Passpoint - Medication and I.V. Administration
The physician prescribes 20 units of U-100 regular insulin for a client. The only syringe available is a 1-ml tuberculin syringe. How many milliliters of insulin should the nurse administer? 0.2 0.002 2 20
0.2
A client is receiving furosemide, 40 mg by mouth twice per day. In the plan of care, the nurse should emphasize teaching the client about the importance of consuming: low-fat milk. creamed corn. bananas and oranges. fresh green vegetables.
bananas and oranges.
A client is prescribed metformin to control type 2 diabetes. The nurse should monitor for which life-threatening adverse reaction? Vomiting Lactic acidosis Nausea Megaloblastic anemia
Lactic acidosis
A nurse is teaching a client about a newly prescribed drug. What physiological changes does the nurse recognize that could cause a geriatric client to have difficulty learning about prescribed medications? Decreased drug excretion Lack of family support Sensory deficits Fixed income
Sensory deficits
A medication nurse is preparing to administer 9 a.m. medications to a client with liver cancer. Which consideration is the nurse's highest priority? necessity of the medication frequency of the medication metabolism of the medication purpose of the medication
metabolism of the medication
When reviewing a client's file, the nurse reviews the following medication order "Vitamin K 10 mg intramuscular (I.M.) daily × 3 days?" The nurse recognizes this as which type of order? Stat order Standing order Single order Standard written order
Standard written order
A nurse is administering eye drops to a client. Which technique is correct? Pull the lower lid down, press the tear duct, and drop medication into the conjunctival sac. Tilt the head to the side and drop the medication into the outer canthus. Have the client look upward and drop medication into the inner canthus. Hold both lids open and drop medication onto the sclera.
Pull the lower lid down, press the tear duct, and drop medication into the conjunctival sac.
A client is prescribed heparin 6,000 units subcutaneously every 12 hours for deep vein thrombosis prophylaxis. The pharmacy dispenses a vial containing 10,000 units/1 mL. How many milliliter(s) of heparin should the nurse administer? Record your answer using one decimal place.
0.6
A client with diabetes mellitus is receiving insulin. The nursing instructor asks the nursing student to correctly describe an insulin unit. How does the student appropriately respond? "It is a common measurement in the metric system." "It is the basis for solids in the avoirdupois system." "It is a measure of effect, not a standard measure of weight or quantity." "It is the smallest measurement in the apothecary system."
"It is a measure of effect, not a standard measure of weight or quantity."
The licensed practical nurse (LPN) is coassigned with a registered nurse (RN) who is administering I.V. hydrocortisone; 40 mg b.i.d. Which laboratory value would the nurses expect to be elevated as a result of this medication regimen? magnesium glucose calcium potassium
glucose
The physician prescribes 60 mEq of potassium chloride liquid as a one-time dose. The pharmacy supplies a liquid containing 20 mEq/15 ml. How many milliliters of solution should the nurse administer? 15 ml 45 ml 30 ml 60 ml
45 ml
When drawing up a medication, the nurse notes there are small air bubbles adhering to the interior surface of the syringe. The nurse knows which effect the bubbles might have on parenteral administration? Altered onset of action Altered duration Altered drug absorption Altered drug dose
Altered drug dose
The nurse is preparing to discharge a child who has rheumatic fever. Which medication would the nurse expect to be prescribed to prevent recurrence of rheumatic fever? Anti-inflammatory medications Glucocorticoids Digoxin Antibiotics
Antibiotics
Which nursing action is appropriate when administering a glycerin suppository to a client? Instructing the client to bear down during insertion Applying a lubricant to the suppository Removing the suppository from the refrigerator 30 minutes before insertion Assisting the client to a right-side lying position with the left leg flexed upward
Applying a lubricant to the suppository
The nurse is preparing to administer an intramuscular (I.M.) injection to a 6-month-old infant. Which appropriate site would the nurse inject the infant? Vastus lateralis muscle Ventrogluteal area Gluteus maximus muscle Deltoid muscle
Vastus lateralis muscle
The nurse is caring for a client who is taking an anticoagulant. The nurse should teach the client to: use a straight razor when shaving. take aspirin for pain relief. report incidents of diarrhea. avoid foods high in vitamin K.
avoid foods high in vitamin K.
