Adaptive Quizzing: Medication Administration (Chapter 32)

A patient has to be given a bladder irrigation with 100 mL of medicated solution with 1/1000 dilution. How much of the medication should the nurse dissolve in 100 mL of solvent? Record your answer using a whole number. ___ mg

1/1000 solution indicates the presence of 1 gram of medication in 1000 mL of solution. This means that each mL of the solution contains 1 mg of the medication. Because the nurse has to prepare 100 mL of the solution, the nurse should dissolve 100 mg of medication in 100 mL of solvent.

The nurse has been asked to prepare a 1% solution of medication in distilled water. How much of the medication should the nurse dissolve in 100 mL of distilled water? Record your answer using a whole number, and, please note, no comma is needed. ___ mg

A 1% solution contains 1 gram of the medication dissolved in 100 mL of the solution. Because the unit is mg, and 1 gram is 1000 mg, the nurse should dissolve 1000 mg of the medication in 100 mL of water.

The nurse is attending to a patient with a pulmonary infection. The healthcare provider prescribes antibiotics for the patient. Which instructions should the nurse give to the patient regarding antibiotic treatment? Select all that apply. 1. Emphasize taking the full prescription. ** 2. Explain that improper treatment may worsen the patient's condition. ** 3. Emphasize discontinuing the treatment once the patient attains symptomatic relief. 4. Explain that improper treatment may cause development of bacterial resistance. ** 5. Emphasize continuation if the condition does not improve with a full course of medication.

A full prescription of the antibiotics should be completed to ensure the therapeutic effect. An incomplete course of antibiotics may worsen the condition being treated and also lead to development of resistance to the antibiotic. Full treatment must be taken even if the patient attains early symptomatic relief. If the patient's condition does not improve with full treatment, then treatment should be discontinued.

Which statement about medication names requires correction? 1. The trademark for generic names is indicated by the superscript "TM." ** 2. United States Adopted Names Council approves generic names of drugs. 3. The nonproprietary name of a medication is the generic name given to the drug. 4. The Institute for Safe Medication Practices publishes a list of medications that are frequently confused with another.

Brand names of any drug are indicated by the trademark of superscript "TM." The United States Adopted Names Council approves the generic name of the drug released into the market as the first trade name. The nonproprietary name of a medication is the generic name given to the drug. The Institute for Safe Medication Practices publishes a list of medications that are frequently confused with another medications.

Which instruction is beneficial for a patient who receives medication through buccal mucosa? 1. "You should drink adequate fluids with the medication." 2. "You should use the same cheek for the subsequent administration." 3. "You should swallow the medication after a few minutes of administration." 4. "You should place the medication against the mucous membrane of the cheek." **

Buccal route of medication administration involves placing the medication against the mucous membrane of the cheek until the medication dissolves. The patient should avoid drinking fluids with the medication. The patient should use alternate cheeks for the subsequent administration. The patient should avoid swallowing the medication.

The nurse is preparing a medication ordered by the physician. The physician ordered 250 mg of Tylenol to be given to the patient. The medication comes from the pharmacy in dosage strength of 1 gram of Tylenol in 2 mL. How many mL should the nurse administer? Record your answer using one decimal place. ____________ mL

By using the formula method: (Dose ordered/Dose on hand) x amount on hand = Amount to administer. (250 mg/1000 mg) x 2 mL = ½ mL = 0.5 mL. Test-Taking Tip: When taking the NCLEX exam, an on-screen calculator will be available for you to determine your response, which you will then type in the provided space.

Which statement about various routes of drug administration requires correction? 1. Chemotherapeutic agents are administered through the intrapleural route. 2. Intradermal injection deposits the medication just below the dermis of the skin. ** 3. Intraosseous administration of drugs is most commonly used in infants and toddlers. 4. Patients taking medication through sublingual route are instructed not to drink water until the tablet dissolves.

