Pharm PrepU

A nurse is administering a pain medication to a patient. In addition to checking his identification bracelet, the nurse correctly verifies his identity by: Asking the patient his name Reading the patient's name on the sign over the bed Asking the patient's roommate to verify his name Asking, "Are you Mr. Brown?"

Ask their name

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You are preparing supplies for a tuberculosis screening. You should choose which of the following syringes and needles?

1 mL tuberculin syringe 1/2 inch 26 gauge

A physician orders 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, a client should receive how many milliliters of I.V. fluid per hour? a) 50 ml/hour b) 100 ml/hour c) 240 ml/hour d) 120 ml/hour

120

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

You are preparing to administer a transdermal medication. How should this be accomplished?

Apply directly to skin

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?

As gauge number becomes larger the size of the needle becomes smaller

Which of the following statements indicates that a new graduate nurse understands central venous pressure (CVP) measurement when used on a client? a) "A high CVP leads to superior vena cava syndrome." b) "The test determines approximate blood pressure." c) "It will assess pressure and volume changes in the right atrium." d) "The test will accurately measure rate and rhythm of breathing patterns."

Assess pressure and volume in right atrium

A nurse administers a dose of an oral medication for hypertension to a patient who immediately vomits after swallowing the pill. What would be the appropriate initial action of the nurse in this situation? Readminister the medication and notify the primary care provider. Readminister the pill in a liquid form if possible. Assess the vomit, looking for the pill. Notify the primary care provider.

Assess vomit

Factor to calculate drug dosage for child

Body surface area

Ms. Hall has an order for hydromorphone (Dilaudid), 2 mg, intravenously, q 4 hours PRN pain. The nurse notes that according to Ms. Hall's chart, she is allergic to Dilaudid. The order for medication was signed by Dr. Long. What would be the correct procedure for the nurse to follow in this situation? Administer the medication; the doctor is responsible for medication administration. Call Dr. Long and ask that she change the medication. Ask the supervisor to administer the medication. Ask the pharmacist to provide a medication to take the place of Dilaudid.

Call Dr. Long and ask that she change the medication.

A nurse is preparing medications for patients in the ICU. The nurse is aware that there are patient variables that may affect the absorption of these medications. Which statements accurately describe these variables? Select all that apply. Patients in certain ethnic groups obtain therapeutic responses at lower doses or higher doses than those usually prescribed. Some people experience the same response with a placebo as with the active drug used in studies. People with liver disease metabolize drugs more quickly than people with normal liver functioning. A patient who receives a pain medication in a noisy environment may not receive full benefit from the medication's effects. Oral medications should not be given with food as the food may delay the absorption of the medications. Circadian rhythms and cycles may influence drug action.

Certain ethnic groups get different doses Some people experience same response as placebo as with drug Patient gets pain med in noisy env might not get full benefit Circadian stuff can influence drug action

Giving anti-hypertensive, how do they identify patient before admin?

Check ID bracelet

A nurse discovers that she made a medication error. What should be the nurse's first response? Record the error on the medication sheet. Notify the physician regarding course of action. Check the patient's condition to note any possible effect of the error. Complete an incident report, explaining how the mistake was made.

Check patient!

Which adverse effects occur when there is too rapid an infusion of TPN solution? a) circulatory overload b) negative nitrogen balance c) hypokalemia d) hypoglycemia

Circulatory overload

The nurse is to administer an antibiotic to a client with burns, but there is no medication in the client's medication box. What should the nurse do first? a) Inform the unit's shift coordinator. b) Borrow the medication from another client. c) Contact the client's health care provider (HCP). d) Call the pharmacy department.

Contact pharmacy department

What must occur at change of shifts regarding med admin?

Count narcotics

What to do if child won't take meds/

Crush it up and put in food

nurse is administering a hepatitis B immunization injection to an adult patient. Which site would the nurse choose for this injection?

Deltoid muscular site

You are preparing to administer a transdermal medication. How should this be accomplished?

Directly to skin

A nurse is administering an oral medication to a patient via a gastric tube. The nurse observes the medication enter the tube, and then the tube becomes clogged. What would be the appropriate initial action of the nurse in this situation? Attempt to dislodge the medication with a 10-mL syringe. Notify the primary care provider. Remove the tube and replace it with another tube. Flush the tube with 60 mL of water.

Dislodge with 10mL syringe

A medication order reads: "Hydromorphone, 2 mg IV every 3 to 4 hours PRN pain." The prefilled cartridge is available with a label reading "Hydromorphone 2 mg/1 mL." The cartridge contains 1.2 mL of hydromorphone. Which nursing action is correct? Give all the medication in the cartridge because it expanded when it was mixed. Call the pharmacy and request the proper dose. Refuse to give the medication. Dispose of 0.2 mL correctly before administering the drug.

