Prep U: Chapter 29: Medications

The nurse has received a telephone order for a client from a health care provider. How will the nurse indicate in the documentation that the order was received via telephone?

Record "T.O." at the end of the order.

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

The nurse should apply the medication directly to the skin.

The Z-track technique is utilized during drug administration by which route?

Intramuscular

The nurse is caring for a client who is taking nitroglycerin. Which client statement requires immediate nursing intervention?

"I am taking tadalafil in addition to nitroglycerin."

The nurse is teaching a client with heart failure about taking digoxin safely. Which statement by the client indicates teaching was effective?

"I will call the health care provider if I develop dizziness, blurred vision, or nausea."

Which statement by a client indicates to the nurse that teaching was effective regarding the different parts of a syringe?

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

The nurse is preparing to administer an allergy test intradermally. At what angle will the nurse plan to insert the needle into the client?

10 to 15 degrees

The nurse is reviewing the plan of care for several clients who have prescriptions for intravenous medications. The nurse understands that which client is at the highest risk for greater effect of the IV medication?

73-year-old client diagnosed with liver disease

The nurse is preparing to administer insulin to an obese client. At what angle will the nurse plan to insert the needle into the client?

90 degrees

The client asks the nurse how to administer medication purchased over the counter for relief of arthritis pain. The nurse reviews the medication and determines that it is to be applied topically. Which instructions should the nurse provide?

Apply the medication to clean, dry skin of the affected area using gloves.

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.

The client is to receive an oral antihypertensive medication. Parameters for the medication are to hold if the blood pressure is less than 100 mm Hg systolic and less than 60 mm Hg diastolic. The client's blood pressure is 92/64 mm Hg. The nurse administered the antihypertensive and realized the error after administration. Place the actions in order that the nurse will perform them. Use all options.

Assess the client. Notify the supervising nurse and health care provider. Document actions in the nurse's notes. Complete an incident report.

A nurse receives orders from the physician to mix a client's insulin in a syringe with two other medications. What is the recommended guideline in this situation?

Call the pharmacist to determine compatibility of the drugs.

The nurse is preparing to administer a liquid form of medication to a client. What action will the nurse take to ensure that administration of the drug is at the desired potency?

Check the expiration date.

A nurse is administering a hepatitis B shot intramuscularly. What would be the appropriate site for administration?

Deltoid

The nurse is teaching a client how to take medications upon discharge. The client is alert and oriented but unable to articulate the teaching back to the nurse. What is the appropriate nursing action?

Give written instructions to the client and caregivers.

The nurse is educating a client on how to use an insulin pen. Which steps reflect recommended procedure? Select all that apply.

Hold the pen upright and tap to force any air bubbles to the top. Dial the dose selector to 2 units to perform an "air shot" to get rid of bubbles. Clean injection site and administer injection by holding pen like a dart.

Which situation accurately describes a recommended guideline when administering oral medications to clients?

If a child refuses to take medication, crush the medication, if allowable, and add to a small amount of food.

The nurse is preparing to administer an allergy test via an intradermal injection. Which injection site would be most appropriate in this situation?

Inner surface of the forearm

A nursing responsibility in managing IV therapy is to monitor the fluid infusions and to replace the fluid containers as needed. What is an accurate guideline for IV management that the nurse should consider?

It is the responsibility of the nurse to provide ongoing verification of the IV solution and the infusion rate with the physician's order.

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

Lock the medications in a cart and finish them upon return.

The nurse is preparing to administer the second dose of ordered antibiotics to a client and notes that the first dose of medication is still in the automated medication-dispensing system. The medication administration record (MAR) does not show that the initial dose was given. What is the appropriate nursing action?

Notify the health care provider.

A nurse brings a client the prescribed dose of medication and finds that the client is not in the unit. What should the nurse do in this case?

Return the medication to the medication cart or medication room.

A nurse is assessing a client's lower arm for insertion of an IV catheter. The nurse palpates the vein and notes that it feels hard. Which action by the nurse would be most appropriate?

Select another site.

The nurse administers the client's scheduled morning medications. The previous dose of antihypertensive was held due to a blood pressure that was too low according the health care provider's parameters. What does the nurse do with this upcoming dose of scheduled unit-dose packaged antihypertensive medication?

Set the antihypertensive dose aside pending assessment.

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 the antibiotic.

Which nursing strategy should the nurse employ to assist a child who has difficulty coordinating inspiration with the use of a handheld inhaler?

The nurse should use a nebulizer to administer the medication.

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

Therapeutic range

A client requests more medication for pain at the surgical site rated 8 out of 10. There is a PRN prescription for 10 mg PO of oxycodone for pain greater than 6 out of 10 on the pain scale. Which action should the nurse take first?

Verify clients name and date of birth

The nurse is preparing to administer a bolus of an intravenous medication. How should the medication be administered?

all at once

A client with chronic obstructive pulmonary disease has been prescribed a bronchodilator to be administered by small-volume nebulizer. The nurse should ensure that the client:

breathes through his or her mouth until all the medication has been inhaled.

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 would help maximize drug absorption in this client?, Spacer

The nurse is performing the admissions assessment for a client admitted with right hip pain. When performing the assessment

the client stated all of the prescribed medications they take from the previous admission. Which question is the priority for the nurse to ask the client?, "Do you take any over-the-counter medications?"

After teaching a group of nursing students about pharmacokinetics

the instructor determines that the education was successful when the students identify what process by which the medication is delivered to the target cells and tissues?, Distribution

When administering a subcutaneous injection to a client

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.

In preparing to administer a drug to a client

the nurse has pierced a multi-use vial of medication. What is the appropriate nursing action?, Place the date on the vial and retain for future use.

The nurse is preparing to administer prescribed intravenous antibiotics to a client. While assessing the medication lock

the nurse notes that there is resistance when administering the saline flush solution. What would be the best action by the nurse?, Insert a new IV medication lock and remove the old one.

When instructing a client regarding sublingual application

the nurse should inform the client that which action is contraindicated when administering the drug?, swallowing the medication

What is the best explanation from the nurse as to why a client must return to the unit in 48 hours after having a tuberculin skin test intradermal?

to determine the extent to which the client responded to the drugs