PHARM NCLEX 4, 5, 6

The nurse is administering medications. Examples of high-alert medications include: (SELECT ALL THAT APPLY) a. insulins b. antibiotics c. opiates d. anticoagulants e. potassium chloride for injection

a. insulins c. opiates d. anticoagulants e. potassium chloride for injection

In which step of the medication process can a medication error occur? (Select all that apply.) a. Procurement b. Prescribing c. Transcribing d. Verification e. Administration

a. procurement b. prescribing c. transcribing e. administration Medication errors can occur at any point in the medication process: procuring, prescribing, transcribing, dispensing, and administration. Verification is a step in the medication reconciliation process.

What is the chief purpose of the program Micromedex? 1 To provide articles citing the latest health care research 2 To provide detailed drug information in different languages 3 To collect and store the patient's health-related information 4 To provide information about various diseases and their symptoms

2 The Micromedex program provides detailed information (dosage, side effects, and adverse effects) on various drugs in different languages. This program provides updated information about drugs but does not provide the latest articles on health care research. This program does not collect and save the health information of individual patients. The program also does not provide any information about diseases and their signs and symptoms. The purpose of the program is to ensure that people across various cultures are able to administer medications safely.

The nurse is caring for a patient whose body mass index is low. Which assessment will the nurse perform for effective management of the patient's health condition? 1 Sensory status 2 Nutritional status 3 Cognitive abilities 4 Mobility and motor skills

2 The assessment of the patient's health status is the primary step in the effective management of illness. The assessment includes several subjective and objective data. Patients with a lower body mass index are assessed for the nutritional status that is contributing to the disease condition. Assessment of the sensory status is needed for the patient with impaired touch or vibratory sensation. Cognitive abilities are assessed in patients with cognitive impairment and decreased mental status. Mobility and motor skills are assessed for patients with decreased musculoskeletal activity.

When the nurse completes patient teaching on a new medication, which method will the nurse use to evaluate the patient's understanding of the information? 1 Observe the patient taking the medication. 2 Ask specific questions to evaluate understanding. 3 Assess the patient for response to the medication. 4 Document the education session in the patient chart.

2 The nurse should ask the patient very specific questions to determine if the patient has a true understanding of the medication. Observing the patient taking the medication, checking the therapeutic response, and documenting the education session are not used to evaluate the patient's understanding of medication information.

The nurse is assessing an older adult who will undergo retinal surgery. What precaution will the nurse take to obtain the patient's informed consent? 1 Provide written instructions. 2 Print the material in bright colors. 3 Use interactive methods like audiovisuals. 4 Provide the instructions in an easy-to-read format.

2 The teaching-learning session should be brief and concise so that it can be easily understood by the patient. Certain conditions such as cognitive impairment require attentive care for the interaction. Nurses employ several methods in educating cognitively impaired patients. Older adults may have reduced visual acuity and have difficulty in reading and in distinguishing colors. Care should be taken that the printed material has a large font size and is printed in bright colors. Written instructions are provided to patients with decreased short-term memory. Audiovisuals are used for patients with decreased ability to think and analyze. Instructions in an easy-to-read format are used for patients with auditory impairments.

The nurse is teaching a group of nursing students about the steps involved in effective teaching-learning interaction to treat cardiac disorders. Prioritize the order of terms included in the lecture as they would be performed by a nurse. 1. Prevention of noncompliance 2. Nutritional status assessment 3. Reinforcement of the patient teaching 4. Use of Fry readability formula

2, 3, 1, 4 Assessment of nutritional status is the initial step in patient education about drug therapy. The assessment provides the health status and helps to identify the root cause of the condition in the patient. It is followed by prevention of noncompliance in the patient. Noncompliance can be minimized by providing devices such as medication calendars, pill reminder stickers, and weekly pill containers. The Fry readability formula provides essential information about the medication procedure. It is a computerized program that provides the material in the form of pamphlets, books, and pictures. However, illiterate and cognitively impaired patients are provided several interactive devices. Finally, the efficiency of the teaching is evaluated by the reinforcement of the technique in a summarized form.

What information will a nurse gather while performing an assessment of a patient's family support system for effective patient teaching? Select all that apply. 1 The eating habits in the family 2 The financial status of the family 3 The diseases that run in the family 4 The roles of the various family members 5 The communication patterns in the family

2, 4, 5 The nurse should gather information about the financial resources of the family, the various roles in the family, and communication patterns in the family. This should be done while performing assessment of the family support system. This information will help the nurse to plan out effective teaching to the patient. Knowing about the eating habits in the family is not a part of the assessment of the family support system. The nurse should also find out about the diseases that run in the family while identifying the diseases to which the patient is susceptible.

A visually impaired adolescent takes oral contraceptives. Which teaching and learning aid does the nurse use when educating this patient about drug administration? 1 Pictures 2 Videotapes 3 Audiotapes 4 Readability tools

3

The nurse is teaching a group of patients about drug administration. How will the nurse identify that the education is effective? 1 Gaining trust 2 Sharing knowledge 3 Observing changes in behavior 4 Incorporating the previous experience

3 Patient education is the most important task prior to the start of any medication or drug administration. The ultimate goal of patient education is learning. The nurse identifies effective learning by noticing marked changes in the behavior of the patients. Gaining trust is essential for providing knowledge of the treatment procedure. Sharing knowledge demonstrates effective teaching. Incorporating previous experiences is part of educating patients using affective domain.

