investigate the symptoms further with the client and suggest contacting the physician.
A nurse is preparing to administer digoxin elixir to a client. Which principle regarding this medication is correct? The adult therapeutic level for digoxin is 2 to 3 mg/ml. Although serious, digoxin toxicity isn't life-threatening. Digoxin shouldn't be administered if the client's heart rate is below 100 beats/minute or lower. Liquid digoxin should be measured with a calibrated dropper or syringe.
Liquid digoxin should be measured with a calibrated dropper or syringe.
Which information should the nurse include in a teaching plan that addresses the adverse effects of antipsychotic medication? information about all potential adverse effects research data about rare adverse effects adverse effects that can be seen or felt percentages associated with each adverse effect
adverse effects that can be seen or felt
While attempting to obtain a blood sample from a peripherally inserted central catheter (PICC) line with a nonocclusive dressing, the nurse inadvertently dislodges the catheter. The catheter did not come all the way out and is still partially inserted. What should the nurse do first? Change the catheter dressing and document the incident. Secure the catheter and send the client for a chest x-ray. Remove the dressing and push the catheter back in place. Secure the catheter and call the health care provider.
Secure the catheter and call the health care provider.
The nurse is reviewing laboratory values on a client with heart failure and atrial fibrillation. The client has a potassium level of 2.8 mEq/L (2.8 mmol/L). The client is scheduled to receive their 0900 dose of digoxin. What is the nurse's best action? Draw a stat potassium level and compare the earlier result with the current result. Administer the dose of digoxin and offer the client a banana with breakfast. Withhold the dose of digoxin and notify the healthcare provider. Give half of the digoxin and offer potassium-rich foods all day. Review the dietary needs of the client and consult the dietitian.
Withhold the dose of digoxin and notify the healthcare provider.
A client with an I.V. of normal saline at 150 mL/hour reports dyspnea and restlessness. What is the priority nursing action? decrease IV rate assess lung sounds obtain client weight obtain electrolyte laboratory results
assess lung sounds
During a client's recent admission, family members report exhaustion and difficulty taking care of the dependent client at home. The client's interests are best served by: facilitating a meeting with family members and the patient to discuss concerns. providing the caregivers with information on support groups for similar conditions. encouraging the family to transfer the client to a nursing care facility. calling a family conference and asking Social Services or Service Canada for assistance.
calling a family conference and asking Social Services or Service Canada for assistance.
A client with depression is taking a prescribed antidepressant that can cause anticholinergic side effects. The nurse anticipates that this client is at particular risk for developing which anticholinergic side effect? vomiting constipation diarrhea weight loss
constipation
The nurse is instructing a sexually active female who is taking isoniazid (INH). What should the nurse tell the client? INH: increases the risk for vaginal infection. has mutagenic effects on ova. decreases the effectiveness of hormonal contraceptives. inhibits ovulation.
decreases the effectiveness of hormonal contraceptives.
The emergency department nurse is assessing a client with reports of right-sided dull, abdominal and flank pain, nausea, and vomiting. The client's temperature is 101.2° F (38.4° C), pain is 10 out of 10, and rebound tenderness is exhibited. The health care provider orders: VS q 30 min, CBC, morphine 2 mg IM q 4 hours, regular diet, and enemas until clear. Which orders should the nurse question? Select all that apply. vital signs enemas until clear CBC morphine regular diet
enemas until clear regular diet
The client who is 28 weeks gestation is at the obstetric (OB) clinic reviewing lab work. The human immunodeficiency virus (HIV) test is positive, and treatment is indicated. Which medication should the nurse expect to administer that will help to prevent transmission of the virus to the fetus? zidovudine fluvastatin dimenhydrinate disulfiram
zidovudine
The nurse is assessing for blood return from a client's implanted port. Which nursing intervention is appropriate to assure that the needle will be flushed with pure saline? Wash hands before and after the procedure. Draw the smallest amount of blood required for the sample. Prevent blood from entering the saline flush syringe. Flush with heparin after drawing the sample.
Prevent blood from entering the saline flush syringe.
A client has been prescribed diuretic therapy for hypertension. It has been causing frequent urination at night and now the client is refusing to take the morning dose of furosemide. What would be the best response by the nurse? Reinforce the reason for the medication. Respect the decision if the client still refuses the medication, and chart the refusal. Take the blood pressure and then discuss with the client the dangers of an increased blood pressure if the medication is not taken. Tell the client that the extra fluid will be gone and urination will not be as frequent. Reinforce how much the edema has decreased and how effective the medication has been, and encourage the client to take the medication.
Reinforce the reason for the medication. Respect the decision if the client still refuses the medication, and chart the refusal.
An older adult tells the nurse they have been taking ibuprofen daily for the last few months. The nurse should assess the client for which potential side effect of the drug? rebound headaches neuropathy hypoglycemia impaired renal function
impaired renal function
