nur 203

During a nursing assessment, which question by the nurse allows for greater clarification and additional discussion with the patient?

"What medications do you take?"

Digoxin is available in 0.125-mg tablet form. Convert this dose to microgram strength. (do not round) _______

125 mcg

The nurse is reviewing medication errors. Which situation is an example of a medication error?

A patient receives a double dose of a medication because the nurse did not cut the pill in half.

During an admission assessment, the nurse discovers that the patient does not speak English. Which is considered the ideal resource for translation?

A translator who does not know the patient

The nurse will be injecting a drug into the superficial skin layers immediately underneath the epidermal layer of skin. Which route does this describe?

A. Intradermal

1. Levothyroxine is available in 75-mcg tablet form. Convert this dose to milligram strength. (do not round) _______

ANS: 0.075 mg

1. A patient with a PEG tube is to receive ferrous sulfate, 65 mg per the tube, daily. The medication is available as an elixir, 220 mg/5 mL. How many milliliters will the patient receive per dose? Record your answer using one decimal place.

ANS: 1.5 mL 220 mg:5 mL :: 65 mg:x mL

1. A drug dose that delivers 800 mg has a half-life of 5 hours. Identify how much drug will remain in the body after one half-life. _______

ANS: 400 mg

A 7-year-old child will be receiving amoxicillin (Amoxil) 50 mg/kg/day in two divided doses. The child weighs 55 pounds. The medication, once reconstituted, is available as an oral suspension of 125 mg/5 mL. Identify how many milliliters will the child receive per dose. _______

ANS:25 mL per dose

A patient is to receive prednisone 7.5 mg PO daily. The tablets are available in a 2.5-mg strength. Identify how many tablets will the patient receive. _______

ANS:3 tablets 1 tablet:2.5 mg :: x tablet:7.5 mg.(1 × 7.5) = (2.5 × x); 7.5 = 2.5x; x = 3; therefore 7.5 mg = 3 tablets.

A 60-year-old patient is on several new medications and expresses worry that she will forget to take her pills. Which action by the nurse would be most helpful in this situation?

Assisting the patient with obtaining and learning to use a calendar or pill container

A patient with a new prescription for a diuretic has just reviewed with the nurse how to include more potassium in her diet. This reflects learning in which domain?

Cognitive

The patient is stating that he has a headache and asks the nurse which over-the-counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest?

D. A powder ANS: D

The nurse is setting up a teaching session with an 85-year-old patient who will be going home on anticoagulant therapy. Which educational strategy would reflect consideration of the age-related changes that may exist with this patient?

Develop large-print handouts that reflect the verbal information presented.

When reviewing pediatric medication administration, the nurse recognizes that which type of medication error is most common with children?

Dosing errors

An 83-year-old woman has been given a thiazide diuretic to treat heart failure. She and her daughter should be told to watch for which problems?

Fatigue, leg cramps, and dehydration

During an assessment, the patient tells the nurse that he eats large amounts of garlic for its cardiovascular benefits. Which drug or drug class, if taken, would have a potential interaction with the garlic?

Insulin

A patient calls the clinic to ask about taking cranberry dietary supplement capsules because a friend recommended them. The nurse will discuss which possible concern when a patient is taking cranberry supplements?

It may reduce elimination of drugs that are excreted by the kidneys.

The nurse is reviewing a list of verbal medication orders. Which is the proper notation of the dose of the drug ordered?

Levothyroxine 0.75 mg

When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations?

Milligram per kilogram of body weight formula

The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age appropriate for this child?

Offer a brief, concrete explanation of the procedure at the patient's level and with the parent or caregiver present.

For accurate medication administration to pediatric patients, the nurse must take into account which criteria?

Organ maturity

When taking a telephone order for a medication, which action by the nurse is most appropriate?

Repeat the order to the prescriber before hanging up the telephone.

During morning medication administration, the nurse discovered an error on the electronic MAR before the medication was given. Which action by the nurse is appropriate for this "near-miss?"

Report the near-miss using the facility's recommended protocol, and correct the

The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug?