A patient has difficulty reading without reading glasses, which are not at the hospital with the patient. What will the nurse do to promote an effective teaching session? 1 Repeat the instructions as many times as possible 2 Avoid contrast lighting when providing instructions 3 Observe the verbal and nonverbal cues of the patient 4 Place the instructional materials within the patient's visual field

4 Patients with decreased visual acuity face difficulty in making use of written instructions. Reading glasses can be helpful, but if the patient does not have glasses readily available, the nurse can plan the instructional materials within the patient's visual field to ensure an effective teaching session. Increasing the number of repetitions, avoiding contrast lighting, and observing the verbal and nonverbal cues may not be as directly helpful in coping with the patient's inability to read without reading glasses.

What resource will the nurse use to create written instructions for a patient to provide knowledge about the treatment plan? 1 Lexi-PALS 2 Micromedex 3 Erikson's stages 4 The Fry readability formula

4 Readability tools are used in developing educational materials and written instructions for the patients. These materials are provided as a support along with verbal instructions for an effective teaching-learning interaction. The Fry readability formula is an example of a readability tool for creating patient educational materials. Lexi-PALS and Micromedex are the computerized programs used for patient education. Erikson's stages have to do with assessment of development in patients based on the age factor.

The nurse is caring for a toddler. Which is an important characteristic to remember when giving toddlers medications? 1 The need to develop trust 2 The need to be with peers 3 The need to solve problems 4 The need to develop independence

4 Toddlers are learning to be autonomous and need to express their independence. Nurses should recall this and offer choices when possible. Infants are developing a sense of trust. Adolescents are developing peer relationships. Preschoolers are developing initiative and problem-solving abilities.

What organization announced new regulations requiring bar codes for all prescription and over-the-counter (OTC) medications? a. Drug Enforcement Agency (DEA). b.Federal Bureau of Investigation (FBI). c. U.S. Food and Drug Administration (FDA). d. Department of Health and Human Services (DHHS)

U.S. Food and Drug Administration (FDA)

During a busy night shift, a new nurse administered an unfamiliar medication without checking it in a drug handbook. Later that day, the patient had a severe reaction because he has renal problems, which was a contraindication to that drug. The nurse may be liable for A. medical negligence B. nursing negligence C. non-maleficence D. autonomy

B. nursing negligence

The nurse is reviewing facts about pharmacology. The term legend drug refers to which item? A. over the counter drugs B. prescription drugs C. orphan drugs D. herbal products

B. prescription drugs

High-alert medications are involved in more errors than other drugs. True or False.

False

True or False: All adverse drug events are caused by medication errors.

False

True or False: High-alert medications are involved in more errors then other drugs.

False

There are multiple factors that affect medication response. The nurse recognizes which factors as having a possible effect on medication response? (Select all that apply.) Patient compliance with therapy Genetic influences Body composition Use of alternative therapies Diet and nutrition Level of education Socioeconomic factors

Patient compliance with therapy Genetic influences Body composition Use of alternative therapies Diet and nutrition Level of education Many factors influence medication response for various reasons. For more information, see the section on Influence of Ethnicity and Genetics on Drug Response in your textbook.</div>

The nurse is assessing a patient's culture and race on admission to the hospital. Which concept is important for the nurse to understand regarding drug therapy as it relates to different races of individuals? Polypharmacy Polymorphism Pharmacokinetics Pharmacodynamics

Polymorphism Drug polymorphism refers to the effect of a patient's age, gender, size, body composition, and other characteristics on the pharmacokinetics of specific drugs. The race of an individual may influence drug therapy decisions for the individual. Polypharmacy is the use of many different drugs concurrently in treating a patient, who often has several health problems. Pharmacokinetics is the study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body. Pharmacodynamics is the study of what the drug does to the body.

Allergic reactions are often predictable. True or False

True

What are the three domains of learning

cognitive, affective, and psychomotor

If a student nurse realizes that he or she has made a drug error, the instructor should remind the student of which concept? a. the student bears no legal responsibility when giving medications. b. the major legal responsibility lies w the health care institution at which the student is placed for clinical experience. c. the major legal responsibility for drug error lies w the faculty members. d. once the student has committed a medication error, his or her responsibility is to the patient and to being honest and accountable.

d. once the student has committed a medication error, his or her responsibility is to the patient and to being honest and accountable.

The nurse is reviewing medication orders. Which digoxin dose is written correctly? a. digoxin .25 mg b. digoxin .250 mg c. digoxin 0.250 mg d. digoxin 0.25 mg

digoxin 0.25 mg

The nurse is performing medication reconciliation during a patient's admission assessment. Which question by the nurse reflects medication reconciliation? a. "Do you have any medication allergies?" b. "Do you have a list of all the medications, including over-the-counter, you are currently taking?" c. "Do you need to take anything to help you to sleep at night?" d. "What pharmacies do you use when you fill your prescriptions?"

"Do you have a list of all the medications, including over-the-counter, you are currently taking?"

The nurse is administering medications. Examples of high-alert medications include: (Select all that apply.) a. Chemotherapeutic agents b. Antibiotics c. Opiates d. Antithrombotics e. Potassium chloride for injection

- Chemotherapeutic agents. - Opiates. -Antithrombotics. -Potassium chloride for injection.

In which step of the medication process can a medication error occur? (Select all that apply.) a. Prescribing. b. Verification. c. Transcribing. d. Procurement. e. Administration.

-Prescribing. -Transcribing -Procurement. -Administration. -Medication errors can occur at any point in the medication process: procuring, prescribing, transcribing, dispensing, and administration. Verification is a step in the medication reconciliation process.

The nurse knows that the medication reconciliation process involves which steps? (Select all that apply.) a. Reporting. b. Verification. c. Clarification. d. Reconciliation. e. Administration.

-Verification. -Clarification. -Reconciliation. * The three steps of the medication reconciliation process are verification, clarification, and reconciliation.

Convert 250 micrograms to milligrams. Be sure to depict the number correctly according to the guidelines for decimals and zeroes.

