Nursing - GOOD REVIEW
A nurse is applying a vaginal cream to a patient with a vaginal infection. Which of the following is a recommended guideline for this application?
Cleanse area at vaginal orifice with wash cloth and warm water
The nurse is preparing to administer meperidine (Demerol) as an intramuscular injection in an adult patient's deltoid site. Which of the following needles should the nurse select for this injection?
1" with a 22 gauge
You are preparing to administer a transdermal medication. How should this be accomplished?
adsorbed through the skin
Subcutaneous injections
administered into the adipose tissue layer
The "Rights of Medication Administration" help to ensure accuracy when administering medications. Which of the following represent these five rights?
(1) Right medication is given to the (2) right patient in the (3) right dosage through the (4) right route at the (5) right time
A nurse is administering a subcutaneous injection to a client. What is the common maximum volume of a subcutaneous injection?
1 mL
The nurse is caring for a client who has problems coordinating his breathing with the inhaler use. Therefore, the client is unable to receive the full dose. Which of the following would help maximize drug absorption in this client?
A spacer would help maximize the absorption of the drug in a client who is having problems coordinating his breathing with the inhaler use. A spacer provides a reservoir for the aerosol medication. As the client takes additional breaths, he continues to inhale the medication held in the reservoir. This tends to maximize the drug's absorption because it prevents drug loss
A nurse needs to administer a prescribed medication to a client using IV push. In which of the following ways is the medication being administered to the client?
A bolus is a large amount of medication given all at once; bolus administration is described as a drug given by IV push, or rapid IV
To which of the following patients would the nurse be most likely to administer a PRN medication?
A complaint of "breakthrough" pain, especially postsurgery
A nurse is administering intermittent IV medication to an active adolescent. Which of the following IV systems could be used to allow the patient more freedom?
A peripheral venous access device allows the patient more freedom. The patient is connected to the IV line when it is time to receive the medication and disconnected when the medication is completed. The device is kept patent (working) by flushing with small amounts of saline pushed through the device on a routine basis
If an elderly client is having difficulty comprehending the discharge instruction, the nurse should involve a second responsible person in the instruction in order to ensure client safety
A referral for skilled nurse visits is appropriate for homebound older adults who need additional instructions about medication routines after discharge
A client suffers from infectious diarrhea. Based on his loss of fluid, his protein level is below normal. What blood product will the physician order to restore intravascular volume?
Albumin
A nurse should read the instructions stated on a vial container before reconstituting it and administering it to a client. Which of the following instructions are stated on the label of a vial container?
Amount of diluent to be added
A nurse is reviewing information about prescribed drug in a drug handbook in preparation for administration to a client. When reading about the drug, the nurse identifies which name as the generic name?
Ampicillin sodium
A nurse at the health care facility needs to instill eye medication in a client with conjunctivitis. What care should the nurse take to avoid injury when instilling the medication?
Ask the client to blink his eye
Which of the following are recommended guidelines for the nurse who is administering a piggyback intermittent intravenous infusion of medication?
Attach infusion tubing to the medication container by inserting the tubing spike into the port with a firm push and twisting motion
The maintenance of client safety with medication administration is of primary importance in healthcare. The most commonly used system for billing and record keeping is the
Automated dispensing system - keeps an account of all medication used for billing, controlled substance & record keeping. Access by using a password or by fingerprint. The medication is delivered in a unit-dose package.
Medications administered that are renal toxic should have frequent assessments of which blood values?
BUN and creatinine
A nurse is providing care for a patient who has a history of dementia. Which of the following methods should the nurse use in order to determine the patient's identity prior to medication administration?
Check the patient's identification band.
A nurse needs to use a moisturizer for an elderly client with dry skin. Why is the onset of the medication action typical in an elderly client?
Diminished subcutaneous fat
A nurse is caring for a client with an intravenous catheter. When administering medication through the intravenous port, the nurse pinches the tubing upstream from the port when instilling it with the drug. Which of the following reasons explains the nurse's action?
Ensure administration of medication. Pinching ensures that the tube does not get backfilled and that the drug gets administered to the client
A nurse is using an 18-gauge needle to administer a medication to a client. The nurse knows that when compared to a 27-gauge needle, an 18-gauge needle has which of the following features?
For most injections, 18- to 27-gauge needles are used; the smaller the number, the larger the diameter
A nurse is administering medications through an enteral tube to a client with swallowing difficulties due to a cerebrovascular accident (CVA). Which of the following actions should the nurse perform to prevent gastric reflux?
Help the client into a Fowler's position
A nurse is administering pain medication to an 80-year-old woman. What altered drug response might be expected due to the patient's age?
Increased possibility of toxicity due to higher drug plasma concentrations & a decreased number of protein-binding sites
A nurse caring for a client with diarrhea needs to establish an intravenous (IV) access to administer fluids and medication. When explaining intravenous access to the client, which of the following would the nurse most likely incorporate into the description?