The nurse is caring for a 2-year-old child following surgery. The nurse is preparing to administer a dose of hydrocodone syrup to the child for postoperative pain. What should the nurse select to administer this drug? a clear, one ounce medicine cup an oral syringe a teaspoon a 3 mL syringe with the needle removed
an oral syringe
A client received a new prescription for oral contraceptives. When reinforcing education, what should the nurse be sure to inform the client to report? Select all that apply. decreased menstrual flow breakthrough bleeding within first 3 months of use blurred vision and headache breast tenderness pain in the calf with dorsiflexion of the foot
blurred vision and headache pain in the calf with dorsiflexion of the foot
When a nurse administers a medication, which details of a client's drug therapy is the nurse legally responsible for documenting? Select all that apply. peak concentration time of the drug time the drug was administered safe ranges of the drug client's socioeconomic data client's reaction to the drug
client's reaction to the drug time the drug was administered
A client with generalized arthritis who takes aspirin several times per day arrives at the clinic for a regular checkup. What data collected should the nurse pay particular attention to? fragile skin and weight gain orange color and fruity smell of urine easy bruising and reports of unusual bleeding history of constipation and fatigue
easy brushing and reports of unusual bleeding
A nurse prepares to administer eardrops to an adult client. Which action should the nurse take before instilling the drops? Direct the medication toward the base of the ear canal. Warm the eardrops in tepid water. Identify the client by calling the client's name. Gently pull the auricle up and back.
Gently pull the auricle up and back.
The label of a drug package reads "hydralazine, 20 mg/ml." How many milliliters would the nurse give a client for a 25-mg dose? 1.25 1.5 0.5 1.0
1.25
A client has a nasogastric (NG) tube. The physician prescribes an oral medication that is not available in liquid form. Which action should the nurse utilize to administer the tablet form to this client? Crush the tablets and wash the powder down the NG tube, using a syringe filled with saline solution. Dissolve the tablets, and then pour the liquid down the NG tube. Cut the tablets in half and wash them down the NG tube, using a syringe filled with water. Crush the tablets and prepare a liquid form, and then insert it into the NG tube using using a syringe.
Crush the tablets and prepare a liquid form, and then insert it into the NG tube using using a syringe.
The nurse prepares to administer a client's morning medication. Which action should the nurse take first? Use two client identifiers. Check client allergies. Perform hand hygiene. Open the packages.
Perform hand hygiene.
A client has a nasogastric (NG) tube. The physician prescribes an oral medication that is not available in liquid form. Which action should the nurse utilize to administer the tablet form to this client? Crush the tablets and wash the powder down the NG tube, using a syringe filled with saline solution. Crush the tablets and prepare a liquid form, and then insert it into the NG tube using using a syringe. Cut the tablets in half and wash them down the NG tube, using a syringe filled with water. Dissolve the tablets, and then pour the liquid down the NG tube.
Crush the tablets and prepare a liquid form, and then insert it into the NG tube using using a syringe.
A nursing student is preparing to administer a parenteral medication. The nursing instructor asks the student which administration route places a drug directly into the circulation, requiring no absorption. Which method does the student relay to the instructor? Subcutaneous (subQ) Intradermal Intravenous (I.V.) Intramuscular (I.M.)
Intravenous (I.V.)
A geriatric client has experienced several adverse drug reactions. What does the nurse recognize that this client may benefit from? Frequent visits to the physician Reduced drug dosages Increased drug doses at longer intervals Nursing home placement
Reduced drug dosages
The nurse is preparing to administer an injection from an ampoule. To avoid injury, how should the nurse open the ampoule? Use a syringe without the needle attached to withdraw the medication. Using a pad, break ampoule away from the body. Ask the patient care technician to open the ampoule. Wearing gloves, break ampoule toward the body.
Using a pad, break ampoule away from the body.
The physician orders nitroglycerin, 5 mg by mouth twice per day, for a client. The drug is dispensed in 2.5-mg tablets. How many tablets will the nurse administer twice per day? Four Six Two Eight
Two
A nurse is caring for a child who has just been immunized. When reinforcing education with the child's parents about potential adverse effects, what should the nurse identify as requiring immediate attention? Select all that apply. Localized swelling at the injection site generalized urticaria mild temperature elevation swelling of the lips and tongue pain at the injection site wheezing
generalized urticaria wheezing swelling of the lips and tongue
The client is to receive an I.V. infusion of 3,000 ml of dextrose and normal saline solution over 24 hours. The nurse observes that the rate on the infusion pump is set at 150 ml/hour. If the solution runs continuously at this rate, the infusion will be completed in: 24 hours. 20 hours. 50 hours. 12 hours.
20 hours
A client is on the surgical unit after orthopedic surgery. The health care provider has prescribed 4 mg of morphine sulfate IM for pain. The vial reads "morphine sulfate 10 mg per 1 mL." How many milliliters should the nurse administer? Record your answer using one decimal place.
0.4 (1 mL/10 mg) x 4 mg/dose = 0.4 mL/dose
A nurse is caring for a client with deep vein thrombosis who is scheduled to receive an injection of enoxaparin 75 mg subcutaneously daily. On hand is enoxaparin 100 mg per milliliter (ml). How many milliliter(s) should the nurse administer to the client? Record your answer using two decimal places.
0.75
A health care provider prescribes I.V. normal saline solution to be infused at a rate of 150 mL/hour for a client. How many liter(s) of solution will the client receive during an 8-hour shift? Record your answer using one decimal place.