Dispose of 0.2 mL correctly before administering the drug.

A nurse who is administering medications to patients in an acute care setting studies the pharmacokinetics of the drugs being administered. Which statements accurately describe these mechanisms of action? Select all that apply. -Distribution occurs after a drug has been absorbed into the bloodstream and is made available to body fluids and tissues. -Metabolism is the process by which a drug is transferred from its site of entry into the body to the bloodstream. -Absorption is the change of a drug from its original form to a new form, usually occurring in the liver. -During first-pass effect, drugs move from the intestinal lumen to the liver by way of the portal vein instead of going into the system's circulation. -The gastrointestinal tract, as well as sweat, salivary, and mammary glands, are routes of drug absorption. -Excretion is the process of removing a drug, or its metabolites (products of metabolism), from the body.

Distribution occurs after a drug has been absorbed into the bloodstream and is made available to body fluids and tissues. During first-pass effect, drugs move from the intestinal lumen to the liver by way of the portal vein instead of going into the system's circulation. Excretion is the process of removing a drug, or its metabolites (products of metabolism), from the body.

A nurse is administering heparin subcutaneously to a patient. What is the correct technique for this procedure? Aspirate before giving and gently massage after the injection. Do not aspirate; massage the site for 1 minute. Do not aspirate before or massage after the injection. Massage the site of the injection; aspiration is not necessary but will do no harm.

Do not aspirate before or massage after the injection.

client at a health care facility has been prescribed scopolamine, to be administered transdermally. Which of the following statements describes transdermal application?

Drugs bonded to adhesive and applied to ski

When administering a subcutaneous injection to a patient, the needle pulls out of the skin when the skin fold is released. What would be the appropriate next action of the nurse in this situation

Engage safety shield on needle guard and discard needle appropriately

Preparing injection by withdrawing solution from multi dose vial What is necessary to do?

First inject an equal amount of air into vial

A nurse needs to administer an intradermal injection to a client. Which of the following is the most common site for administering an intradermal injection?

Forearm

Nurse administering through enteral tube to someone who has trouble swallowing, what do you do to prevent gastric reflux

Fowler's position

The Z-track technique is utilized during drug administration by which of the following routes?

IM (intramuscular)

A client has an intravenous line in place for 3 days and begins to state discomfort at the insertion site. Based on the nurse's progress note, what condition has most likely occurred? Cool, swelling, WBC normal a) Infiltration b) Phlebitis c) Infection and infiltration d) Infection

Infiltration

A patient requires 40 units of NPH insulin and 10 units of regular insulin daily subcutaneously. What is the correct sequence when mixing insulins? Inject air into the regular insulin vial and withdraw 10 units; then, using the same syringe, inject air into the NPH vial and withdraw 40 units of NPH insulin. Inject air into the NPH insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the regular insulin vial and withdraw 10 units; then, withdraw 40 units of NPH insulin. Inject air into the regular insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the NPH insulin vial and withdraw 40 units; then, withdraw 10 units of regular insulin. Inject air into the NPH insulin vial and withdraw 40 units; then, using the same syringe, inject air into the regular insulin vial and withdraw 10 units of regular insulin.

Inject air into the NPH insulin vial, careful not to allow the solution to touch the needle; next, inject air into the regular insulin vial and withdraw 10 units; then, withdraw 40 units of NPH insulin. Regular or short-acting insulin should never be contaminated with NPH or any insulin modified with added protein. Placing air in the NPH vial first without allowing the needle to contact the solution ensures that the regular insulin will not be contaminated.

patient presents in the ER with signs and symptoms of VTE. What type of medication administration would most likely be ordered to infuse a large dose of heparin for this patient?

Intravenous bolus or push through an intravenous infusion Bolus push is a single injection of concentrated solution into IV Used for emergencies

What is the advantage of using automated medication dispensing equipment? a) It keeps a record of narcotic usage. b) It facilitates the change-of-shift count of narcotics. c) It cancels the charges for narcotics. d) It allows nurses unmonitored access to narcotics.

Keeps record of narcotic usage

The nurse manager on a pediatric floor is updating safety recommendations for the unit. Which strategy would help reduce pediatric medication errors? Select all that apply. a) Limit the size of IV fluid bags that can be hung on small children. b) Increase the number of steps in the medication administration procedure. c) Eliminate the pediatric satellite pharmacy. d) Reduce the available concentrations or dose strengths of high-alert medications to the minimum. e) Avoid using parenteral syringes when administering liquid oral medications.

Limit size of IV fluid bags Reduce available concentrations of high alert Avoid using parental (should only use oral syringes)

The client is started on simvastatin as a component of cholesterol management. Which laboratory test needs to be monitored while on this therapy? a) serum glucose b) liver function tests c) total protein d) complete blood count

Liver function tests

nurse preparing medication for a patient is called away to an emergency. What should the nurse do?