Chemotherapeutic agents are the most common medications administered through intrapleural injection. Subcutaneous injection deposits the medication just below the dermis of the skin. The intraosseous method of medication administration involves the infusion of medication directly into the bone marrow. It is used most commonly in infants and toddlers who have poor access to their intravascular space. Patients taking medication through the sublingual route are instructed not to swallow or drink water until the tablet dissolves.

A patient has been prescribed enoxaparin. Which points should the nurse keep in mind when administering enoxaparin? Select all that apply. 1. The injection should be given in the abdomen. ** 2. The injection should be given over a bony prominence. 3. Air should be expulsed from the syringe before administration. 4. The injection site should be pinched while the needle is being inserted. ** 5. The injection should be given over large underlying muscles.

Enoxaparin is a low-molecular-weight heparin that is administered in subcutaneous tissue of the abdomen, at least 2 inches away from the umbilicus. The injection site has to be pinched as the needle is inserted. This helps ensure that the medicine is injected into the subcutaneous tissue. Subcutaneous injections are not to be given over bony prominences, because doing so can cause injury. When administering enoxaparin, air within the syringe should not be expelled, because doing so can affect the dosing. Subcutaneous injections should not be given over large underlying muscles, because the medicine can be accidently injected into the muscles. Medication injected into a muscle is absorbed more quickly than from the subcutaneous tissue. Test-Taking Tip: Be sure to note whether a question is a single-answer, multiple-choice question versus a multiple response, select-all-that-apply question! If you think there is just one answer, and it is really a multiple-response question, you might submit just the first answer you know to be true and miss the additional correct responses.

Which medication route is absorbed slowly after administration? 1. Medications placed on the skin ** 2. Medications placed under the tongue 3. Medications placed in the oral mucosa 4. Medications placed on the respiratory airways

Every route of administration has different rates of absorption. The physical makeup of the skin makes the absorption slow for medications placed on the skin. Medications placed under the tongue have quick absorption. Respiratory airways and mucous membranes have many blood vessels. Therefore, medications placed in the oral mucosa, on the respiratory airways, and on the mucous membranes are absorbed most quickly after administration.

The nurse who is responsible for dispensing medications understands that every patient requires a different dosage for a given drug. Various factors affect the absorption of drugs. Which factors influence absorption? Select all that apply. 1. Total body weight 2. Body temperature 3. Route of administration ** 4. Lipid solubility of the drug ** 5. Blood flow to the site of administration **

Factors that influence absorption are the route of administration, ability of the medication to dissolve, blood flow to the site of administration, body surface area (BSA), and lipid solubility of medication. The absorption of drugs depends on the route of administration; oral route has the least absorption, and the intravenous route has the highest absorption. The human body absorbs medications in a liquid state more readily than tablets and capsules. Higher blood flow to the site of administration favors faster absorption of drugs. Because the cell membrane has a lipid layer, highly lipid-soluble medications cross cell membranes easily and are absorbed quickly. Absorption of drugs depends on body surface area, not on body weight. Body temperature does not affect the absorption of drugs. STUDY TIP: Regular exercise, even if only a 10-minute brisk walk each day, aids in reducing stress. Although you may in the past have been able to enjoy regular sessions at the health club or at an exercise class several times a week, you now may have to cut down on that time without giving up a set schedule for an exercise routine. Using an exercise bicycle that has a book rack on it at home, at the YMCA, or at a health club can help you accomplish two goals at once. You can exercise while beginning a reading assignment or while studying notes for an exam. Listening to lecture recordings while doing floor exercises is another option. At least a couple of times a week, however, you should do the exercise routine without the mental connection to school; time for the mind to unwind is necessary, too.

While assessing a patient, the nurse observes raised, irregularly shaped skin eruptions with red margins. Which mild allergic reaction does the nurse document in the medical record? 1. Rash 2. Hives ** 3. Rhinitis 4. Pruritus

Hives, or urticaria, is a mild allergic reaction that is characterized by raised, irregularly shaped skin eruptions with red margins. Rash is a mild allergic reaction that is characterized by small, raised vesicles that are usually reddened all over the body. Inflammation of the mucous membrane lining the nose mucosa is referred to as rhinitis. Pruritus is a mild allergic reaction that involves itching of the skin that accompanies rashes.

