Pre U 29 Fundamental Nursing

The nurse is teaching a nursing student regarding safety of chemotherapeutic medication. Which statement by the nurse is correct?

"Antineoplastic drugs can be absorbed through the skin."

The nurse is caring for a client with diabetes. Which client statement reflects that nursing teaching has been effective?

"I will eat a meal within a half hour of taking my morning insulin." Teaching has been effective when the client recognizes that a meal should be consumed within a half hour of taking morning insulin. Further teaching is needed so the client knows that orange juice should be consumed when experiencing low blood glucose levels; that blood glucose levels should be tested before and 2 hours after meals; and that meals should be consumed three times daily (with appropriate snacks in between) at approximately the same time day to day.

Nurse A is having difficulty logging into the automated medication-dispensing system, and asks Nurse B to log in momentarily so that Nurse A is not delayed in administering client medications. What is Nurse B's appropriate response? A. "I will log in so that you can proceed with medication delivery." B. "I am giving you my password so you can log in." C. "I will get the hospital's information systems' phone number for you." D. "I can log in and give the medications for you."

"I will get the hospital's information systems' phone number for you." Passwords and logins should never be shared with anyone else, nor should a nurse use his or her own password or login information to allow another individual to access the automated medication-dispensing system. Nurse B will not log in and give the medications, but rather will provide a solution by offering contact information for information systems to Nurse A so that he or she can work through their login issue.

A client who has been prescribed an inhaler points to the spacer and asks, "What is this for?" What is the appropriate nursing response? A. "This is to decrease the amount of drug that you receive." B. "Medication stays in the chamber so you can continue to inhale it." C. "You will receive the medication faster as it goes through this device." D. "It makes the inhaler easier to hold in case you have arthritis."

"Medication stays in the chamber so you can continue to inhale it." A spacer provides a reservoir for aerosol medication. The client can take additional breaths (after the initial breath) to continue inhaling the medication held in the reservoir. The spacer does not decrease the amount of medication received, make the medication move faster, nor serve as a holding device.

The nurse just completed a refresher course on parenteral drug administration. Which statement by the nurse indicates that teaching was effective? A. "Reconstitution is the process of adding liquid, known as diluent, to a powdered substance." B. "Reconstitution is a sealed glass cylinder of parenteral medication with an attached needle." C. "Reconstitution is a glass or plastic container of parental medication with self-sealing rubber stopper." D. "Reconstitution is a sealed glass drug container that must be broken to withdraw the medication."

"Reconstitution is the process of adding liquid, known as diluent, to a powdered substance." Reconstitution is the process of adding liquid, known as diluent, to a powdered substance. A sealed glass cylinder of parenteral medication with an attached needle is a refilled cartridge, not reconstitution. A glass or plastic container of parental medication with self-sealing rubber stopper is a vial, not reconstitution. A sealed glass drug container that must be broken to withdraw the medication is an ampoule, not reconstitution.

Which statement by a client indicates to the nurse that teaching was effective regarding the different parts of a syringe? A. "The plunger is the part of the syringe that moves back and forth to withdraw and instill medication." B. "The barrel is the part of the syringe that resets the dose window to zero following an injection" C. "The barrel is the part of the syringe to which the needle is attached." D. "The plunger is the part of the syringe that holds the medication."

"The plunger is the part of the syringe that moves back and forth to withdraw and instill medication."

A client who is taking Tylenol for a fever asks a nurse if there is a generic form that is less expensive. What would the nurse tell him? "No, Tylenol is all that is available." "No, not that I am aware of." "Yes, and it is acetaminophen." "Yes, and it is also called Tylenol."

"Yes, and it is acetaminophen." The generic name of a drug is the name assigned by the manufacturer that first develops the drug. The drug company that sells the drug selects the trade name. Tylenol is a trade name, and its generic name is acetaminophen.

The nurse is preparing supplies for a tuberculosis screening. The nurse should choose which syringes and needles? A. 1 mL syringe; ½-inch (1.25 cm), 26-gauge needle B. 10-mL syringe; 3-inch (8 cm), 18-gauge needle C. 5-mL syringe; 2-inch (5 cm), 20-gauge needle D. Insulin syringe; 1-inch (2.5 cm), 16-gauge needle

1 mL syringe; ½-inch (1.25 cm), 26-gauge needle

A nurse is preparing to administer IV therapy to a client and selects a catheter with a large lumen. Which catheter would have the largest lumen? A. 18 gauge B. 20 gauge C. 21 gauge D. 22 gauge

18 gauge IV catheters are available in various sizes. The lumen size is measured in gauges; odd numbers designate winged infusion needles (19, 21, 23), whereas even numbers designate catheter sizes. The most common adult catheter sizes are 22, 20, and 18. As the numbers increase, the lumen size decreases; thus, a 22-gauge needle is smaller in diameter than an 18-gauge needle. Of the catheter gauges listed, 18 would be the largest.