0.25 mg

Convert 250 micrograms to milligrams. Be sure to depict the number correctly according to the guidelines for decimals and zeros.

0.25 mg

What strategy will the nurse implement in the effective teaching-learning interaction of drug administration in an illiterate patient? 1 Pictures 2 Pamphlets 3 Readability tools 4 Written instructions

1 The nurse plays a major role in educating the patient about the importance and methods of drug administration. Illiterate patients are incapable of reading written materials and so are educated by pictures. Pictures provide a clear and concise idea of the treatment procedure and thereby support verbal communication. Pamphlets, readability tools, and written instructions are used for patients who are capable of reading and abstracting the methodology of the treatment; these tools are not used for illiterate patients.

During the development of a new drug, which would be included in the study by the researcher to prevent any bias or unrealistic expectations of the new drug's usefulness? A. A placebo B. FDA approval C. Informal consent D. Efficacy information

A. A placebo

A patient is undergoing major surgery and asks the nurse about a living will. He states, "I don't want anybody making decisions for me. And I don't want to prolong my life." The patient is demonstrating: a. autonomy b. beneficence c. justice d. veracity

autonomy

New drugs must go through extensive research and testing before approval for use in humans. The nurse is providing education to a patient on a new medication and will inform the patient that the average length of time a medication is researched before being prescribed for humans is a. 2 to 4 years. b. 6 to 8 years. c. 10 to 12 years. d. 14 to 16 years.

c. 10 to 12 years The average length of time it takes for a drug to move from the application and research process to being prescribed for a patient is 10 to 12 years.

During the medication administration process, it is important that the nurse remembers which guideline? a. When in doubt about a drug, ask a colleague about it before giving the drug b. Ask what the patient knows about the drug before giving it c. When giving a new drug, be sure to read about it after giving it d. If a patient expresses a concern about a drug, stop, listen, and investigate the concerns

d. If a patient expresses a concern about a drug, stop, listen, and investigate the concerns

What behavior would be expected in a 5-year-old child according to Erikson's stages of development? 1 The child learns basic problem solving. 2 The child develops a sense of self-worth. 3 The child integrates many roles into self-identity. 4 The child establishes deep relationships with people.

1 According to Erikson's stages of development, a 5-year-old child (preschool age) learns basic problem solving skills and starts initiating activities. The child develops a sense of self-worth upon reaching the ages of 6 to 12; this is also known as the school-age group. The adolescence stage (12 to 18 years of age) is characterized by the adolescents' attempts to integrate many roles into their self-identity. People belonging to the 18 to 45 age group start developing deep and long-lasting relationships.

The nurse uses effective communication skills to gain the trust of a patient so that the patient is able to learn effectively. Which domain of learning is the nurse using to facilitate the learning process? 1 Affective domain 2 Cognitive domain 3 Behavioral domain 4 Psychomotor domain

1 Affective behavior refers to the conduct that expresses feelings, needs, beliefs, values, and opinions. The nurse is using communication skills to develop a rapport with the patient to facilitate learning. This indicates that the nurse is using the affective domain to facilitate the learning process. The cognitive domain of learning refers to the thinking process that is involved in the learning process. The behavioral domain does not belong to any type of learning domain. Psychomotor learning refers to the learning that occurs by performing different motor activities. It is accomplished by demonstrating the procedure.

The nurse is caring for a Spanish-speaking patient who is visually impaired. How can the nurse ensure an effective teaching-learning interaction? 1 By taking help from a translator 2 By providing written instructions 3 By using printed materials with a larger font 4 By performing a baseline hearing assessment

1 Nurses and health care professionals should be trained to provide patient education in the patient's native language. Communication in the patient's language helps to build rapport between the nurse and the patient. Therefore, a translator can be used for building a better nurse-patient relationship. A Spanish-speaking nurse can also help create a better teaching-learning interaction. Written instructions and printed materials with a larger font are used for cognitively impaired patients and may not be directly involved in the education of a non-English-speaking patient. Baseline hearing assessment is performed for patients with auditory impairment.

The nurse teaches a group of adolescent girls from a low socioeconomic background that contraceptives are not an effective treatment for sexually transmitted diseases. Which educational strategy will the nurse use to support the teaching process? 1 Pictures 2 Pamphlets 3 Written instructions 4 Educational materials

1 Patients from poor socioeconomic backgrounds may have minimal knowledge and limited educational status. Although verbal communication is a common process of patient education, the use of visual aids enhances the quality of teaching. Illustrations and pictures are most helpful for educating such patients. Pamphlets and educational materials are used in patients who are literate and are able to read and understand the information provided. Written instructions are commonly used for patients with short-term memory loss.

While teaching a group of older patients, the nurse finds that many of the patients pause before responding to questions. What is the most likely reason for this response? 1 They have impaired reaction time. 2 They have impaired short-term memory. 3 They have impaired cognitive functioning. 4 They have impaired ability to concentrate.

1 Several age-related barriers may influence the process of teaching-learning interaction among the patients. Older patients with impaired reaction time require a sufficient time for the teaching methodology and for receiving feedback. Patients with impaired short-term memory may need the nurse to repeat the procedure and provide written instructions. Patients who have an impaired ability to concentrate may benefit by decreasing external stimuli. Patients with cognitive impairment require a slow pace of presentation.