1.2 The ordered infusion rate is 150 mL/hour. The nurse should multiply 150 mL by 8 hours to determine the total volume in milliliters the client will receive during an 8-hour shift (1,200 mL). Then the nurse should convert milliliters to liters by dividing by 1,000. The total volume in liters that the client will receive in 8 hours is 1.2 L.
A client with severe pain is prescribed hydromorphone 10 mg by mouth every 4 hours as needed for pain. The client rates pain as eight on a one-to-ten scale, so the nurse prepares to administer a dose. The oral liquid contained in the unit's opioid stock contains 5 mg/5 mL. How many milliliters of solution should the nurse give to the client? Record your answer using a whole number.
10 The following formula is used to calculate drug dosages: dose on hand/quantity on hand = dose desired/X. In this example, the equation is as follows: 5 mg/5 mL = 10 mg/X; so X = 10 mL.
The nurse is caring for a client who underwent internal fixation of the right hip. Before administering the client's warfarin, the nurse checks the laboratory report for the client's International Normalized Ratio (INR) results. Which indicates the therapeutic range for this client? 1.0 to 2.0 2.0 to 3.0 1.5 to 2.0 3.0 to 4.0
2.0 to 3.0
A client is to receive a glycerin suppository. When inserting the suppository, the nurse should advance it approximately how far into the client's rectum? 3" (7.5 cm) 2" (5 cm) 4" (10 cm) 1" (2.5 cm)
3" (7.5 cm)
The nurse is caring for a client who is receiving warfarin. The nurse reinforces to the client that anticoagulant effects may not be seen for how many days? 1-2 6-8 9-11 3-5
3-5
The physician orders dextrose 5% in water, 1,000 ml to be infused over 8 hours. The I.V. tubing delivers 15 drops/ml. The nurse should check that the I.V. is infusing at a rate of: 21 drops/minute. 125 drops/minute. 15 drops/minute. 32 drops/minute.
32 drops/minute.
A nurse is preparing to administer oral doxycycline to a client. What is the nurse's appropriate action? Administer with an antacid. Administer with food. Administer with full glass of water. Administer with milk.
Administer with full glass of water.
A client who is at risk for blood clots after orthopedic surgery is scheduled to receive subcutaneous heparin. A multidose vial of heparin contains 10000 units in 1 mL. How many milliliters should the nurse administer for an ordered dose of 5,000 units? 4 mL 0.25 mL 5 mL 0.5 mL
0.5 mL
After laparoscopic cholecystectomy, a client reports pain and nausea. A nurse is preparing 75 mg of meperidine and 12.5 mg of promethazine to be administered IM in the same syringe. If the label on the meperidine reads 50 mg/mL and the label on the promethazine reads 25 mg/mL, how many milliliters should the nurse have in the syringe after the correct doses are drawn up? Record your answer using a whole number.
2
A licensed practical nurse (LPN/LVN) is working with the RN in verifying a heparin IV infusion rate. The prescribed dose is 400 units of heparin per hour. The heparin is in a solution of 5,000 units/100 mL NS. How many milliliters per hour should the pump be set? Record your answer using a whole number.
8 mL/hour = 100 mL/5,000 U x 400 U/1 hour = 8 mL/hr (Dimensional Analysis) 5,000 units divided by 100 mL NS = 50 units/mL. 400 units divided by 50 units/mL = 8 mL. 50 units of heparin in each milliliter of the solution; 8 mL/hour delivers 400 units.
A client is prescribed an I.V. solution of 1,000 mL to be infused from 0800 to 2000. The nurse will use an infusion pump that delivers in milliliters per hour. At what rate should the nurse set the pump to deliver the solution? Record your answer using a whole number.
83 First, determine how many hours the infusion needs to run. 0800 to 2000 is 12 hours. Use the following equation to determine the milliliters per hour: Volume to infuse/infusion time = Flow rate per hour. 1,000 mL/12 hours = 83.3 mL/hour (rounded to 83 mL/hour)
The physician orders ampicillin, 500 mg by mouth every 6 hours. The nurse recognizes this as an example of which type of order? A stat order A single order A standard written order An as-needed order
A standard written order
Which information must be included in a medication order? drug class health care provider's signature client allergies possible adverse reactions
health care provider's signature
A client develops hepatic encephalopathy 1 week after portal caval shunt surgery. Her physician prescribes neomycin, 4 g by mouth daily in four divided doses. Her husband asks how neomycin decreases his wife's serum ammonia concentration. How should the nurse respond? "It binds with ammonia in the GI tract." "It acidifies the colon and traps ammonia in the GI tract." "It increases the growth of such bacteria as Escherichia coli." "It decreases the number of ammonia-producing bacteria in the GI tract."
"It decreases the number of ammonia-producing bacteria in the GI tract."