The nurse is infusing ampicillin IV for Mr. B. The medication is diluted in 100 mL of NS and is to infuse over 1 hour. The nurse has tubing with a drop factor of 20 drops/mL. What is the drip rate of this infusion?

33 drops/minute

A nurse is reviewing information about a 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? A. Ampicillin sodium B. Omnipen-N C.Polycillin-N D. SK Ampicillin-N

Ampicillin sodium

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 for some time.

A nurse needs to administer a subcutaneous injection to a client. How far from the previous injection site to the area should the nurse administer the injection?

At least 1 inch (2.5 cm)

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? Add medications to the formula. Mix all the medications together in 15 mL of water. Use cold water when mixing powdered medications. Avoid crushing sustained-release pellets.

Avoid crushing sustained-release pellets. When administering medications through an enteral tube for a tube-fed client, the nurse must avoid crushing sustained-release pellets because keeping them whole ensures their sequential rate of absorption. The nurse should not add medications to the formula because some medications may interact with the components in the formula, causing it to curdle or change its consistency. Additionally, a slow infusion would alter the medication's dose and rate of absorption. The nurse should mix each medication separately, not together, with at least 15 to 30 mL of water. The nurse should use warm water when mixing powdered medications to promote dissolving the solid form.

A medication order has ac written after the medication dosage. What does ac stand for?

Before meals

A nurse is providing care for a client who has a history of dementia. Which method should the nurse use in order to determine the client's identity prior to medication administration? A. Check the client's identification band. B. Ask the client his name prior to giving the drug. C. Cross-reference the MAR with the client's medical record. D. Enlist the help of a colleague who is familiar with the client.

Check the client's identification band.

An oral medication has been ordered for a client who has a nasogastric tube in place. Which nursing activity would increase the safety of medication administration? A. Check the tube placement before administration. B. Have the client swallow the pills around the tube. C. Flush the tube with 30 to 40 mL saline before medication administration. D. Bring the liquids to room temperature before administration.

Check the tube placement before administration. The nurse must first verify that the tube is in place and not in the lungs prior to administering the medication. Next, the nurse can bring the liquids to room temperature. Typically the tube is flushed with 15 to 30 mL of water for adults (5 to 10 mL for children). The nurse should never have the client swallow the pills if the client has an nasogastric tube.

The nurse is preparing to administer two IV medications. What is the appropriate nursing action? Prepare to administer through two separate tubes. Administer the drugs through the same tubing. Consult current drug reference book for IV compatibility. Hold one medication for an hour and administer it after the first medication.

Consult current drug reference book for IV compatibility. The nurse should consult a current drug reference book for compatibility before administering two IV medications. Other answers are incorrect.

The nurse is preparing to give medications to a client with high blood pressure. The order indicates that the client is to have Adderal, 40 mg by mouth twice daily. What is the appropriate nursing action? A. Administer the drug as ordered. B. Ask another nurse to verify the order. c. Assume that provider meant to order inderal. D. Contact the health care provider for order clarification.

Contact the health care provider for order clarification. Before administering the medication, the nurse should immediately contact the health care provider to verify the order; no one else can verify the order. Adderal and inderal are drugs that have look-alike and sound-alike properties, but are very different in indication and dosage.

The nurse is assessing a client with diabetes who has poor vision. Which feature of the insulin pen makes it beneficial for this client? A. The insulin pen is easily transported on the client. B. It is easier to learn how to use an insulin pen than a syringe and vial. C.Each unit of insulin is accompanied by a clicking sound in the pen. D. With an insulin pen, a large variety of insulin types are available.

Each unit of insulin is accompanied by a clicking sound in the pen. Each unit of insulin is accompanied by a clicking sound in the pen. This is a beneficial feature for the client who has poor vision, as the sound will alert the client to count when selecting the prescribed dose. Being easily transported, being easier to learn, and having a variety of types available are all advantages for using insulin pens, but they do speak specifically to this client.

A nurse needs to administer an intradermal injection to a client. What is the most common site for administering an intradermal injection? A. Forearm B. Chest C. Back D. Stomach

Forearm The most common site for an intradermal injection is the inner aspect of the forearm. Intradermal injections are commonly used for diagnostic purposes. Examples include tuberculin tests and allergy testing. Small volumes, usually 0.01 to 0.05 mL, are injected because of the small tissue space. Other areas that may be used are the back and upper chest, not the stomach.

Which medication would most likely be administered via a transdermal patch? A. Epinephrine B.Antibiotics C.Hormonal medications D. Antidepressants

Hormonal medications Transdermal patches are commonly used to deliver hormones, narcotic analgesics, cardiac medications, and nicotine.