Sedatives

The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity?

The liver is not fully developed.

The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?

The patient uses multiple medications simultaneously.

The nurse is developing a care plan for a patient who will be self-administering a metered-dose inhaler. Which statement reflects a measurable outcome?

The patient will demonstrate the proper technique of self-administering a metered-dose inhaler.

An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy?

The patient will receive the lowest possible dose at first, and then the dose will be increased as needed

The nurse is reviewing the teaching plan for a clinic patient who was seen for a sinus infection. Which of these outcomes reflect the affective domain of learning

The patient will take the prescribed antibiotic for the full 14 days of the prescription.

When administering drugs, the nurse remembers that the duration of action of a drug is defined as which of these?

The time period at which a drug's concentration is sufficient to cause a therapeutic response ANS: D

The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent?

a. "Right time" ANS: A

The nurse can prevent medication errors by following which principles? (Select all that apply.)

a. Assess for allergies after giving medications.b. Use two patient identifiers before giving medications.c. Always following the rights of medication administration.d. Minimize the use of verbal and telephone orders.e. Use trade names instead of generic names to avoid confusion. ANS: B,C,D

1. The patient is receiving two different drugs. At current dosages and dosage forms, both drugs have the same concentration of the active ingredient. Which term is used to identify this principle?

a. Bioequivalent ANS: A

The nurse is developing a human needs statement for a patient who has a new diagnosis of heart failure. Identification of human needs statements occur with which of these activities?

a. Collection of patient data ANS: A

Which are appropriate considerations when the nurse is assessing the learning needs of a patient? (Select all that apply.)

a. Cultural background b. Family history c. Level of education d. Readiness to learn e. Health beliefs ANS: A,C,D,E

The nurse is teaching an older patient about the use of an incentive spirometer after surgery. Which of these age-related changes are appropriate for the nurse to consider when teaching older patients? (Select all that apply.)

a. Decreased sense of touch b. Increased conduction of sound c. Decreased cognitive function d. Decreased short-term memory e. Increased ability to concentrate ANS: A,C,D

The nurse is trying to give a liquid medication to a -year-old child and notes that the medication has a strong taste. Which technique is the best way for the nurse to give the medication to this child?

a. Give the medication with a spoonful of ice cream.

The nurse is giving a lecture about current U.S. laws and regulations of herbal products. According to the Dietary Supplement and Health Education Act of 1994, which statement is true?

a. Medicinal herbs are viewed as dietary supplements.

1. Which drugs would be affected by the first-pass effect when administered? (Select all that apply.)

a. Morphine given by IV push injection b. Sublingual nitroglycerin tablets c. Diphenhydramine (Benadryl) elixirs d. Levothyroxine (Synthroid) tablets e. Transdermal nicotine patches f. Esomeprazole (Nexium) capsules g. Penicillin given by IV piggyback infusion ANS: C,D,F

A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy?

a. Palliative therapy ANS: A

The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?

a. Parenteral drugs bypass the first-pass effect. ANS: A

Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as the last phase. (Select all that apply.)

a. Planningb. Evaluation c. Assessmentd. Implementatione. Human needs statement ANS: A,B,C,D,E

Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension?

a. Providing education on keeping a journal of blood pressure readings ANS: A

1. When giving medications, the nurse will follow the rights of medication administration. The rights include the right documentation, the right reason, the right response, and the patient's right to refuse. Which of these are additional rights? (Select all that apply.)

a. Right drug b. Right route c. Right dose d. Right diagnosis e. Right time f. Right patient ANS: A,B,C,E,F

The nurse is reviewing the criteria for over-the-counter drugs. Which criteria for over-the-counter status in the United States are accurate

a. The drug must be easy to use. c. The consumer must be able to monitor the drug's effectiveness. d. The drug must have a low potential for abuse.