A client with a fluid volume deficit is receiving an I.V. infusion of dextrose 5% in water and lactated Ringer's solution at 125 ml/hour. Which data collection finding indicates the need for additional I.V. fluids? Temperature of 99.6° F (37.6° C) Serum sodium level of 136 mEq/L Dark amber urine Neck vein distention
Dark amber urine
A client who sustained a head injury in a motor vehicle accident is prescribed phenytoin liquid to prevent seizures. The client is unable to take anything by mouth and has a feeding tube in place for enteral feedings. Which intervention by the nurse is most appropriate when administering phenytoin to this client? Assessing for signs of bleeding Administering the phenytoin 2 hours before or 2 hours after beginning the tube feedings Monitoring the phenytoin level closely because enteral feedings increase the drug level Asking the registered nurse to administer the phenytoin I.V.
Administering the phenytoin 2 hours before or 2 hours after beginning the tube feedings
A client with left hemiparesis is having difficulty swallowing a potassium chloride 20 meq tablet. What should the nurse do? Crush the pill and administer with a small amount of liquid. Administer the medication with a large amount of liquid. Ask the health care provider for an order to administer a different consistency through a different route. Break the pill into small pieces and administer with apple sauce.
Ask the health care provider for an order to administer a different consistency through a different route.
When checking a client's I.V. insertion site, the nurse notes normal color and temperature at the site and no swelling. However, the I.V. solutions haven't infused at the ordered rate; the flow rate is slow even with the roller clamp wide open. When the nurse lowers the I.V. fluid bag, no blood returns to the tubing. What should the nurse do first? Check the tubing for kinks and reposition the client's wrist and elbow. Elevate the I.V. fluid bag. Irrigate the I.V. tubing with 1 ml of normal saline solution. Discontinue the I.V. infusion at that site and have it restarted it in the other arm.
Check the tubing for kinks and reposition the client's wrist and elbow.
When preparing to give a client a prescribed drug, the nurse realizes that the drug is one the nurse has never administered before. No drug references on the nursing unit contain information about the drug in question. What is the nurse's best action? Refuse to give the drug because no written information exists. Ask other nurses on the unit for information about the drug. Consult the physician for information about the drug. Contact a pharmacist to obtain information about the drug.
Contact a pharmacist to obtain information about the drug.
During a shift report, a nurse is told that a postoperative client with diabetes is on "sliding scale" insulin coverage. The primary health care provider has prescribed the following sliding scale. Insulin aspart SC, before meals based on the following blood glucose (BG) levels: BG level less than 110 mg/dL 0 units BG level between 110 and 130 mg/dL 3 units BG level between 131 and 150 mg/dL 4 units BG level between 151 and 200 mg/dL 6 units BG level greater than 200 mg/dL Call provider The nurse obtains a fingerstick blood glucose level just before breakfast. It is 207 mg/dL. What is the nurse's action? Call the provider for further prescriptions. Administer 4 units of insulin aspart. Administer 6 units of insulin aspart. Administer 6 units of insulin aspart, and then call the provider.
Call the provider for further prescriptions.
A client reports difficulty swallowing when the nurse tries to administer a medication in capsule form. What action should the nurse take to resolve this problem? Break the capsule and give the contents with applesauce. Dissolve the capsule in a full glass of water. Withhold the medication. Check for availability of a liquid preparation.
Check for availability of a liquid preparation.
The nurse is delivering the client's 10 a.m.(10:00) medications. The client is away from his room for a diagnostic study. Which action is most appropriate for the nurse to take? Follow the facility protocol for securing the medications. Leave the medications on the client's bedside table. Ask a family member to keep the client's medications. Omit this dose of medication until the next time it is scheduled.
Follow the facility protocol for securing the medications.
A nurse is administering morning medications to a client on warfarin. Upon reviewing the laboratory results, the nurse notes a prothrombin time (PT) of 27.3. What should the nurse do? Hold the medication and notify the health care provider. Withhold the morning dose of warfarin and give it later in the day. Give warfarin as prescribed. Repeat the laboratory result.
Hold the medication and notify the health care provider.
What is one disadvantage of using the rectal route for drug administration? It can cause rectal tears. It can cause orthostatic hypotension. It can cause hypersensitivity to the drug. It can result in incomplete drug absorption.
It can result in incomplete drug absorption.
A client receiving IV therapy tells the nurse that the IV site is swollen and cool to touch. What priority intervention should the nurse implement? Decrease the rate of infusion. Run the IV at a higher rate. Notify the charge nurse. Apply a cold compress to the site.
Notify the charge nurse.
A hospital is conducting a root cause analysis for a serious medication error made by a nurse that injured a client. What is the expected outcome of the root cause analysis? The client's family sues the hospital. The nurse is terminated for making such an error. The pharmacist that processed the order is terminated. The cause of the error is identified through system-wide analysis.