Insertion of a needle into a peripheral vein
Which parenteral route of administration has the longest absorption time?
Intradermal injections administered into the dermis, just below the epidermis, this route has the longest absorption time
A nurse is using the Z-track technique to administer an injection to a client. Which of the following injection routes utilizes the Z-track technique?
Intramuscular
A post-surgical patient's MAR provides for PRN administration of a number of analgesics by various routes. Which of the following routes will likely provide the most rapid pain relief for the patient?
Intravenous drugs, because they are introduced directly into the circulatory system
A nurse is explaining to a client the correct method of using a metered-dose inhaler when self-administering a prescribed dose of medication. Which of the following is a feature of a metered-dose inhaler?
It is a canister that contains pressurized medication
A nurse is administering medication to a patient with a gastrointestinal tube. Which of the following is a recommended guideline for medication administration using this route?
Medications should be crushed to a fine powder and mixed with 15 to 30 mL of water before delivery through the tube. Use liquid medications when possible, because they are readily absorbed and less likely to cause tube occlusions
A client has an order for an intermittent infusion of 250 mL of 0.9 normal saline. The nurse understand that this type of infusion is used for which situation?
Medications that need to be infused over 20 to 60 minutes
When administering heparin subcutaneously, the nurse should
Never aspirate
A nurse is bunching the tissue of a client when administering a subcutaneous injection. The nurse knows that which of the following is the reason for bunching when injecting subcutaneously?
Nurses bunch tissue between the thumb and fingers before administering the injection to avoid instilling medication within the muscle
The physiologic and biochemical effects of a drug
Pharmacodynamics refers to the physiologic and biochemical effects of a drug on the body
What is involved in the absorption, distribution, metabolism, and excretion of medication?
Pharmacokinetics
The process by which a drug moves through the body and is eventually eliminated is
Pharmacokinetics is the process by which a drug moves through the body and is eventually eliminated
A 17-year-old girl is admitted to pediatrics with a diagnosis of diabetic ketoacidosis. She requires intravenous therapy to
Provide access for the administration of insulin
A client has been prescribed nasal medication. What care should the nurse take to avoid potential complications due to the administration of this medication?
Review the client's medication, allergy, and medical history
A nurse is administering enoxaparin, (blood thinner) to a patient with DVT, via the subcutaneous route. Which of the following is a recommended guideline when administering a subcutaneous injection?
Subcutaneous injections are administered into the adipose tissue layer just below the epidermis and dermis
A nurse needs to withdraw a prescribed medication from an ampule and administer it to a client. Which of the following actions should she perform to ensure that all the medication is equally distributed when withdrawing?
Tapping the top of the ampule distributes all the medication to the lower portion of the ampule
Drugs known to cause birth defects are called
Teratogenic
Which of the following medication-administration systems protects the client by identifying the rights of medication administration?
The Barcode Medication Administration system will warn of a potential error
A nurse needs to administer a subcutaneous heparin injection to a client. Which of the following injection sites is most suitable for heparin?
The abdomen, because of less pain intensity
During a visit to the clinic, the physician prescrbes an intramuscular injection of a medication for an 8-month old. When administering this medication to the child, which of the following sites would the nurse be least likely to select?
The dorsogluteal is not used in infants and toddlers. Muscles in this site are not well developed until children begin to walk
A nurse educator is teaching a student nurse how to choose the correct needle for an injection. Which of the following guidelines for needle selection might they discuss?
The larger the gauge, the smaller the needle
A nurse needs to administer an intramuscular injection to a thin and frail elderly client. Which of the following actions should the nurse perform to avoid striking the bone when injecting?
The muscular tissue should be pinched together to avoid striking the bone when administering an intramuscular injection if the older person has decreased subcutaneous fat
A nurse needs to administer medications to a client through an IV port. Which of the following actions should she perform to ascertain that the IV catheter is in the vein?
The nurse should observe for blood in the tubing near the IV catheter or insertion device because blood validates that the IV catheter is in the vein
A patient with chronic obstructive pulmonary disease has been prescribed an inhaled bronchodilator. Which of the following techniques should the nurse implement in order to ensure safe and complete delivery of the prescribed medication?
The use of an extender or spacer ensures that the patient receives as much of the inhaled medication as possible
What is the term used for the concentration of drug in the blood serum that produces the desired effect without causing toxicity?
Therapeutic range
Children's medication dosages are most often calculated using the child's body surface area and
Weight
A nurse is administering an injection to a client at a 15-degree angle. The client has a venous access port. Which of the following injections can be administered at this angle?
When giving an intradermal injection, instills the medication shallowly at a 10- to 15-degree angle of entry
A nurse is administering medication to a patient via a gastric tube and finds that the medicine enters the tube and then the tube becomes clogged. What is the appropriate intervention in this situation?