A primary health care provider prescribed an antihistamine to a pediatric patient and informed the caretakers that the child may become drowsy after taking this medication. However, on the contrary, the child became extremely agitated and excited after taking the medication. What is this reaction called? 1. Toxic effect 2. Allergic reaction 3. Therapeutic effect 4. Idiosyncratic reaction **

Idiosyncratic reaction is any unpredictable drug reaction. Therefore, the child exhibits an idiosyncratic reaction. The toxic effect often develops after prolonged intake of medication or when a medication accumulates in the blood because of impaired metabolism or excretion. Allergic reactions are sudden onset immunological reactions seen after a drug intake. The therapeutic effect is a reaction that is the expected or predicted physiological response caused by a medication.

The nurse works in a geriatric unit. Which physiological changes affecting the metabolism of medication should the nurse be aware of in these patients? Select all that apply. 1. Reduced liver function ** 2. Reduced absorptive capacity ** 3. Reduced functioning of brain receptors 4. Shortening of half-life of drugs excreted through the kidneys 5. Reduced function of the immune system

In elderly patients, liver function is grossly reduced, which affects the metabolism of drugs and prolongs the half-life of drugs. The absorptive capacity of the intestines also declines in elderly patients. The brain receptors become more sensitive, and the patients are very much susceptible to psychoactive drugs. The kidney function diminishes and the half-life of drugs excreted through the kidney lengthens. The efficiency of the immune system decreases with age, but the immune system does not interact with the drug metabolism process.

A diabetic patient has been switched from oral antidiabetic drugs to insulin. Which information would help the patient to ensure correct self-administration of insulin? Select all that apply. 1. Insulin is given as a subcutaneous injection. ** 2. The insulin is absorbed more quickly when injected into the abdomen. ** 3. The site of injection should be changed monthly. 4. Once a site is chosen for injection, the same site should be used for further injections. 5. The recommended sites of injection include the upper arm, thigh, abdomen, and buttocks. **

Insulin is given as a subcutaneous injection for slower absorption. The rate of absorption of insulin differs in various sites. The abdomen has the quickest absorption. The recommended sites of insulin injection include the upper arms, anterior and lateral part of the thighs, buttocks, and abdomen. These sites have the appropriate amount of subcutaneous tissue for absorption of insulin. The injection site should not be chosen again for a month. The injection site should be rotated with each injection. Repeated injection at the same site may lead to lipodystrophy.

The nurse is educating a diabetic patient about how to administer insulin. Which statements pertaining to use of insulin are appropriate? Select all that apply. 1. The insulin vial should be shaken well before drawing the injection. 2. Insulin should not be mixed with any other medication. ** 3. Insulin detemir should not be mixed with any insulin. ** 4. Insulin glargine should be mixed only with regular insulin. 5. Rapid-acting insulin mixed with NPH insulin should be given along with meals.

Insulin should never be mixed with any other medication, because it can hamper the effectiveness of the insulin. Mixing insulin detemir with any other insulin can make it ineffective. Shaking an insulin vial can form bubbles that can interfere with correct dosage. Insulin glargine should not be mixed with any other insulin. Rapid-acting insulin mixed with NPH insulin must be given 15 minutes before meals for maximum benefit. STUDY TIP: Record the information you find to be most difficult to remember on 3" × 5" cards and carry them with you in your pocket or purse. When you are waiting in traffic or for an appointment, just pull out the cards and review again. This found time may add points to your test scores that you have lost in the past.

Which statements are true regarding routes of medication administration? Select all that apply. 1. Parenteral route causes anxiety in patients. ** 2. Inhalational routes have higher absorption rates. 3. Medications are absorbed slowly through the skin. ** 4. Oral route is avoided in patients with gastrointestinal disorders. ** 5. Oral route is used in patients with reduced gastrointestinal motility.