The cause of the error is identified through system-wide analysis.
The nurse is caring for four clients on a medical surgical unit. Which interaction between the nurse and a client is the best example of the nurse using the ethical principle of fidelity? The client refused pain medication and the nurse documented that the client refused. The nurse states returning in 10 minutes with medication for the client but forgot to return by the end of the shift. The client asked for information regarding a new medication. The nurse provided written instructions. A client on a hospice unit asked the nurse, "Am I going to die?" The nurse said no.
The client asked for information regarding a new medication. The nurse provided written instructions.
The nurse is to give a client a 325-mg aspirin suppository. The client has diarrhea and is in the bathroom. The best nursing approach at this time would be to: substitute 325-mg aspirin by mouth. withhold the suppository and notify the client's physician. tell the client you'll give him the suppository when he's finished in the bathroom. wait 15 minutes after the diarrhea stops and then administer the suppository.
withhold the suppository and notify the client's physician.
The physician prescribes 250 mg of a drug. The drug vial reads 500 mg/ml. How much of the drug should the nurse give? 1 ml ¼ ml 2 ml ½ ml
½ ml
A health care provider's order reads: amoxicillin 500 mg capsules × 2 PO now, followed by 500 mg PO every 6 hours. How many grams of amoxicillin will the nurse administer as the initial dose? Record your answer as a whole number.
1 The order states the nurse is giving two 500 mg capsules now. This would equal a total of 1,000 mg (1 g) followed by 500 mg (0.5 g) every 6 hours. Therefore the correct answer is 1 g.
A nurse is monitoring a client receiving intravenous (IV) fluid via pump. The alarm of the pump starts to beep for occlusion. What should the nurse do first? Check the roller clamp. Flush the IV line with heparin solution. Shut off the pump. Increase the rate of infusion to flush the line.
Check the roller clamp.
A nurse is administering iron dextran IM. A client asks why the skin is pulled to the side before the needle is inserted. Which statements are appropriate for the nurse to make? Select all that apply. It prevents medication leaking into subcutaneous tissue. It prevents staining of the skin. It prevents injection pain. It allows another injection to be given at the same location. It prevents an infection.
It prevents medication leaking into subcutaneous tissue. It prevents staining of the skin.
A nurse administers the client's prescribed antibiotic. The client tells the nurse, "I usually take a white tablet, not a yellow tablet." What is the priority action by the nurse? Reassure the client that the tablet is the correct medication. Withhold the medication and notify the health care provider. Perform a recheck of the medication name and strength. Tell the client that the yellow tablet is from a different manufacturer.
Perform a recheck of the medication name and strength.
A nurse needs to administer prescribed medications to a client with heart failure. Prior to administering the medications, what actions should the nurse take? Select all that apply. Ask the client if there are any medications that will be refused. Perform handwashing. Hold all the medications until the primary health care provider has examined the client. Check the client's medical record number and name on the identification bracelet. Check the client's allergies in the medical record, and verify them with the client.
Perform handwashing. Check the client's medical record number and name on the identification bracelet. Check the client's allergies in the medical record, and verify them with the client.
When checking a client's medication profile, the nurse notes that the client is receiving a drug that is contraindicated in clients with glaucoma. The nurse knows that this client has a history of glaucoma and has been receiving the medication for the past 3 days. What should the nurse do first? Continue to give the medication because the client has been receiving it for 3 days. File an incident report because several other staff members gave the medication. Find out whether there are extenuating reasons for giving the drug to this client. Report the information to the physician to ensure client safety.
Report the information to the physician to ensure client safety.
The nurse has an order to administer an intramuscular (I.M.) injection using the Z-track technique. When carrying out this order, what nursing intervention should the nurse implement? Pull the skin laterally toward the injection site. Simultaneously withdraw the needle and release the skin. Insert the needle at a 45-degree angle. Wipe the needle immediately after injection.
Simultaneously withdraw the needle and release the skin.
The nurse is caring for a client on an oncology unit who is refusing further chemotherapy treatment after the rationale for the treatment has been clearly explained. What is the nurse's best action? Support the client's decision and hold all treatments. Involve the client's family for encouragement to continue treatment. Continue to provide treatment because it will benefit the client. Tell the client that it is wrong not to accept treatment.
Support the client's decision and hold all treatments.
Which information would the nurse educator include in an in-service as disadvantages of using the rectal route for drug administration? Select all that apply. can cause orthostatic hypotension can cause hypersensitivity to the drug can cause cardiac dysrhythmias can result in incomplete drug absorption can cause rectal tears
can cause cardiac dysrhythmias can result in incomplete drug absorption
A nurse is teaching a client regarding his or her medication schedule. What is the best nursing intervention to improve this client's compliance with the prescribed medication schedule? Devise the simplest medication schedule possible. Encourage the client to hire a visiting nurse. Change the administration schedule to longer intervals. Give all instructions at least three times.