Lock the meds in cart and finish upon return

Administer heparin subcutaneously

Never aspirate

What is the priority action that a nurse should take after omitting an ordered medication? a) Document the omission and the reason for it. b) Notify the nursing supervisor. c) Notify the prescriber. d) Write an incident report.

Notify prescriber

A nurse receives a report that a client has had an overdose of heparin. Which of the following actions by the nurse is most important in managing the overdose? a) Have the client remain on bed rest to prevent injury. b) Obtain an order to give protamine sulfate. c) Inform the client that nosebleeds may occur. d) Review the client's coagulation studies.

Obtain an order to give protamine sulfate

What is involved in the absorption, distribution, metabolism, and excretion of medication?

Pharmacokinetics

The nurse is administering a medication to a patient via a nasogastric tube. Which are accurate guidelines related to this procedure? Select all that apply. Crush the enteric-coated pill for mixing in a liquid. Flush open the tube with 60 mL of very warm water. Check for proper placement of the nasogastric tube. Give each medication separately and flush with water between each drug. Lower the head of the bed to prevent reflux. Adjust the amount of water used if patient's fluid intake is restricted.

Proper placement of tube Each med separately and flush with water between Adjust amount of water if have restrictions

Nurse brings med to patient but they are not in unit, what do you do?

Put the meds back in the cart

When a central venous catheter dressing becomes moist or loose, what should a nurse do first? a) Notify the physician. b) Remove the dressing, clean the site, and apply a new dressing. c) Remove the catheter, check for catheter integrity, and send the tip for culture. d) Draw a circle around the moist spot and note the date and time.

Remove Clean Apply new dressing

A nurse is teaching an adolescent patient how to use a meter-dosed inhaler to control his asthma. What are appropriate guidelines for this procedure? Select all that apply. Remove the mouthpiece cover and shake the inhaler well. Take shallow breaths when breathing through the spacer. Depress the canister releasing one puff into the spacer and inhale slowly and deeply. After inhaling, exhale quickly through pursed lips. Wait 1 to 5 minutes as prescribed before administering the next puff. Gargle and rinse with salt water after using the MDI.

Remove the mouthpiece cover and shake the inhaler well. Depress the canister releasing one puff into the spacer and inhale slowly and deeply. Wait 1 to 5 minutes as prescribed before administering the next puff.

client is taking paroxetine 20 mg PO every morning. The nurse should monitor the client for which adverse effect? a) orthostatic hypotension b) sleep disturbance c) hypertensive crisis d) sexual problems

Sexual problems

The nurse is teaching a client about taking prophylactic warfarin sodium. Which statement indicates that the client understands how to take the drug? Select all that apply. a) "Maximum dosage is not achieved until 3 to 4 days after starting the medication." b) "Effects of the drug continue for 4 to 5 days after discontinuing the medication." c) "The drug's action peaks in 2 hours." d) "I should have my blood levels tested periodically." e) "Protamine sulfate is the antidote for warfarin."

Should have blood levels tested Effects of drug continue for 4 to 5 days after stopping

A client is receiving intravenous fluids and upon assessment presents with increased pulse, increased respirations, and jugular vein distension. What is the priority action by the nurse? a) Lower the head of the bed. b) Repeat the vital signs in 1 hour. c) Slow the intravenous rate and notify the physician. d) Administer oxygen and encourage the client to breathe deeply.

Slow and notify physician

Order: 100 mg PO daily What kind of order?

Standing

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 client has disorders that affect absorption of meds

A nurse is reconstituting powdered medication in a vial. Which action is a recommended step in this process? The nurse draws up the proper amount of powered medication into the syringe. The nurse inserts the needle through the rubber stopper of the diluent vial. The nurse gently agitates the powdered medication vial to mix the powder and diluent completely. The nurse draws up the prescribed amount of medication while holding the syringe horizontally at eye level.

The nurse gently agitates the powdered medication vial to mix the powder and diluent completely.

A medication order reads: "K-Dur, 20 mEq po b.i.d." When and how does the nurse correctly give this drug? Daily at bedtime by subcutaneous route Every other day by mouth Twice a day by the oral route Once a week by transdermal patch

Twice a day by the oral route

What is aspiration

Use of the Z-track, or zigzag, technique for injections. A. Normal skin and tissues. B. Move the skin to one side. C. Insert the needle at a 90-degree angle and aspirate for blood. D. Withdraw the needle, and allow the displaced tissue to return to normal position, thereby keeping the solution from leaving the muscle tissue.

A client has been prescribed digoxin. Which symptom should the nurse tell the client to report as a potential indication of digoxin toxicity? a) urticaria b) shortness of breath c) hypertension d) visual disturbances

Visual disturbances

Applying vaginal cream, what is guideline?

Wash area with warm water and washcloth