Skills - Prep u chapter 32

The nurse is teaching a client about indomethacin SR. When the client asks, "What does the SR mean?" what is the appropriate nursing response?

sustained release

The nurse is to administer an oral medication through a nasogastric tube that is connected to low intermittent suction. The nurse:

clamps the nasogastric tube for 30 minutes after medication administration.

The client has difficulty swallowing pills and requests to have the medication crushed and mixed in applesauce. The medication the nurse can choose to administer this way is one that is a:

scored tablet

An acute care facility follows the unit dose supply method to supply medication to the clients. What is meant by the unit dose supply method?

self-contained packets that hold one tablet or capsule for individual clients

The client is to receive a medication on an empty stomach. The client is also receiving a continuous tube feeding. The nurse:

stops the feeding for 15 minutes before and after medication administration.

The nurse is teaching a client about metformin SA. When the client asks, "What does the SA mean?" what is the appropriate nursing response?

sustained action

What is an example of drug diversion? The nurse:

takes a medication from one client's container to use for another person

The nurse is preparing a client newly prescribed digoxin for discharge. Which safety consideration should the nurse include in the client teaching?

"Check your radial pulse before taking the medication each day."

The client refuses a medication. Which is the best response from the nurse?

"What is the reason you do not want to take this medication?"

The nurse manager is reviewing medication order protocols with staff nurses. Which teaching will the nurse include? Select all that apply.

-Refrain from using abbreviations. -Be mindful of look-alike and sound-alike drugs. -Nurses and health care providers are accountable for drug safety.

What would be considered a "right" of drug administration? Select all that apply.

-Right drug -Right documentation -Right dose -Right client

The nurse is administering an oral opioid medication to a client who reported pain. The client dropped the medication on the floor. What actions would the nurse take now? Select all that apply.

-search for the pill on the floor until the pill is found -discard the pill in an appropriate container with a witnessing nurse present -obtain another dose of the medication for the client

The nurse receives a medication prescription for amoxicillin 250 mg QID. by mouth for a client with an infection. What approximate scheduled times will the nurse document the client requires the medication?

0800, 1200, 1600, 2200

A nurse is converting the dosage of a medication to a different unit in the metric system. The medication label specifies the drug as being 0.5 g per tablet. The order is for 500 mg. How many tablets will the nurse give?

1

The nurse is to administer levothyroxine 0.125 mg PO at 0600. The package is labeled levothyroxine 125 mcg. Calculate the number of tablets the nurse will administer. Record your answer as a whole number.

1 tablet

A client has been prescribed 300 mg of metronidazole. The supply is metronidazole 200 mg tablets. How many tablets will the nurse administer? Record your answer using one decimal place.

1.5

A pediatric client has a fever for which the provider has prescribed ibuprofen 200 mg orally every 6 hours. The instructions on the bottle indicate there is 100 mg/5ml. How many milliliters should the nurse give? Record your answer using a whole number.

10

A health care provider at the health care facility orders 500 mg of a medication to be administered by the oral route, four times a day for a client. The medication is available in a liquid form of 250 mg per 5 ml. What quantity of the medication should the nurse administer to the client?

10ml

The prescribed medication is digoxin 250 mcg po now. The supplied drug is digoxin 0.125 mg tablets. How many tablets will the nurse administer? Record your answer using a whole number.

2

The nurse has a prescription to administer 25 mg of furosemide IV to a client. The drug is supplied in a vial 40 mg/4 ml. How many milliliters will the nurse administer of the medication?

2.5

The health care provider prescribes ciprofloxacin 500 mg PO q12h for a pediatric client with bronchial pneumonia. The nurse has liquid ciprofloxacin 250 mg/10 mL on hand. How many milliliters would the nurse dispense? Record your answer using a whole number.

20

At what point should the nurse perform the first of the three checks of medication administration?

As the nurse reaches for the drug package or container.

A nurse is caring for a client in the nursing unit when the health care provider, during the rounds, verbalizes a prescription for a medication. What appropriate action should the nurse take to ensure the accuracy of the verbal medication order?

Ask the health care provider to write out the order.

The nurse has inadvertently administered medication ordered for Client A to Client B. What is the appropriate nursing action? Select all that apply.

Assess Client B thoroughly. Complete an incident report. Contact the provider to report the error.

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.

The nurse is preparing to administer oral medication to a client. Which is the first action the nurse will take?

Compare the medication administration record (MAR) with the written medical order.

The nurse is preparing to give medications to a client with anxiety. The order indicates that the client is to have bupropion, 7.5 mg by mouth twice daily. What is the appropriate nursing action?

Contact the health care provider for order clarification.

The nurse is caring for a 70-year-old client who reports seeing a number of different health care providers. Which follow-up assessment question will the nurse ask?

Do you get all of your medication filled at the same pharmacy

The health care provider writes a prescription for ampicillin 1 gram every 6 hours for a client. How should the nurse best respond to this prescription?

Elicit the desired route from the primary care provider

A nurse is taking care of a client who requests acetaminophen to help with a headache. The nurse checks to see if there is an order for acetaminophen and notices that the client is able to have 650 mg every 4 hours as needed for pain. What type of order is this considered?

PRN order

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 client has continuous enteral feedings through a nasointestinal tube. The client has a thyroid medication that is to be taken on an empty stomach. What action does the nurse perform?

Stop the infusion for 30 minutes before and after administration of the thyroid medication.