Devise the simplest medication schedule possible.
Before administering the evening dose of a prescribed medication, the nurse on the evening shift finds an unlabeled, filled syringe in the client's medication drawer. What priority action should the nurse implement? Obtain a label for the syringe from the pharmacy. Call the day nurse to verify the contents of the syringe. Use the syringe because it looks like it contains the same medication the nurse prepared to give. Discard the syringe to avoid a medication error.
Discard the syringe to avoid a medication error.
A client who is recovering one day after an extensive abdominal surgery is having incisional pain. When should the nurse plan to administer analgesics for this client? Four times a day Every 3-4 hours When requested by the client Three times a day
Every 3-4 hours
A client who underwent abdominal surgery returns from the postanesthesia care unit with a nasogastric (NG) tube in place. The client complains of nausea. While preparing to attach the client's NG tube to intermittent suction, the nurse notices that the ground on the suction machine's plug is broken. What priority action should the nurse perform first? Report the problem to the supervisor. Use the machine as is because the client is nauseous. Tape the broken ground to the plug and use the machine. Obtain another machine from central supply.
Obtain another machine from central supply
The nurse is reconstituting a powdered medication in a vial. After adding the solution to the powder, which action should the nurse perform next? Do nothing Shake the vial vigorously Roll the vial gently between the palms Invert the vial and let it stand for 2 to 3 minutes
Roll the vial gently between the palms
The nurse is developing a teaching plan for a client who has just been diagnosed with breast cancer. The nurse should expect the health care practitioner to prescribe which medication? Tamoxifen Dopamine Progesterone Acetaminophen
Tamoxifen
The newly hired graduate nurse asks the nurse preceptor what is the only advantage of using a floor stock system. Which rationale does the preceptor give the graduate nurse? The nurse receives input from the pharmacist. The system reinforces accurate calculations. The nurse can implement medication orders quickly. The system minimizes transcription errors.
The nurse can implement medication orders quickly.
The nurse is teaching a client how to rotate insulin injection sites. What is the purpose of rotating injection sites? To prevent erratic drug distribution To prevent medication leakage from the tissue or muscle To prevent bruising To prevent the formation of hard nodules
To prevent the formation of hard nodules
The nurse has an order to administer an iron dextran 50 mg intramuscular (I.M.) injection. When carrying out this order, which method should the nurse utilize? Use the Z-track technique. Pull the skin laterally toward the injection site. Insert the needle at a 45-degree angle. Wipe the needle immediately after injection.
Use the Z-track technique.
A client with hypothyroidism is prescribed levothyroxine 0.05 mg by mouth daily before breakfast. As the nurse gives the client the medication, the client states, "What dose am I getting? I've been taking 0.15 mg every day for years." Which action by the nurse is most appropriate? Verify the dose against the health care provider's prescription in the client's medical record. Tell the client that the primary health care provider must have lowered the dose. Administer the medication. Check the prescription against what is written on the medication administration record.
Verify the dose against the health care provider's prescription in the client's medical record.
The nurse is preparing to administer a dose of chlorpropamide to a client with type 2 diabetes. Before administering the drug, the nurse checks the client's allergies and notices that the client is wearing an allergy alert bracelet that indicates an allergy to sulfa drugs. Which action should the nurse take? Withhold the drug and notify the health care provider. Administer the drug as prescribed. Confirm that the dosage is correct, then administer the drug. Notify the nursing supervisor immediately.
Withhold the drug and notify the health care provider.
A histamine (H2) receptor antagonist is prescribed for a client with recurrent gastrointestinal discomfort. The nurse is instructing the client from a medication pamphlet and highlights which medications in this classification? Select all that apply. nizatidine ranitidine cimetidine famotidine esomeprazole
cimetidine ranitidine nizatidine famotidine
Progress Note I.V. site assessed and found to have blanching around the site, swelling, and coolness to the touch. Laboratory results include a white blood cell count within normal limits. A client has an I.V. line in place for 3 days and begins to report discomfort at the insertion site. Based on the client's progress notes shown, what condition has most likely occurred? infiltration infection phlebitis infection and infiltration
infiltration
The nurse is obtaining vital signs from a client who is receiving an intravenous antibiotic for the first time. Which observation made by the nurse requires immediate intervention? Select all that apply. reports mouth is dry heart rate of 86 inspiratory wheezes reports severe itching all over rash on skin of face, chest, and arms
rash on skin of face, chest, and arms reports severe itching all over inspiratory wheezes
A client weighing 167 lb (76 kg) is brought to the emergency department in status epilepticus. The primary care provider asks the nurse to prepare diazepam 0.25 mg/kg. How many milligrams will be given to this client? Round your answer to a whole number.
19 0.25 mg/kg x (1 kg/2.2 lb) x 167 lb = 19 mg.