Which situation accurately describes a recommended guideline when administering oral medications to clients? A. Assume that the client is the authority on whether or not the medication was swallowed. B. If a pill is dropped, it should be briefly immersed in saline to remove any dirt or germs. C. If a client vomits immediately after receiving oral medications, re-administer the medication. D. If a child refuses to take medication, the medication can be crushed and added to a small amount of food.

If a child refuses to take medication, the medication can be crushed and added to a small amount of food. Medication can be added to small amounts of food, but should not be added to liquids. If it is questionable whether the medication was swallowed, check the client's mouth and cheeks. If a pill is dropped, it should be discarded. If a client vomits, notify the physician to see if the medication should be re-administered.

A nurse is administering an injection to a client at a 15-degree angle. The client has a venous access port. Which injection can be administered at this angle?

Intradermal When giving an intradermal injection, the nurse instills the medication shallowly at a 10- to 15-degree angle of entry. When the nurse administers a subcutaneous injection, the angle of entry is either 45 degrees or 90 degrees, whereas for intramuscular injections, the angle is 90 degrees. Intravenous injections are instilled into the veins of the client at an angle of around 15 degrees, but only if no venous access port is in place.

A postoperative client's MAR provides for prn administration of a number of analgesics by various routes. Which route will likely provide the quickest pain relief for the client? A.Intravenous B. Intramuscular C. Subcutaneous D. Oral

Intravenous

If the dosage is inappropriate for a client, who is responsible? A.Physician B. Pharmacist C. Nurse D.Medical technician

Nurse Whereas physicians and other health care providers prescribe and pharmacists dispense therapeutic agents, it is the nurse's legal domain to administer medications in a safe and timely manner.

Which technique should the nurse employ when instilling otic medication in an adult ear?

Pull the client's ear up and back.

Which medication system allows for client independence? A Unit dose system B. Self-administered medication system C. Automated medication-dispensing system D. Bar Code Medication Administration (BCMA)

Self-administered medication system The self-administered system allows the client independence and responsibility. It also allows nursing supervision, education, and evaluation for client compliance and safety medication management prior to facility discharge.

A code is called and Nurse A hands several drugs to Nurse B, stating while rushing off, "Give these to my client while I help with the code." What is Nurse B's appropriate response? A. Administer the medications. B. Hold the medications for Nurse A. C. Ask another staff nurse to give the medications. D. State, "I cannot give medications for other nurses."

State, "I cannot give medications for other nurses." Nurses must never administer medications prepared by another nurse. Nurse B will professionally reply, "I cannot give medications for you." Nurse B should not hold the medications, nor ask another nurse to give the medications.

A client who has been receiving a secondary infusion of a new antibiotic for several minutes reports itching and a sensation of throat tightness. What is the priority nursing intervention?

Stop the infusion of antibiotic. The client may be experiencing a reaction to the antibiotic. Because intravenous administration occurs quickly, life threatening reactions can also occur quickly. The first nursing action is to stop the infusion. The nurse will proceed to assure that there is an open airway, assess the skin for rash, and activate the Rapid Response Team if needed.

A nurse enters a client's room to check on his intravenous infusion. An electronic infusion device is not being used. When checking the solution container and rate, the nurse notes that that fluid is infusing at a rate slower than intended. When assessing the client, which finding would the nurse identify as most likely contributing to the slowed rate of infusion?

The client is resting his arm with the IV on his head. When the extremity is elevated, such as the client resting his arm on his head, the fluid will infuse more slowly. Kinked or obstructed tubing (not visible and running freely), a patent catheter (such that the fluid is infusing), and the height of the solution container (such as when the client gets up and walks in the hall pushing the IV pole with the hand containing the IV) are factors that would contribute to a slowed rate.

The nurse is preparing to administer a transdermal medication. How should this be accomplished?

The nurse should apply the medication directly to the skin.

Which statement best describes the nurse's rationale for selecting the ventrogluteal site when using the Z-track technique for administering an injection? A. The ventrogluteal site provides a location with the capacity for depositing and absorbing drug. B. The ventrogluteal site determines whether or not the needle is in a blood vessel. C. The ventrogluteal site prevents tissue contact with the irritating drug. D.The ventrogluteal site reduces the transmission of microorganisms.

The ventrogluteal site provides a location with the capacity for depositing and absorbing drug. The ventrogluteal site is a large muscular injection site that provides a location with the capacity for depositing and absorbing drug, and is therefore correct. The nurse will reduce the transmission of microorganisms by hand washing and not by selecting the ventrogluteal site. The nurse will aspirate for a blood return to determines whether or not the needle is in a blood vessel. Changing the needle will prevent tissue contact with the irritating drug, and not the usage of the ventrogluteal site.

What is the term used for the concentration of drug in the blood serum that produces the desired effect without causing toxicity?