The nurse is caring for a patient who develops symptoms of hypoglycemia after taking vitamin supplements. What will the nurse assess for effective illness management? 1 Over-the-counter medication received 2 Psychosocial growth and development 3 Misinformation of treatment procedure 4 Alternative and complementary therapies

1 The assessment includes several observations and verbal communications with the patient. Dietary supplements may interact with over-the-counter medications to produce adverse reactions. Over-the-counter medications are assessed for drug-drug interactions in patients, as they can lead to adverse reactions. Psychosocial growth and development indicate Erikson's stages of development based on the age factor. Misinformation of the treatment procedure indicates the health illiteracy of the patient; therefore the patient may need reinforcement of the teachings provided. Alternative and complementary therapies usually do not cause adverse effects such as hypoglycemia.

Which process of patient education helps patients to make appropriate health decisions? 1 Health literacy 2 Affective domain 3 Cognitive domain 4 Psychomotor domain

1 The role of the nurse in educating the patient is applicable for both clinical care and self-care in home. Health literacy provides basic knowledge of the treatment plan. The basic knowledge includes the goal of treatment and its role in illness management. The affective domain explains the behavioral changes in the patient by verbal and nonverbal interaction. The cognitive domain refers to the learning and storage of basic knowledge. The psychomotor domain describes the techniques involved in the treatment plan.

The nurse is providing discharge teaching to an older adult with short-term memory problems. Which strategies will the nurse use in educating the patient? Select all that apply. 1 Repeat information frequently. 2 Provide written instructions for home use. 3 Perform several short teaching-learning sessions. 4 Instruct patient to take all medications in the morning. 5 Encourage use of daily medication containers with alarms.

1, 2, 3, 5 Repeating instructions, providing written instructions, and encouraging use of daily medication containers (which will remind the patient to take the medication as well as enable the patient to know whether medication has been taken) are all appropriate interventions for a patient with short-term memory difficulties. The nurse also may have to conduct several brief teaching-learning sessions for the patient to absorb the information. Having the patient take all the medications at once does not necessarily prevent overdosage or ensure that they will be taken. Also, some medications may have adverse interactions if taken at the same time.

The nurse is teaching a group of nursing students about health illiteracy in patients. To evaluate the efficiency of learning, the nurse asks about the cause of health illiteracy in school-aged individuals. Which student answer describes effective learning? 1 It is due to sensorial abilities. 2 It is due to limited educational level. 3 It is due to poor socioeconomic status. 4 It is due to multiple disease processes.

2 Health illiteracy in patients often presents itself as a major obstacle to effective learning during the patient-nurse interaction. Health illiteracy in school-aged individuals is mostly due to limited educational levels. School-aged children may not have the maturity to understand the administration of medications. Sensorial abilities are seen in patients with cognitive impairment. Multiple disease processes do not affect health illiteracy; they usually affect the patient's ability for self-care. In some cases, poor socioeconomic status and limited educational level also contribute to the increase in health illiteracy.

The nurse is assessing a group of preschool children. Which tool will the nurse use to assess their growth and development? 1 The Fry readability formula 2 Erikson's stages of development 3 The USP drug information volume 4 The simple measure of Gobbledygook

2 Health screening is the prior step in the process of drug therapy in patients. Nurses use Erikson's stages of development in assessing vital signs in preschool children. The vital signs, including height and weight, are helpful in estimating the developmental stages in children. The Fry readability formula and the simple measure of Gobbledygook are the readability tools used for creating written materials. The USP drug information volume provides detailed information on the drug, class, properties, and many more assessments.

The nurse is teaching a group of preschool-aged children about healthy lifestyles. Which domain will the teaching address when discussing brushing teeth? 1 Health literacy 2 Affective domain 3 Cognitive domain 4 Psychomotor domain

2 Learning or acquisition of knowledge is the central theme of patient education. Effective teaching can be portrayed as the sharing of knowledge, and effective learning can be portrayed as changes in behavior. The need or importance of a healthy lifestyle falls under the affective domain. Patients are encouraged to express their internal feelings. The health teaching based on the affective domain includes the observation of nonverbal communication by the patients. Health literacy is a component of the cognitive domain, which includes the learning of basic health information and health services. The cognitive domain includes activities that promote the learning and storing of basic knowledge. The psychomotor domain includes gaining knowledge of a new technique or procedure.

The nurse is caring for an older adult patient who has impaired memory. What interventions will the nurse take to enhance compliance in this patient? 1 Provide weekly pill containers 2 Provide medication containers with alarm 3 Provide audiovisual materials for education 4 Provide computerized educational materials

2 Older adults may experience problems remembering the medication regimen. This may lead to their noncompliance to the regimen. Nurses must pay special attention to preventing noncompliance in such patients and accordingly can make use of several interactive methods. Providing medication or pill containers with built-in alarms can be effective. For effective drug administration, these containers have an alarm to remind patients of the time and the date of medication dosage. Weekly pill containers, audiovisuals, and computerized educational materials are appropriate reminders for patients with intact memory. These approaches to patient education may not be helpful in patients with memory impairment.

The nurse is educating a group of visually impaired patients. How will the nurse provide instructions to the patients for effective learning? 1 Readability tools 2 Verbal communication 3 Nonverbal communication 4 Pictures on an electronic screen

2 Patient education is a very important part of the nursing process. Nurses play an initiative role in educating patients and reducing learning barriers for an effective treatment protocol. Visually challenged patients require verbal communication for effective learning. Verbal communication includes an active interaction session between the patient and the nurse. Readability tools, nonverbal communication, and pictures require visualizing capacity for learning, and so they are of no use to visually challenged patients.

The nurse is assessing a diabetic patient who also has dementia. The nurse finds that the patient did not take a prescribed oral antidiabetic drug in the morning and now has elevated blood sugar levels. What is the possible reason for the patient not taking the drug in the morning? 1 Emotional status of the patient 2 Impaired memory of the patient 3 Noncompliant attitude of the patient 4 Restrictive religious beliefs of the patient

2 Patients with dementia have an impaired memory status, which presents a barrier for effective management of illness. These patients may forget to take medicines on time. This problem can be resolved by obtaining the assistance of family members, caregivers, or health care professionals. Several interactive devices are also used for medication administration. Assessments of emotional status as well as ethnicity and religious beliefs are done prior to administration of the drug therapy and may not directly affect the patient's compliance with drug therapy.