The health care provider prescribes acetaminophen 650 mg by mouth every 4 hours for a client with a temperature of 102°F (38.8°C) who has a feeding tube in place. The nurse has acetaminophen solution on hand containing 160 mg/5 mL. How many milliliters of solution should the nurse administer? Record your answer using one decimal place.
20.3 The following formula is used to calculate drug dosages: dose on hand/quantity on hand = dose desired/X. In this example, the equation is as follows: 160 mg/5 mL = 650 mg/X, so then X = 20.3 mL.
The health care provider prescribes 60 mEq of potassium chloride liquid as a one-time dose. The pharmacy supplies a liquid containing 20 mEq/15 ml. How many milliliters will the nurse administer? Record your answer using a whole number.
45 The nurse can calculate the dose by setting up the following equation: 60 mEq/20 mEq = X ml/15 ml Then cross multiply the fractions: X x 20 mEq = 15 ml x 60 mEq Then solve for X: X = 45 ml
The nurse is caring for an infant who is receiving I.V. therapy. The health care provider orders D5NS 400-mL to infuse in 8 hours. How much I.V. solution would the nurse place in the buretrol? 50-mL 30-mL 150-mL 100-mL
50-mL
A 76-year-old client who failed swallowing studies has a nasogastric (NG) tube in place for medication administration. When the nurse checks the client's medications, she notices that only tablets have been dispensed by the pharmacy. How should the nurse proceed? Return all of the medications to the pharmacy and request them in liquid form. Crush those tablets that may be crushed according to the manufacturer and administer them through the NG tube; request an alternate form of those that can't be crushed. Notify the physician and request that he change the administration route of the medications to I.V. Request that the pharmacy crush all of the client's medications.
Crush those tablets that may be crushed according to the manufacturer and administer them through the NG tube; request an alternate form of those that can't be crushed.
A client newly diagnosed with diabetes mellitus is experiencing difficulty with self-administration of insulin. Despite further teaching, the client shows little improvement. What action by the nurse is most appropriate? Explain to the physician that a family diabetes education class might be beneficial to the client. Notify the physician of the client's lack of progress and request a diabetes education department consult. Consult with family members and begin family insulin administration education. Inform the physician of the lack of progress and request that discharge be delayed.
Notify the physician of the client's lack of progress and request a diabetes education department consult.
A client is prescribed a corticosteroid inhaler along with a bronchodilator inhaler. Which instruction about these drugs should the nurse give the client? "Use the bronchodilator whenever you feel you need it." "You should be able to take almost any over-the-counter medication you feel you need." "Use the bronchodilator first, then wait about 5 minutes before using the corticosteroid." "Notify your physician if your heart rate increases by more than 50 beats/minute after after using these medications."
"Use the bronchodilator first, then wait about 5 minutes before using the corticosteroid."
The physician prescribes an infusion of 2,400 ml of I.V. fluid over 24 hours, with half this amount to be infused over the first 10 hours. During the first 10 hours, the client should receive how many milliliters of I.V. fluid per hour? 240 ml/hour 120 ml/hour 100 ml/hour 50 ml/hour
120 ml/hour
The nurse is caring for a client receiving an opioid via patient-controlled analgesia (PCA) for pain management. Which findings should the nurse report immediately? Select all that apply. oxygenation saturation level 95% respiratory rate 10 breaths/minute blood pressure 118/60 mm Hg 80 mL of urine output in 3 hours heart rate 90 beats/minute arouses easily with verbal stimuli
80 mL of urine output in 3 hours respiratory rate 10 breaths/minute
For which rationale, when administering a Z-track injection, the nurse measures the correct medication dose and then draws a small amount of air into the syringe? Adding air prevents the solution from entering a blood vessel. Adding air decreases pain caused by the injection. Adding air prevents the drug from flowing back into the needle track. Adding air ensures that the client receives the entire dose.
Adding air prevents the drug from flowing back into the needle track
If a central venous catheter becomes disconnected accidentally, what should the nurse do immediately? Tell the client to take a deep breath and hold it. Apply a dry sterile dressing to the site. Call the physician. Clamp the catheter.
Clamp the catheter.
A nurse is administering medication to a client who is allergic to penicillin. Which drug is contraindicated for this client? cephalexin cefepime ticarcillin cefprozil
ticarcillin
The nurse is preparing to give a 9-year-old client a preoperative I.M. injection. Which size needle should the nurse use? 20G, 1½" 22G, 1" 22G, 1½" 20G, 1"
22G, 1"
A client who's aphasic and has left-sided paralysis after sustaining a stroke is scheduled for debridement of a left leg ulcer. Whenever passive range-of-motion (ROM) exercises are performed on the left leg, the client grimaces and moans. Which action should the nurse take before the physician performs the debridement? Avoid moving the client's leg whenever possible. Ask the physician if the debridement can be rescheduled because the client is uncomfortable. Check the client's medication administration record to see when he last received pain medication and administer a dose, if appropriate, before debridement. Explain the procedure to the client and notify the physical therapist of the client's discomfort during ROM exercises.