Medications are absorbed slowly through the skin due to the makeup of the skin. The oral route of administration is contraindicated in patients with gastrointestinal disorders. The administration of medications through the parenteral route often causes anxiety in patients, especially in children. The intramuscular and intravenous routes have higher absorption rates. The oral route is contraindicated in patients with reduced gastrointestinal motility.

A registered nurse is teaching a nursing student about medications in patients with renal disease. Which statements, if made by the nursing student, indicate a need for further teaching? Select all that apply. 1. "Renal failure may lead to drug toxicity in the body." 2. "Adequate fluid intake promotes proper elimination of medications through the kidneys." 3. "Most drugs undergo biotransformation in the kidney before they are excreted." ** 4. "Health care providers should decrease the medication dose in patients with renal disease." 5. "Enemas will accelerate excretion of the drug through the kidneys in patients with renal failure." **

Most of the drugs undergo biotransformation in the liver before they are excreted through kidneys. Enema, which increases the rate of peristalsis, will accelerate the excretion of medication through feces. Renal failure may result in drug toxicity due to improper excretion of the drug from the body. Adequate fluid intake promotes proper elimination of medications through kidneys. Drug doses should be minimized in patients with renal disease to avoid the risk of drug toxicity. Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation.

Which nursing actions are appropriate for safe narcotic administration? Select all that apply. 1. Making a note of a discrepancy in the record 2. Obtaining the signature of the witness nurse in the paper record ** 3. Storing the medication in the drawer near the patient 4. Disposing of the unused part in the presence of another nurse ** 5. Dispensing wasted parts of medications in sharps containers

Narcotics should be administered with guidelines for safe administration. The nurse should administer the medication in the presence of a witness nurse and should obtain the signature of the nurse in the paper record. The nurse administering the medication should dispense the medication in the presence of another nurse. When a discrepancy occurs, the nurse should correct and report it immediately. The wasted or unused part of the medication should not be dispensed in sharps containers. Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.

Which medication forms are commonly prepared for administration by parenteral routes? Select all that apply. 1. Elixir 2. Troche 3. Extract 4. Powder ** 5. Solution **

Powder and solution are medication forms that are commonly prepared for administration by parenteral routes. Elixir is a clear fluid containing water and or alcohol that is given orally. Troche is a lozenge that is given orally. Extract is a concentrated form of medication that is made by removing the active part of medication from its other components. It is given orally.

The primary health care provider has prescribed naloxone (Narcan) STAT to a patient. What does the nurse interpret from the prescription? 1. The medication should be as desired. 2. The medication should be given every day. 3. The medication should be given immediately. ** 4. The medication should be given whenever it is needed.

STAT (or stat) in the prescription indicates that the medication should be administered immediately. When the medication should be given as desired, it is written as ad lib. If the provider uses the term daily, it indicates that the medication should be given every day. Prn indicates that the medication should be given whenever it is needed.

What are the clinical signs and symptoms of pruritus? 1. Itching of skin ** 2. Small raised vesicles over the body 3. Raised, irregularly shaped skin eruption 4. Inflammation of mucous membrane lining the nose

Skin itching is the primary sign of pruritus. Raised, irregularly shaped skin eruption is referred to as a rash. Raised, irregularly shaped skin eruption is referred to as urticaria. Inflammation of mucous membrane lining the nose is a condition associated with rhinitis.

What is the role of state's Nurse Practice Act (NPA) in nursing? 1. Controlling sales and distribution of medicines. 2. Defining the scope of nurse's professional function. ** 3. Ensuring safe and effective medications to the general population. 4. Establishing the individual policies to meet federal, state, and local regulations.

State NPAs define the scope of nurses' professional functions and responsibilities. Federal medication laws control medication sales and distribution. The Food and Drug Administration ensures safe and effective medications to the general population. Health care agencies establish individual policies to meet federal, state, and local regulations.