The nurse is caring for a child who has cancer. Which strategy will the nurse use to educate the child regarding chemotherapeutic drug administration? 1 Readability tools 2 Verbal instructions 3 Audiovisual materials 4 Nonverbal instructions

3 Children have little knowledge of medication procedures and are incapable of understanding the skills of medication administration. Although the child's caregivers and parents may be educated, they may not be able to give proper treatment, as the child may refuse or reject the treatment. Interactive strategies such as providing instructions through audiovisuals help educate children about treatment plans. Readability tools are used for patients capable of understanding the method of drug administration. Verbal instructions are used for cognitively impaired patients. Nonverbal instructions are used for patients with altered auditory capacity.

The nurse is caring for an adolescent who has a neurological disorder. Which necessary measure will the nurse implement for a better teaching-learning interaction? 1 Palpating for prominent pulse sites 2 Performing baseline hearing assessment 3 Using examples for explaining information 4 Keeping the teaching materials within the visual field

3 Neurological disorders can result in an impaired ability to think and understand the teaching-learning interaction. The nurse should adopt measures for better patient education. The teaching strategy involves the use of examples that will help grab the patient's attention and promote an effective teaching-learning interaction. Palpation of prominent pulse sites is an assessment that is not required for patient teaching. Baseline hearing assessment is not required for patients with neurological deficits; such an assessment is commonly completed for patients with auditory defects. Patients with visual defects lack the prominent power of vision, so the teaching materials are placed in their visual field.

The nurse is caring for a Hispanic patient who has limited English skills. Which nursing intervention would be appropriate when developing a therapeutic relationship between the nurse and the patient? 1 Always using a translator 2 Playing audiovisuals in Spanish 3 Completing medication calendar 4 Speaking Spanish when possible

4 Making attempts to speak in a patient's native language helps to build trust and to establish a therapeutic relationship. Making use of a translator may not be strictly necessary in this scenario since the patient does speak some English and primary goal is to build the therapeutic relationship between the nurse and patient. Playing audiovisuals in Spanish and completing a medication calendar will be helpful in providing patients knowledge of medication, but these interventions are not primarily used in building the relationship.

The nurse is caring for a Mexican-American patient who is concerned about a high-risk surgery. What intervention will the nurse consider to put this patient at ease and to provide more individualized care? 1 Arrange for a translator 2 Provide an English dictionary 3 Provide written instructions in Spanish 4 Ask if the patient would like a clergy visit

4 Nurses can build rapport with patients by providing individualized nursing that incorporates the patient's culture, religion, and language in addition to just medical needs. Since 90% of Mexicans are Roman Catholic, the nurse should consider arranging for a clergy visit to address the needs of this nervous patient before a serious medical procedure. While the nurse may also arrange for a translator, an English dictionary, or written instructions in Spanish, these interventions are generalized and do not demonstrate individualized care for this particular patient.

A patient is undergoing major surgery and asks the nurse about a living will. He states, "I don't want anybody else making decisions for me. And I don't want to prolong my life." The patient is demonstrating which ethical term? A. Autonomy B. Beneficence C. Justice D. Veracity

A. Autonomy

When receiving a patient transferred from another unit, which action is most useful to prevent medication errors? A. Completing a medication reconciliation between units B. Participating in a verbal report from the transferring nurse C. Asking the patient what medications were received upon transfer D. Asking the physician to rewrite all medication orders upon transfer

A. Completing a medication reconciliation between units Medication reconciliation to verify all of the patient's correct medications at each point of care (e.g., transfer from ICU to the general nursing unit) is an important nursing action to prevent medication errors. Reports should be written for better documentation. Patients may not remember or be aware of specific medications they received. Asking a physician to rewrite medication orders can only prevent errors if the physician also performs a medication reconciliation to verify that the correct medications are reordered.

When planning interventions aimed at reducing medication errors, the nurse recognizes that A. only 10% of all preventable adverse drug reactions (ADRs) begin at the medication ordering (prescribing) stage. B. disciplinary action is necessary to increase the nurse's vigilance in preventing medication errors. C. the majority of medication errors result from weaknesses within the system rather than individual shortcomings. D. the use of trailing zeros (i.e., 1.0 mg) and omission of leading zeros (i.e., .25 mg) reduces transcription errors.

A. only 10% of all preventable adverse drug reactions (ADRs) begin at the medication ordering (prescribing) stage. It is widely recognized that the majority of medication errors result from weaknesses within the "system" structure of health care organizations, resulting less often from individual shortcomings. Vindictive disciplinary action or "finger pointing" is now generally recognized as being counterproductive in the prevention of medication errors. Studies have shown that one half of all preventable ADRs begin at the medication ordering (prescribing) stage. The use of leading zeros and omission of trailing zeros will help prevent transcription errors.

A member of an investigational drug study team is working with healthy volunteers whose participation will help to determine the optimal dosage range and pharmacokinetics of the drugs. the team member is participating in what type of study? A. phase I B. phase II C. phase III D. phase IV

A. phase I

The nurse is providing discharge teaching to an older patient with short-term memory problems. Which strategies will the nurse use in educating the patient? (Select all that apply.) a. Repeat information frequently. b. Provide written instructions for home use. c. Perform several short teaching-learning sessions. d. Instruct the patient to take all medications in the morning. e. Encourage use of daily medication containers with alarms.