Check the client's medication administration record to see when he last received pain medication and administer a dose, if appropriate, before debridement.
The nurse is caring for a 62-year-old client with type 2 diabetes. The client takes an oral antidiabetic to control blood glucose levels. The physician prescribed ramipril to help treat this client's elevated blood pressure. The nurse should be alert for which drug interaction? Hyperkalemia Hypoglycemia Excessive hypotension Sodium retention
Hypoglycemia
A client who takes over-the-counter drugs regularly is seen at a clinic. The nurse should take which actions to ascertain the client's safety when taking these drugs? Select all that apply. Determine whether the drugs are generic Determine whether the client knows that these drugs are available in the hospital Determine whether the client knows the correct reason for using the drug and its proper route of administration Determine whether the drugs are expensive Determine whether the client knows the appropriate drug dosages and administration schedules
Determine whether the client knows the appropriate drug dosages and administration schedules Determine whether the client knows the correct reason for using the drug and its proper route of administration
A client admitted with bacterial pneumonia is prescribed cefuroxime axetil 550 mg I.V. every 4 hours. While assessing the client, the nurse notices that cefazolin 500 mg I.V. is infusing. Which action by the nurse is most appropriate? Increasing the infusion rate of the medication and notifying the physician of the error Decreasing the infusion rate of the medication and notifying the physician of the error Discontinuing the medication and documenting assessment findings Discontinuing the medication and notifying the physician of the error
Discontinuing the medication and notifying the physician of the error
A nurse is assisting with developing an education plan for a client diagnosed with type 1 diabetes. Which method is most effective for educating the client about self-administration of insulin? a discussion and demonstration between the nurse and the client an audiotape version of discharge instructions a list of instructions written at a sixth-grade reading level a short videotape that provides useful information and demonstrations
a discussion and demonstration between the nurse and the client
A client reports a severe headache and blurred vision. The nurse immediately obtains vital signs, which reveals a blood pressure of 192/110 mm Hg. The nurse reviews the client's medical record and notes a prescription for clonidine 0.1 mg by mouth as needed for systolic blood pressure greater than 170 mm Hg and diastolic blood pressure greater than 100 mm Hg. The nurse checks the client's medication supply, but no clonidine is available. How should the nurse proceed? Inform the pharmacy that the medication is unavailable, ask them to prepare it, and and tell them that someone will pick it up immediately. Call the pharmacy, and ask them to dispense the medication with the next scheduled delivery. Notify the primary health care provider, and document that the medication is unavailable. Notify the pharmacy, and document in the medical record that the medication is unavailable.
Inform the pharmacy that the medication is unavailable, ask them to prepare it, and and tell them that someone will pick it up immediately.
The nurse is initiating an intravenous (IV) access for a client who needs an infusion of normal saline solution. Which nursing action should the nurse perform before the venipuncture? Use the biggest needle size for infusion. Check laboratory values for electrolytes. Prime the IV tubing before initiating the intravenous access. Check for latex allergy before applying the tourniquet.
Check for latex allergy before applying the tourniquet.
A nurse is reinforcing education with a client about three medications that the client will receive after discharge. While performing the discharge education, the nurse notices that the client suddenly becomes withdrawn and appears anxious. What action should the nurse take? Acknowledge the client's behavior, and seek clarification. Notify the primary health care provider, and request a change in the prescriptions. Request that the primary health care provider prescribe generic alternatives. Explore with the client whether the client can purchase the medications over an extended period.
Acknowledge the client's behavior, and seek clarification
The nurse prepares to administer a cleansing enema. Which position will the nurse help the client assume for this procedure? Left lateral Sims' Prone Dorsal recumbent Supine
Left lateral Sims'
The health care provider's order reads 2 g of cephalexin PO daily in equally divided doses of 500 mg each. How many times per day should the nurse administer this medication? Record your answer using a whole number.
4 The nurse would administer the medication four times per day. Two grams is equivalent to 2,000 mg. To give equally divided doses of 500 mg, divide the desired dose of 500 mg into the total daily dose of 2,000 mg. This gives an answer of four times per day. The nurse would give 500 mg every 6 hours for a total of four times per day.
A nurse is preparing to administer ferrous sulfate to a client. What is the nurse's appropriate action? Mix the drug with pudding. Mix with cola to disguise the taste. Administer undiluted with a small snack. Dilute with juice and administer through a straw.
Dilute with juice and administer through a straw.
The nurse is administering sublingual nitroglycerin to the client. Immediately after administration, the nurse observes the client for which possible sign or symptom? Drowsiness or blurred vision Throbbing headache or dizziness Nervousness or paresthesia Tinnitus or diplopia
Throbbing headache or dizziness