Medications undergo vigorous testing before they are made available to the public. Which regulatory agency is responsible for ensuring this process? 1. Medicare program. 2. National Formulary. 3. United States Pharmacopeia. 4. Food and Drug Administration. **

The Food and Drug Administration ensures that all medications available in the market undergo vigorous testing to ensure their safety and efficacy. The Medicare program does not ensure testing of drugs. The United States Pharmacopeia and the National Formulary set standards for medication strength, quality, purity, packaging, safety, and dose form.

Which statement is true regarding systems of medication measurement? 1. The metric system is most familiar to people. 2. The apothecary system is used infrequently today. ** 3. Household measurements allow the use of teaspoons and cups. 4. The metric system of measurement is officially adopted by the U.S. Congress.

The apothecary system of measurement is used infrequently today. Household measurement is most familiar to people. Household measurement does not allow the use of teaspoons and cups. The metric system of measurement is not officially adopted by the U.S. Congress but is used by most health professionals in the United States.

The nurse is preparing an intravenous medication for an infant in the pediatric unit and is using a tuberculin syringe for precise medication measurement. The tuberculin syringe is calibrated in hundredths of a milliliter. What is the capacity of the syringe? Record your answer using a whole number. __ mL

The capacity of the tuberculin syringe is 1 mL and is used to prepare small amounts of medications (e.g., intradermal or subcutaneous injections). Test-Taking Tip: When using this program, be sure to note whether you guess at an answer. This will permit you to identify areas that need further review. Also it will help you to see how correct your guessing can be.

The nurse is reviewing a medication order for a patient. What are the components of medication orders? Select all that apply. 1. Dose and frequency ** 2. Specific nurse in charge 3. Route of administration ** 4. Generic name of medication ** 5. Chemical name of medication

The components of a medication order include dose and frequency of the medication, route of administration, and generic name of the medication. The dose and frequency are decided based on the patient's weight and the amount of medication required to obtain the therapeutic effect. The route of administration depends on the types of medication and the condition of the patient. The medication can be given via enteral or parenteral route. The generic name of the drug is an important component of the medication order and is used to identify the drug. The chemical name of the medication and the name of the nurse in charge are not components of the medication order.

Using the sliding scale for insulin prescribed by the healthcare provider, 2 units of insulin is required for a blood glucose level between 150 and 200 mg/dL. The nurse finds that a patient's blood glucose level is 175 mg/dL. How much insulin should the patient be given? Record your answer using a whole number. ___ units

The correction or sliding scale of insulin is based on the patient's blood sugar levels at a given point in time. The prescribed dose of insulin for a blood glucose level of 150 to 200 mg/dL is 2 units; because the patient's level falls in that range, the patient should be given 2 units

Which route is used for the administration of regional analgesia for surgical procedures? 1. Epidural ** 2. Intrapleural 3. Intraosseous 4. Intraperitoneal

The epidural route involves the administration of medications in the epidural space. Regional analgesia for surgical procedures is administered through the epidural route by a nurse anesthetist or an anesthesiologist. Chemotherapeutic agents are administered through the intrapleural route. The intraosseous route is commonly used for infants and toddlers who have poor intravascular access. Chemotherapeutic agents, insulin, and antibiotics are administered through the intraperitoneal route.

A medication has a minimum effective concentration of 25 mg/dL and the therapeutic range is 25 to 100 mg/dL. What is the plasma concentration above which the toxic effects of the drug may appear? Record your answer using a whole number. ___ mg/dL

The highest reading of a therapeutic range corresponds to the toxic range of plasma concentration. Any drug levels above this concentration are toxic. The highest value of the therapeutic range of the drug in question is 100 mg/dL, so plasma concentration of the drug above 100 mg/dL is toxic.

Which route of administration is beneficial for an infant who does not have access to intravascular space in an emergency situation? 1. Intrathecal 2. Intrapleural 3. Intraosseous ** 4. Intraperitoneal

The intraosseous route of administration involves the infusion of medication directly into the bone marrow. It is used in infants who have poor access to intravascular space. The intrathecal route of administration is usually used for long-term treatment that involves administration in the subarachnoid space. The intrapleural route and intraperitoneal route are not indicated in infants who have poor access to intravascular space.