A.) Repeat information frequently. B.) Provide written instructions for home use. c) Perform several short teaching-learning sessions. E.) Perform several short teaching-learning sessions

Which statement best reflects the nurse's understanding of cultural influences on drug therapy and other health practices? a. Administration of some drugs may elicit varied responses in specific racial-ethnic groups. b. Regardless of one's cultural background, it is crucial to always adhere to recommended medical practices. c. Most cultures are fairly standard in reference to the use of medications during illness. d. Dietary habits and practices can be of little value to the care of an ill adult.

Administration of some drugs may elicit varied responses in specific racial-ethnic groups. Knowledge about drugs that may elicit varied responses in specific racial or ethnic groups must remain current. For example, genetic changes in certain CYP enzymes affect the rate of drug metabolism and thus affect drug levels and dosage amounts. Cultural practices vary among individuals and should be implemented as an integral part of holistic nursing care. Dietary habits and practices can affect the pharmacokinetics of medications and are thus an important aspect of the patient's history.

What is the nurse's role in the development of new and investigational drugs? Monitoring for and reporting any adverse effects noted during Phase IV studies Selecting patients to participate in Phase I studies Identifying patients who are receiving placebo drugs during Phase III studies Informing patients of the specific drug they are receiving within a blinded investigational study during Phase III

Monitoring for and reporting any adverse effects noted during Phase IV studies Phase IV studies rely on health care professionals to report adverse effects that may not have been apparent in previous phases. In most studies, neither the health care providers nor the patients know which patients are being given the real drug versus the placebo.

The nurse is administering medications. Examples of high-alert medications include: (select all that apply) a. Insulins b. Antibiotics c. Opiates d. Anticoagulants e. Potassium chloride for injection

a. Insulins c. Opiates d. Anticoagulants

When evaluating polymorphism and medication administration, the nurse considers which factors? SELECT ALL THAT APPLY a. Nutritional status b. Drug route c. Patient's ethnicity d. Cultural beliefs e. Patient's age

a. Nutritional status c. Patient's ethnicity d. Cultural beliefs e. Patient's age

When reporting a medication error what should be included in the documentation? a. Patient's status before and after the error b. Specific orders carried out in response to the error c. Family members input about the error d. Never document medication errors in patient's chart

a. Patient's status before and after the error b. Specific orders carried out in response to the error

Why are specific medications classified as "high-alert" medications? a. Potential for patient harm is higher with these medications. b. Medications always cause certain adverse effects. c. States require that these medications be on the high-alert list. d. Only RNs are allowed to administer these medications.

a. Potential for patient harm is higher with these medications. Medications on the high-alert list of medications have been identified as such because of their potentially toxic nature and their need for special care when prescribing, dispensing, and administering.

A patient of Japanese descent describes a family trait that manifests frequently: She says that members of her family often have "strong reactions"after taking certain medications, but her white friends have no problems w the same dosages of the same drugs. The nurse recognizes that bc of this trait, which statement applies? a. She may need lower dosages of the medications prescribed. b. She may need higher dosages of the medications prescribed. c. She should not receive these medications bc potential problems w metabolism. d. These situations vary greatly, and her accounts may not indicate a valid cause for concern.

a. She may need lower dosages of the medications prescribed.

A 47-year-old patient with diabetes is being discharged to home and must take insulin injections twice a day. The nurse keeps in mind which concepts when considering patient teaching? a. Teaching needs to begin at the time of diagnosis or admission and is individualized to the patient's reading level. b. The nurse can assume that because the patient is in his forties he will be able to read any written or printed documents provided. c. The majority of teaching can be done with pamphlets that the patient can share with family members. d. A thorough and comprehensive teaching plan designed for an eleventh-grade reading level needs to be developed.

a. Teaching needs to begin at the time of diagnosis or admission and is individualized to the patient's reading level.

What organization announced new regulations requiring bar codes for all prescription and over-the-counter medications? a. U.S. Food and Drug Administration (FDA) b. Drug Enforcement Agency (DEA) c. Federal Bureau of Investigation (FBI) d. Department of Health and Human Services (DHHS)

a. U.S. Food and Drug Administration (FDA) In February 2004, the FDA passed legislation requiring bar codes for all prescription and over-the-counter medications.

The nurse knows that the medication reconciliation process involves which three steps? (Select all that apply.) a. Reporting b. Reconciliation c. Verification d. Administration e. Clarification

b, c, e The three steps of the medication reconciliation process are verification, clarification, and reconciliation.

The nurse is giving medications to a newly admitted patient who is to receive nothing by mouth (NPO status) and finds an order as follows "Digoxin, 250 mcg stat." Which action is appropriate? a. Give the medication immediately (stat) by mouth bc the patient has no IV access at this time. b. Clarify the order w the prescribing physician before giving the drug. c. Ask the charge nurse what route the physician meant to use d. Start an IV line, then give the medication IV so that it will work faster, bc the patient's status is NPO at this time.

b. Clarify the order w the prescribing physician before giving the drug.

The nurse is giving medications to a newly admitted patient who is to receive nothing by mouth, and finds an order written as follows: "Digoxin, 250 mcg stat." Which action is appropriate? a. Give the medication immediately by mouth because the patient has no intravenous access at this time b. Clarify the order with the prescribing physician before giving the drug c. Ask the charge nurse what route the physician meant to use d. Start an IV line, then give the medication IV so that it will work faster, because the patient's status is NPO at this time

b. Clarify the order with the prescribing physician before giving the drug

Which action assists the nurse in prevention of a potential medication error? a. Ask the patient what disease the medication is for before administering. b. Encourage the patient to question medications if the medications are different than he or she expects. c. Allow the patient to take home medications when desired. d. Administer the patient's medications from his or her personal bottles while in the hospital.

b. Encourage the patient to question medications if the medications are different than he or she expects. The nurse should encourage patients to question any medication that they are not familiar with or are not expecting to take.