When medication becomes clogged in the tube, you should attach a 10-mL syringe onto the end of the tube, pull back, and then lightly apply pressure to the plunger in a repetitive motion
If the dosage is inappropriate for a client, who is responsible?
Whereas physicians and other healthcare providers prescribe and pharmacists dispense therapeutic agents, it is the nurse's legal domain to administer medications in a safe and timely manner
A nurse needs to combine two different prescribed drugs in a syringe and then administer them to a client with influenza. Which of the following precautions should the nurse take when combining drugs?
Withdraw exact amounts of each drug from each container
The nurse of a newly admitted patient notes a penicillin allergy, yet the physician has just written an order for an antibiotic in the same drug family; after reviewing the patient's wound culture and sensitivity. How should the nurse respond to this situation?
Withhold the medication until the potential drug allergy has been addressed by the care team
A nurse is caring for a patient with pancreatic cancer who is receiving continuous morphine for pain. Which of the following would be the most effective method to administer this medication?
a continuous subcutaneous infusion of morphine - longer rate of absorption
A severe allergic reaction from a medication requires
anaphylactic reaction, requires immediate medical intervention because it can be fatal. Treatment includes discontinuing the medication and administering epinephrine, IV fluids, and antihistamines
A nurse at the health care facility needs to administer an otic application for a client with an earache. What should the nurse do after instilling the prescribed eardrops in the client's ear?
ask the client to maintain the position until the solution travels toward the eardrum. When instilling the medication in the client's ear, the nurse first manipulates the client's ear to straighten the auditory canal. Tilting the client's head away, the nurse then administers the prescribed number of drops of medication. The client remains in this position briefly as the solution travels toward the eardrum. The nurse then places a cotton ball loosely in the ear to absorb the excess medication. The nurse then waits for at least 15 minutes before administering the medication in the opposite ear if prescribed
A nurse is caring for a client in the nursing unit when the physician, during the rounds, prescribes a medication for the client. What appropriate action should the nurse take to ensure the accuracy of the verbal medication order?
ask the physician for a written order. When obtaining phone orders, it is important to repeat the dosages of medications and to spell medication names for confirmation of accuracy
A nurse is caring for a client who is being tube fed. What care should the nurse take when administering medications through an enteral tube?
avoid crushing sustained-release pellets because keeping them whole ensures their sequential rate of absorption
What is an venous access port?
for patients who require long-term IV medication. The port is usually placed just under the skin on the upper part of the chest
A client is ordered to receive an intramuscular injection of medication. When preparing to administer the injection, the nurse selects the ventrogluteal site based on which reason?
free of major blood vessels and fat. It is considered the safest and least painful site
After teaching a group of nursing students about pharmacokinetics, the instructor determines that the teaching was successful when the students identify which of the following as the process by which the medication is delivered to the target cells and tissues?
distribution, absorption is the process by which a medication enters the bloodstream
Which of the following patients receives a drug that requires parenteral route?
drugs administered by intravenous, injections, & syringe
A nurse is administering a prescribed dose of medication to a client through a medication lock. How often should the nurse flush the medication lock to maintain patency?
flush medication locks every 8 to 12 hours with saline or heparin
An elderly client with pneumonia has been prescribed the use of a bronchodilator by the physician. What should the nurse monitor in a client taking an inhaled bronchodilator?
heart rate and blood pressure of the elderly client who uses inhaled bronchodilators. It is important to monitor the vital signs because these medications commonly cause tachycardia and hypertension. Either or both of these effects increase the risks of complications, especially in elderly clients with underlying cardiovascular disease
A nurse needs to administer an intradermal tuberculin skin test injection to a client. Which of the following is the most suitable angle when administering an intradermal injection?
hold the syringe almost parallel to skin at a 10-degree angle with the bevel pointing upward. This facilitates delivering the medication between the layers of the skin and advances the needle to the desired depth
Which one of the following medications would most likely be administered via a transdermal patch?
hormones, narcotic analgesics, cardiac medications, and nicotine
A nurse at a health care facility administers a prescribed drug to a client and does not record doing so in the medical administration record. The nurse who comes during the next shift, assuming that the medication has not been administered, administers the same drug to the client again. The nurse on the previous shift calls to inform the health care facility that the administration of the drug to this client in the earlier shift was not recorded. What should the nurse on duty do immediately upon detection of the medication error?
immediately check the client's condition. When medication errors occur, nurses have an ethical and legal responsibility to report them to maintain the client's safety. As soon as the nurse recognizes an error, he or she should check the client's condition and report the mistake to the prescriber and supervising nurse immediately.