Therapeutic range Therapeutic range is the concentration of drug in the blood serum that produces the desired effect without causing toxicity. Peak level is the highest plasma concentration. Trough level is the point when the drug is at the lowest concentration. Half-life is the amount of time it takes for 50% of the blood concentration of a drug to be eliminated from the body.

Which "rights" are included in the "six rights for medication administration"? Select all that apply.

To prevent medication errors, always ensure that the: (1) Right medication is given to the (2) right client in the (3) right dosage through the (4) right route at the (5) right time, followed by the (6) right documentation.

A client with chronic obstructive pulmonary disease (COPD) has been prescribed an inhaled bronchodilator. Which technique should the nurse implement in order to ensure safe and complete delivery of the prescribed medication? A. Use a spacer or extender with the metered-dose inhaler. B. Provide oxygen therapy 30 minutes prior to administration. C. Provide multiple puffs of the medication in rapid sequence. D. Place the inhaler as deeply into the client's mouth as is comfortable.

Use a spacer or extender with the metered-dose inhaler. The use of an extender or spacer ensures that the client receives as much of the inhaled medication as possible. MDIs are placed 1 or 2 inches (2.5 or 5 cm) in front of the mouth, not deeply into the mouth. Oxygen therapy prior to administration does not aid in delivery. Multiple puffs, if ordered, are given after 1 to 5 minutes.

Which client does the nurse recognize that will require intramuscular administration versus intravenous administration?

Vaccines are always administered intramuscularly. Other agents mentioned would be given intravenously.

A physician at a health care facility suggests the use of a metered-dose inhaler for an asthmatic client. Which describes the mechanism of a metered-dose inhaler? a. a canister containing medication that is released when the container is compressed b. a propeller-driven device that spins and suspends a finely powdered medication c. a device that forces liquid drug through a narrow channel using pressurized air d. a device that forces medication through a narrow channel with the help of inert gas

a canister containing medication that is released when the container is compressed A metered-dose-inhaler is a canister that contains medication under pressure; the aerosolized drug is released when the container is compressed. A turbo-inhaler is a propeller-driven device that spins and suspends a finely powdered medication. An aerosol results after a liquid drug is forced through a narrow channel using pressurized air or an inert gas.

Which component of a syringe's needle does the nurse recognize that refers to width?

gauge The gauge of a needle refers to width. The lumen is the opening of the needle; the shaft is the length of the needle; the bevel is the slanted portion of the needle that provides access into the vein.

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 feature?

larger diameter

What type of order would a physician most likely write to treat a client whose pain levels vary widely throughout the day? A. Stat B.p.r.n. C. Standing D. One-time

p.r.n. The prescriber may write a p.r.n. order ("as needed") for medication. The client receives medication when it is requested or required. These orders are commonly written for treatment of symptoms. For example, medications used for pain relief, to relieve nausea, and for sleep aids are often written as a p.r.n. order.

Which action describes buccal medication administration?

placing a medication underneath the upper lip or in the side of the mouth Buccal medication is not chewed, swallowed, or placed under the tongue. Sublingual medications are placed under the tongue. Medications that are given through a nasogastric tube are oral. A medication that is designed to produce systemic effects and is absorbed through the skin is called transdermal.

A nurse is preparing to convert a client's IV to an intermittent infusion device. The IV is connected to extension tubing. Before disconnecting the IV tubing from the extension tubing, the nurse clamps the extension tubing for which reason?

prevent air from entering the line When converting to an intermittent infusion device, the nurse clamps the extension tubing to prevent air from entering the line. The primary IV tubing is clamped to prevent blood loss when the IV and tubing are disconnected. Flushing maintains IV line patency. Taping the adapter device and extension tubing secures the device in the proper position.

When instructing a client regarding sublingual application, the nurse should inform the client that which action is contraindicated when administering the drug? A. swallowing the medication B. taking the medication on an empty stomach C.talking when taking the medication D. performing physical activities

swallowing the medication When administering medication by sublingual application, the client should avoid swallowing or chewing the medication. Eating or smoking during administration is also contraindicated. Taking the medication on an empty stomach, talking, or performing physical activities may not be contraindicated when administering drugs sublingually.

A nurse flushes an intravenous lock before and after administering a medication. What is the rationale for this step?

to clear medication and prevent clot formation

The primary reason for the Controlled Substances Act is:

to prevent drug abuse. 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 is caring for a client undergoing IV therapy. The nurse knows that intravenous administration of medication is appropriate in which situation? when the client has disorders that affect the absorption of medications when the drug needs to act on the client very slowly when the client wants to avoid the discomfort of an intradermal injection when the drug needs to be administered only once

when the client has disorders that affect the absorption of medications Intravenous administration may be chosen 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. Intravenous administration is not chosen when a client wants to avoid the discomfort of an intradermal injection but rather when the client wants to avoid the discomfort of repeated intramuscular injections. A single administration of a drug does not indicate the need for intravenous administration.