A patient is being counseled for possible participation in a clinical trial for a new medication. After the patient meets w the physician, the nurse is asked to obtain the patient's signature on the consent forms. The nurse knows that his "informed consent" indicates which of the following? a. Once therapy has begun, the patient cannot withdraw from the clinical trial. b. The patient has been informed of all potential hazards and benefits of the therapy. c. The patient has received only the information that will help to make the clinical trial a success. d. No matter what happens, the patient will not be ale to sue the researchers for damages.

b. The patient has been informed of all potential hazards and benefits of the therapy.

Nurses have the ethical responsibility to tell the truth to their patients. what is the principle known as? a. justice b. veracity c. beneficence d. nonmalefiecence

b. veracity

The nurse keeps in mind that which measure is used to reduce the risk of medication error? a. when questioning a drug order, keep in mind that the prescriber is correct b. Be careful about questioning the drug order a board-certified physician has written for a patient c. Always double-check the many drugs w sound-alike and look-alike names bc of the high risk of error. d. If the drug route has not been specified, use the oral route.

c. Always double-check the many drugs w sound-alike and look-alike names bc of the high risk of error.

The nurse keeps in mind that which measure is used to reduce the risk of medication errors? a. When questioning a drug order, keep in mind that the prescriber is correct b. Be careful about questioning the drug order a board-certified physician has written for a patient c. Always double-check the many drugs with sound-alike and look-alike because of the high risk of error d. If the drug route has not been specified, use the oral route

c. Always double-check the many drugs with sound-alike and look-alike because of the high risk of error

How does the nurse best evaluate the patient's understanding of teaching about a new medication? a. Observe the patient taking the medication. b. Assess the patient for response to the medication. c. Ask specific questions to assess the patient's understanding. d. Document the education session and most used teaching strategy.

c. Ask specific questions to assess the patient's understanding.

What phase of the nursing process provides a framework for the nurse to provide patient and family education about a new medication? a. Planning b. Evaluation c. Assessment d. Implementation

c. Assessment

When planning care for an assigned patient, the nurse identifies the outcome of "Patient will be able to safely self-administer enoxaparin (Lovenox) subcutaneously upon discharge." Which method is best for the nurse to use in evaluating the patient's achievement of this outcome? a. Demonstrate the correct administration procedure to the patient. b. Give the patient detailed written instructions illustrating the procedure. c. Observe the patient's return demonstration of the administration procedure. d. Ask the patient to verbalize the correct administration procedure step by step.

c. Observe the patient's return demonstration of the administration procedure.

The nurse is reviewing the four clinical phases of investigational drug studies. Place the four phases in the correct order of occurrence. a. Studies that are voluntarily conducted by pharmaceutical companies to obtain more info about the therapeutic and adverse effects of a drug. b. Studies that involve small numbers of volunteers who have the disease or ailment that the drug is designed to diagnose or treat. c. Studies that involve small numbers of healthy subjects who do not have the disease or ailment that the drug is intended to treat. d. Studies that involve large numbers of patients who have the disease that the drug is intended to treat; these studies establish the drug's clinical effectiveness, safety, and dosage range.

c. Studies that involve small numbers of healthy subjects who do not have the disease or ailment that the drug is intended to treat. b. Studies that involve small numbers of volunteers who have the disease or ailment that the drug is designed to diagnose or treat. d. Studies that involve large numbers of patients who have the disease that the drug is intended to treat; these studies establish the drug's clinical effectiveness, safety, and dosage range. a. Studies that are voluntarily conducted by pharmaceutical companies to obtain more info about the therapeutic and adverse effects of a drug.

The emergency department nurse is documenting the history of a patient of Asian culture. The patient states that she does not take any medications, but the nurse notes a bottle of capsules in the patient's purse. What information will the nurse collect next? a. Vital signs b. Primary care provider name c. Use of herbs or over-the-counter medications d. Insurance information

c. Use of herbs or over-the-counter medications The nurse will ask the patient if she takes any herbs or other non-prescribed medications. The patient is of Asian culture and may use herbal remedies that she does not consider medications.

For which cultural group must the health care team provider respect the value placed on harmony with nature and the belief that disease is the result ill spirits? a. Hispanics b. Asian Americans c. native Americans d. African Americans

c. native Americans

When caring for an elderly Chinese patient, the nurse recognizes that which of these cultural issues may influence the care of this patient? a. radiographs are seen as a break in the soul's integrity b. hospital diets are interpreted as being healing and healthful c. the use of heat may be an important practice for this patient d. Being hospitalized is a source of peach and socialization for this culture

c. the use of heat may be an important practice for this patient

When admitting an elderly patient to an acute care setting, which nursing strategy is most appropriate to prevent medication errors? a. Call the primary care physician to verify current medications. b. Ask the patient's family to verify medications the patient was taking at home. c. Ask the patient to provide you with a written list of all medications being taken at home. d. Ask the patient and/or family to bring in all medications the patient was taking at home.

d. Ask the patient and/or family to bring in all medications the patient was taking at home. The USP recommends the use of "brown bagging" sessions of medications to identify drugs that patients are taking. Patients, family, and/or the primary care physician may not always accurately report all medications a patient is using. Actual examination of the medications and containers provides the most accurate assessment of current medications and allows for appropriate medication reconciliation.