Which statements are true regarding the elderly and pharmacokinetics? (Select all that apply.)

a. The levels of microsomal enzymes are decreased. b. Fat content is increased because of decreased lean body mass. c. Fat content is decreased because of increased lean body mass. d. The number of intact nephrons is increased. e. The number of intact nephrons is decreased.f. Gastric pH is less acidic. g. Gastric pH is more acidic. ANS: A,B,E,F

Which statements are true regarding pediatric patients and pharmacokinetics? (Select all that apply.)

a. The levels of microsomal enzymes are decreased. b. Perfusion to the kidneys may be decreased and may result in reduced renal function. c. First-pass elimination is increased because of higher portal circulation. d. First-pass elimination is reduced because of the immaturity of the liver. e. Total body water content is much less than in adults. f. Gastric emptying is slowed because of slow or irregular peristalsis. g. Gastric emptying is more rapid because of increased peristaltic activity. ANS: A,B,D,F

The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet?

a. Under the tongue ANS: A

1. The nurse is conducting a class for senior citizens about the use of over-the-counter (OTC) drugs. Which statements are true regarding the use of OTC drugs? (Select all that apply.) a

a. Use of OTC drugs may delay treatment of serious ailments. c. OTC drugs may relieve symptoms without addressing the cause of the problem. e. Patients may misunderstand product labels and use the drugs improperly.

A patient wants to take the herb gingko to help his memory. The nurse reviews his current medication list and would be concerned about potential interactions if he is taking a medication from which class of drugs

b. Antiplatelet drugs

During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order becaus

b. Contact the prescriber to clarify the order.

2. When given an intravenous medication, the patient says to the nurse, "I usually take pills. Why does this medication have to be given in the arm?" What is the nurse's best answer?

c. "The action of the medication will begin sooner when given intravenously." ANS: C

The medication order reads, "Give ondansetron (Zofran) 4 mg, 30 minutes before beginning chemotherapy to prevent nausea." The nurse notes that the route is missing from the order. What is the nurse's best action?

c. Contact the prescriber to clarify the route of the medication ordered. ANS: C

Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?

c. Enhanced blood flow to the fetus ANS: C

The patient wants to take the herbal product kava to help him rest at night. The nurse would be concerned about potential interactions if he is taking a medication from which class of drugs?

c. Sedatives

The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data?

c. The patient reports that he uses the herbal product ginkgo. ANS: C

7. When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug?

c. The patient's last meal ANS: c

The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug's half-life?

c. The time it takes for one half of the original amount of a drug to be removed from the body ANS: C

A 25-year-old woman is visiting the prenatal clinic and shares with the nurse her desire to go "natural" with her pregnancy. She shows the nurse a list of herbal remedies that she wants to buy so that she can "avoid taking any drugs." Which statement by the nurse is correct?

d. "It's important to remember that herbal remedies do not have proven safety ratings for pregnant women."

When given a scheduled morning medication, the patient states, "I haven't seen that pill before. Are you sure it's correct?" The nurse checks the medication administration record and verifies that it is listed. Which is the nurse's best response?

d. "Let me check on the order first before you take it."

The patient has been taking an over-the-counter (OTC) acid-reducing drug because he has had "stomach problems" for several months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement by the nurse is the best advice for this patient?

d. "Using this drug may relieve your symptoms, but it does not address the cause. Please make an appointment with your health care provider."

When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best way to set up the teaching/learning session?

d. After demonstrating the procedure, allow the patient to do several return demonstrations.

The nurse recognizes that an elderly patient may experience a reduction in the stomach's ability to produce hydrochloric acid. This change may result in which effect?

d. Altered absorption of some drugs

The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration pregnancy safety category?

d. Category D

The nurse has been monitoring the patient's progress on a new drug regimen since the first dose and documenting the patient's therapeutic response to the medication. Which phase of the nursing process do these actions illustrate?

d. Evaluation ANS: D

The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?

d. Excretion ANS: D

When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient's blood pressure is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse drug reaction?

d. Pharmacologic reaction ANS: D

When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. Which of these processes describes selective enzyme interaction?

d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme's Action with the normal target cell. ANS: D

When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication, that is not highly protein bound?

d. The duration of action of the medication will be longer. ANS: D

The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient?

d. The patient will demonstrate correct blood glucose testing technique. ANS: D