The nurse is teaching a nursing student about parenteral routes. Which statement made by the nursing student indicates a need for correction? 1. "The intraperitoneal route is used to administer insulin." 2. "Intraarterial medication administration is managed by the nurse." 3. "Epidural medication is used to administered medicine in the spinal canal." 4. "Intrapleural administration is common in toddlers who have poor access to intravascular space." **

The intraosseous route of administration is common in toddlers who have poor access to intravascular space. Insulin is administered through the intraperitoneal route. Epidural medication is administered in the spinal canal in the epidural space. Intraarterial medication administration is managed by the nurse who continuously infuses the clot-dissolving agent and carefully monitors the integrity of the infusion.

The primary health care provider prescribed a medication to be administered in the subarachnoid space of the patient. Which route of administration is the primary health care provider prescribing for the patient? 1. Intrathecal ** 2. Intrapleural 3. Intraosseous 4. Intraperitoneal

The intrathecal route of administration is given in the subarachnoid space or one of the ventricles of the brain. The intrapleural route is used to administer intrapleural medications directly into the pleural space. The intraosseous route is used to administer medication directly into the bone marrow. The intraperitoneal route is used to administer medications into the peritoneal cavity. Test-Taking Tip: Identifying content and what is being asked about that content is critical to your choosing the correct response. Be alert for words in the stem of the item that are the same or similar in nature to those in one or two of the options.

The registered nurse is teaching a nursing student about the various factors that affect drug absorption. Which statement if made by the nursing student indicates a need for further teaching? Select all that apply. 1. "Patients with malnutrition and liver disease are at risk of drug toxicity." 2. "The larger the surface of drug absorption, the less the drug is absorbed." ** 3. "Drugs given through the intravenous route are absorbed faster than the oral route." 4. "The tablet form of medication is more readily absorbed than the solution form." ** 5. "The greater the blood supply to the site of administration, the faster the drug is absorbed."

The larger the surface of drug absorption, the more the drug is absorbed. The solution form of medication is more readily absorbed by the body than the tablet form of medications. Patients with malnutrition and liver disease are at risk of drug toxicity. Drug absorption is faster through the intravenous route (IV) than the oral route, as the IV route facilitates the direct infusion of medication into the blood. The greater the blood supply to the site of administration, the faster the absorption of the drug is. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

A child weighing 10 kg requires a medication dose of 2 mg/kg body weight. The ampule contains 40 mg of the medication in 2 mL. What amount of medication should the nurse administer to the patient? Record your answer using a whole number. ___ mL

The medication dose required for the body weight of the child is calculated by multiplying the body weight by the dose required per kg body weight. Therefore, 10 X 2 = 20 mg. Because the ampule has 40 mg in 2 mL, the dose appropriate to the child is 1 mL, which contains 20 mg of medication.

The healthcare provider instructs the nurse to inject 2 mg/kg of a medication to a pediatric patient. The weight of the patient is 33 lbs. How much of the medication should the nurse administer to the patient? Record your answer using a whole number. ___ mg

The nurse must convert the weight of the patient into kilograms; because 2.2 lbs is equivalent to 1 kg, 33 lbs is equivalent to 15 kg (33/2.2 = 15). The medication has to be administered in the dose of 2 mg/kg body weight; the amount of medication required for this patient is 2 x 15 = 30 mg. Test-Taking Tip: If the question asks for a whole number response and your calculation shows a decimal amount, reread the question and rerun the calculation before submitting your response. You may have misread the question or made a calculation error.