What legislation, which was passed in 1996, ensures the privacy of patient information is protected? a. Federal Food, Drug, and Cosmetic Act b. Durham-Humphrey Amendment c. Medicare Prescription Drug, Improvement, and Modernization Act d. Health Insurance Portability and Accountability Act

d. HIPAA The Health Insurance Portability and Accountability Act (HIPAA) officially required all health-related organizations as well as schools to maintain the privacy of protected health information. The Federal Food, Drug, and Cosmetic Act (FFDCA) required drug manufacturers to provide data proving drug safety with Food and Drug Administration (FDA) review and established the investigational new drug application process. The Durham-Humphrey Amendment to the FFDCA established legend drugs or prescription drugs. The Medicare Prescription Drug, Improvement, and Modernization Act provides seniors and disabled persons with an insurance benefit program for prescription drugs.

During the medication administration process, it is important that the nurse remembers which guideline? a. when in doubt about a drug, ask a colleague about it before giving the drug. b. ask what the patient knows about the drug before giving it. c. when giving the new drug, be sure to read about it after giving it. d. If the patient expresses concern about a drug, stop, listen, and investigate the concerns.

d. If the patient expresses concern about a drug, stop, listen, and investigate the concerns.

The nurse is developing a discharge plan regarding a patient's medication. Which of these statements about the discharge plan is true? a. It will be developed right before the patient leaves the hospital. b. It will be developed only after the patient is comfortable or after pain medications are administered. c. It will include videos, demonstrations, and instructions written at least at the fifth-grade level. d. It will be individualized and based on the patient's level of cognitive development.

d. It will be individualized and based on the patient's level of cognitive development.

The nurse administers a medication to the wrong client. Which is the appropriate nursing action following this error? a. Assess the client for an adverse reaction and report if an adverse event occurs. b. Document the medication error. No further action is required. c. Report the error and document the medication on the patient chart. d. Notify the provider and document the error on an incident report.

d. Notify the provider and document the error on an incident report. All medication errors that involved a patient need to be called to the health care provider's attention and documented on an incident report.

If a student nurse realizes that he or she has made a drug error, the instructor should remind the student of which concept? a. The student bears no legal responsibility when giving medications b. The major legal responsibility lies with the health care institution at which the student is placed for clinical experience c. The major legal responsibility for drug errors lies with the faculty members d. Once the student has committed a medication error, his or her responsibility is to the patient and to being honest and accountable

d. Once the student has committed a medication error, his or her responsibility is to the patient and to being honest and accountable

Which statement best supports the nursing diagnosis of "Deficient knowledge related to medication therapy"? a. Patient is not taking medication as directed. b. Patient is not reporting adverse effects as directed. c. Patient is unwilling to comply with medication therapy. d. Patient is unable to verbalize reason for taking the medication.

d. Patient is unable to verbalize reason for taking the medication.

A new drug has been approved for use, and the drug manufacturer has made it available for sale. During the first 6 months, the FDA receives reports of severe adverse effects that were not discovered during the testing and considers withdrawing the drug. This illustrates which phase of investigational drug studies? a. Phase I b. Phase II c. Phase III d. Phase IV

d. Phase IV

A pharmaceutical company is voluntarily conducting a postmarketing study to obtain further proof of the therapeutic effects of a new drug. What phase of drug study is this considered? a. Phase I b. Phase II c. Phase III d. Phase IV

d. Phase IV Phase IV studies are conducted by pharmaceutical companies after the drug is on the market to obtain further data and information on the drug.

The nurse is educating a patient with newly diagnosed type 1 diabetes mellitus. When the nurse has the patient demonstrate self-injection of insulin, which domain of learning is the nurse assessing? a. Physical domain b. Affective domain c. Cognitive domain d. Psychomotor domain

d. Psychomotor domain

What is the MOST appropriate time the nurse should begin the patient education and the teaching-learning process? a. At the time discharge planning is begun b. After the medical diagnosis is established c. When there are written prescriptions for teaching d. Upon the patient's admission to the health care setting

d. Upon the patient's admission to the health care setting

The nurse is reviewing medication orders. Which digoxin dose is written correctly? a. digoxin .25mg b. digoxin .250 mg c. digoxin 0.250 mg d. digoxin 0.25 mg

d. digoxin 0.25 mg

A patient has been selected as a potential recipient of an experimental drug for heart failure. The nurse knows that when informed consent has been obtained, it indicates that the patient: A. has been informed of the possible benefits of the new therapy. b. will be informed of the details of the study as the research continues. c. will not be sure to receive the actual drug during the experiment. d. has had the study's purpose, procedures, and the risks involved explained to him.

d. has had the study's purpose, procedures, and the risks involved explained to him.

The nurse is assessing an elderly Hispanic woman who is being treated for hypertension. during the assessment, what is important for the nurse to remember about cultural aspects? a. the patient should be discouraged from using folk remedies and rituals. b. the nurse should expect the patient to value protective bracelets and root workers as healers. c. the nurse should remember that the balance among body, mind, and environment would be important for this patient health beliefs. d. the nurses assessment should include information regarding religious practices and beliefs regarding medications, treatment, and healing.

d. the nurses assessment should include information regarding religious practices and beliefs regarding medications, treatment, and healing.

Ethically, a nurse has the responsibility to employ beneficence, the duty to do no harm to a patient. withhold information from the patient as requested by the family. impose his or her own values upon the patient when doing so would help the patient. transfer care of a patient to another professional nurse if caring for the patient would violate personal ethical principles.

transfer care of a patient to another professional nurse if caring for the patient would violate personal ethical principles. Beneficence is the duty to do good; withholding information from a patient is not only unethical but illegal, and imposing your values onto a patient is never appropriate. However, if providing required care to a certain type of patient would violate your personal ethics, then it is your responsibility to transfer care of that patient to another professional nurse rather than not performing necessary care, which would be a form of abandonment.