A nurse has to administer a subcutaneous injection to a client. For which of the following clients can the nurse administer a subcutaneous injection at a 90-degree angle?
in a normal-size or obese client who has a 2-inch tissue fold when it is bunched. For thin clients who have a 1-inch fold of tissue, the nurse inserts the needle at a 45-degree
A nurse is caring for a client with difficulty breathing due to nasal congestion. What care should the nurse take to prevent the client from inhaling large droplets of the medication when the nasal spray is being administered?
instruct the client to breathe through her mouth. Place the tip of the container just inside the nostril confines the spray within the nasal passage. In order to facilitate depositing the drug where its effect is desired, the nurse should help the client to a sitting or lying position with her head tilted backward or to the side if the drug needs to reach one or the other sinus
A nurse needs to administer a prescribed dosage of oral medication to a client with influenza. Which of the following actions should the nurse perform when administering oral medication to the client?
never administer medications prepared by another nurse. Prepare and bring oral medications to the client's bedside in a paper or plastic cup, not in a glass container or ceramic cup, in order to avoid accidents and spills. Check the label of the medication container three times when preparing it
You are preparing to administer a sublingual medication. Which of the following instructions to the patient is correct?
not to swallow while the pill dissolves
Regarding medication administration, what must occur at the change of shifts?
perform a count of controlled medications at specified times (each shift) or when removed from an automated dispensing machine
A nurse needs to administer a prescribed dose of a narcotic medication to a client with acute neck pain. Which of the following precautions should the nurse take when storing narcotic medications?
place narcotic drugs in a double-locked drawer. Narcotics are controlled substances, meaning that federal laws regulate their possession and administration
The nurse is preparing to administer a medication via a nasogastric tube. What guideline is appropriate for the nurse to follow when administering a drug via this route?
position the patient with the head of the bed elevated, administering the medication at room temperature, flushing the tube with water between each drug administered, and avoiding the use of suction for 20 to 30 minutes after the drug is administered
A nurse is administering a prescribed intramuscular injection to a client by the Z-track technique. Which of the following actions ensures that the medicine remains sealed?
pull the tissue laterally until the tissue is taut
A nurse is using a volume control set to administer a dose of prescribed medication to a client. The nurse opens the lower clamp until the tubing is filled with fluid and then reclamps it. Which of the following statements explains the nurse's action?
purges air from the tubing
A client with dry skin has been prescribed inunction. Which of the following should the nurse do to promote absorption of the ointment?
rub the ointment into the client's skin
An acute care facility follows the unit dose supply method to supply medication to the clients. What is meant by the unit dose supply method?
self-contained packets hold one tablet or capsule for an individual client
The nurse transcribes an order that reads: Colace 100 mg PO daily. This is an example of which type of order?
standing order, which is to be carried out as specified until it is cancelled by another order
When instructing a client regarding sublingual application, the nurse should inform the client that which of the following is contraindicated when administering the drug?
the client should avoid swallowing or chewing the medication. Eating or smoking during administration is also contraindicated
The nurse is administering a hepatitis B shot intramuscularly. What would be the appropriate site for administration?
the deltoid, children are administered at the vastus lateralis
The primary reason for the Controlled Substances Act is
to prevent drug abuse and dependence, provide treatment and rehabilitation for people who are dependent on drugs, and strengthen drug abuse laws
A nurse needs to administer a prescribed injection to a toddler. Which of the following injection sites is most suitable for the client?
vastus lateralis site is the most desirable site for administering injections to infants and small children and clients who are thin or debilitated with poorly developed gluteal muscles
A nurse is caring for a client undergoing IV therapy. The nurse knows that intravenous administration of medication is appropriate in which of the following situations?
when clients have disorders, such as severe burns, that affect the absorption and metabolism of medications. IV therapy is also used in an emergency when a quick response is needed
A nurse needs to administer an insulin injection to a client with diabetes. Which of the following actions should the nurse perform to prevent bruising of the injection site? Select all that apply.
• Change the needle before injecting • Rotate the injection sites with each injection • Avoid aspirating the plunger after placing the needle
A nurse is caring for a client who has been prescribed codeine, a narcotic medication to relieve severe postoperative pain. Which of the following responsibilities does the nurse have to complete when handling narcotic medications? Select all that apply
• Maintain an accurate account of the use of the medication • Record each medication used from the stock supply • Count each narcotic medication at the change of each shift
Which of the following actions are included in the required "checks" for safe medication administration? Select all that apply.
• Read the medication label when reaching for the unit dose package. • Read the medication label after retrieving the medication from the drawer. • Read the medication label just before administering a unit dose medication to the patient.
A nurse is assigned to a nursing unit where bar-coded identification systems are used for medication distribution. Which of the following should the nurse do when administering medication to clients wearing bar-coded identification bracelets?
• Scan the client's identification bracelet • Tally the bar code with packaged medication • Check for client confirmation by the system