A patient develops sudden onset of bronchiolar constriction, edema of pharynx and larynx, and shortness of breath following administration of a medication. Which type of allergic reaction is the patient experiencing? 1. Rhinitis 2. Medication allergy 3. Anaphylactic reaction ** 4. Idiosyncratic reaction

The sudden onset of bronchiolar constriction, edema of pharynx and larynx, and shortness of breath indicate the severe form of allergic reaction called anaphylactic reaction. Rhinitis is a minor form of allergic reaction that manifests as sneezing, swelling, and clear nasal discharge. Medication allergy is a nonspecific term and encompasses rhinitis, rash, urticaria, and pruritus. Idiosyncratic reaction is the onset of an unpredictable response in a patient. Test-Taking Tip: Do not worry if you select the same numbered answer repeatedly because there usually is no pattern to the answers.

The nursing instructor is talking to nursing students about the unit-dose system used in medication distribution. Which statements accurately describe the unit-dose system? Select all that apply. 1. It uses carts for distribution. ** 2. It has labeled drawers. ** 3. It has controlled substances kept in foil. 4. It does not contain prn and stock medication. 5. It includes ordered doses of medication for a full course.

The unit-dose system uses a cart with drawers with a 24-hour supply of medications for each patient. The drawers are labeled with the patient's name. Controlled substances are not kept in the patient's drawer; they are kept separately in locked drawers. The cart also has prn and stock medications. The carts have the ordered dose of medication for each patient for 24 hours, which may not be the full course.

Which class of drugs, if administered to the patient without a prescription, is punishable under the Controlled Substance law? 1. Antiemetics 2. Antihistamines 3. Opioid analgesics ** 4. Nonsteroidal anti-inflammatory drugs

The use of opioid drugs is carefully controlled through federal and state guidelines. Violation of these guidelines is punishable under the controlled substance law. Antiemetics, antihistamines, and nonsteroidal anti-inflammatory drugs are not controlled substances.

The healthcare provider has instructed the nurse to administer 4 mg of morphine sulfate intravenously to a patient. The ampule of morphine contains 1 mL of the solution with a concentration of 10 mg/mL. What volume of the medication should the nurse administer to this patient? Record your answer to one decimal place. ___ mL

The volume required is calculated by the formula: (Dose ordered/dose on hand) x Amount on hand = Amount to administer. (4 mg/10 mg) x 1 mL = Amount to administer = 0.4 mL. Therefore, the patient requires 0.4 mL of morphine to be administered.

The registered nurse is teaching a nursing student about guidelines of safe narcotic control. Which statement made by the nursing student indicates a need for further teaching? 1. "A second nurse witnesses the disposal of unused narcotics." 2. "Unused narcotic medication should be disposed of in sharps containers." ** 3. "All narcotics should be placed in a locked, secured cabinet or container." 4. "A nurse should maintain the count of the prescribed narcotics to prevent drug abuse."

Unused narcotic medication should not be disposed of in sharps containers. The second nurse witnesses disposal of the unused part if a nurse gives only part of a dose of a controlled substance. All narcotics should be placed in a locked, secure cabinet or container to avoid drug abuse. A count of narcotics disposal following any remnants of the drugs should be carefully monitored to avoid drug abuse by other persons.

A patient is to receive cephalexin 500 mg PO. The pharmacy has sent 250-mg tablets. How many tablets should the nurse administer? 1. 1/2 tablet 2. 1 tablet 3. 1 1/2 tablets 4. 2 tablets

Using dimensional analysis: Tablets = 1 tablet/250 mg × 500 mg = 500/250 = 2 tablets.

A patient reports severe vomiting, diarrhea, and abdominal cramps to the nurse. Which form of medication is contraindicated in the patient? 1. Lotion applied to the topical surface 2. Tablet administered through the oral route ** 3. Solution administered through an intravenous line 4. Transdermal medicine administered through the skin surface

Vomiting, diarrhea, and abdominal cramps are suggestive of the disturbed gastrointestinal tract. The oral route of drug administration is contraindicated in patients with gastrointestinal disturbance, because there will not be effective drug absorption. The astopial route, intravenous route, and transdermal route do not require gastrointestinal system for drug metabolism, so these routes of drug administration are safe for this patient.