The health care provider has given and signed an order for a specific client for zolpidem, 10 mg by mouth once daily at hour of sleep, and recorded the specific date and time of the order. What is the appropriate nursing action?

administer the drug

The nurse is caring for a client with pneumonia who requires administration of medications. When does the nurse document administration in the medication administration record (MAR)?

after completion of administration of each drug

A client has been prescribed a new medication that is costly and not fully covered by the client's insurance plan. What can the nurse suggest to the client to address the concern?

"Request that the pharmacy partially fill the prescription to evaluate the drug's effectiveness before full purchase."

A nurse is taking care of a 56-year-old man with end-stage liver disease. The nurse has a prescription to give 20 g of lactulose every 6 hours to treat the client's hepatic encephalopathy. On hand, the nurse has containers of lactulose that have 30 g in 45 ml. How many milliliters is the nurse going to administer every 6 hours to the client?

30 mL

The nurse is administering morphine 10 mg oral solution. The medication is provided in a 100-ml container that is labeled morphine 10 mg/5 ml. Which device will the nurse use to most accurately measure the prescribed dose of morphine?

5-ml oral syringe

The nurse is reading a medication prescription for a drug that is routinely administered every 12 hours. The prescription does not state the frequency of administration. What is the appropriate nursing action and accompanying rationale that guides the nurse's action?

Contact the health care provider to clarify the prescription. Assumptions cannot be made about medication administration and the nurse must practice within the state's nurse practice act and the organization's policies and procedures concerning medication administration.

The hospital nurse is using barcode medication administration software when preparing to administer medication to a client. When the scanning system cannot identify the client's identity, what is the appropriate nursing action?

Contact the pharmacy and information technology department for assistance.

A hospital nurse is coming on shift for a night shift and is receiving a change-of-shift report from a colleague. The colleague states that one client refused a prepared medication that was scheduled for 1800. The colleague has left the medication in a paper cup in the client's drawer on the medication cart and asks the nurse to administer the medication when the client goes to bed for the night. How should the nurse respond to this scenario?

Discard the medication and administer a dose of the correct drug from a labeled container.

The client has a nursing diagnosis of "Noncompliance due to inadequately taking prescribed medications." The nurse has employed interventions to facilitate the client's adherence to the medication schedule. How can the nurse evaluate the interventions' effectiveness? Select all that apply.

Encourage the client to relate problems encountered with self-administration. • Verify how many pills are left in the medication containers. Have the client state the frequency of self-administration and time of last dose.

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.

Which contains all the components of a valid order?

John Smith, atenolol 50 mg, twice a day, by mouth

An oral medication is prescribed for the client with an enteral tube because of aspiration. Which form for administration would the nurse select as best?

Liquid

A client is prescribed an HMO-CoA reductase inhibitor for the treatment of elevated cholesterol and triglyceride levels. Which education will the nurse provide to the client regarding the medication prescribed?

Liver function and glucose levels will be checked periodically.

A nurse is caring for a client who has been prescribed codeine, an opioid medication to relieve severe postoperative pain. Which responsibility does the nurse have to complete when handling opioid medications? Select all that apply.

Maintain an accurate account of the use of the medication. Record each medication used from the stock supply. Count each opioid medication at the change of each shift.

The "rights" of medication administration help to ensure accuracy when administering medications. What are some of these rights? Select all that apply.

Medication, client, dosage, route

The nurse is reviewing a medication prescription for a client prior to administration and observes that the route of administration is not present in the prescription. What is the appropriate action by the nurse to address this omission?

Notify the health care provider to add the route and then administer the medication when complete.

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.

What must a nurse do each time medications are administered to ensure that medication errors do not occur?

Observe the three checks and five rights.

The client reports dry mouth following chemotherapy treatments. The nurse is administering oral medications to the client. What action will the nurse perform to aid the client in taking medications?

Offer a sip of water prior to the administration of the medication.

Nurses who will soon complete their 12-hour shift are preparing to account for controlled substances. Which nursing action is appropriate? Select all that apply.

One nurse counts the supply; another nurse checks the record of administration. Two nurses must ensure that the counts of controlled substances agree.

What type of prescription would the health care provider most likely write to treat a client whose pain levels vary widely throughout the day?

PRN

The nurse is assessing a client who was seen 7 days ago with strep throat. The client states, "I felt better after 2 days of the antibiotic the provider prescribed, so I quit taking it." What would the nurse do to address this situation?

Provide education on taking all antibiotics for effective treatment

When the nurse administers the client's amlodipine, the client states that usually only one pill is taken instead of three pills. Which right of medication should now be triple checked before allowing the client to take the medication?

Right dose

A health care provider who just arrived on the unit gives a verbal order to the nurse regarding a nonemergent client situation. What is the nurse's appropriate response!

Tactfully request the provider to input the order into the computerized provider order system.

The nurse has begun caring for a surgical client who has been ordered preoperative antibiotics prior to bowel surgery. While the nurse will adhere to all the principles of safe medication administration, which of the six rights will the nurse pay particular attention to in this situation?

Time

An automated medication- dispensing system has been introduced at healthcare facility, eliminating the need for two nurses to count controlled substances at the end of each shift. Which practice should the nurses on the unit perform to ensure accurate inventory of controlled substances?

Verify the count each time a medication is removed from the system

The nurse has prepared a syringe containing morphine to give to a client. The client refuses the drug, stating that pain is under control. What procedure does the nurse follow to properly dispose of the medication?

Waste the medication with a nurse witness present, and the nurse witness must countersign the control record.

The nurse has drawn opioid pain medication into a syringe. When preparing to administer the medication, the client refuses, stating that pain is controlled currently at a level of 2 on a scale of 1 to 10. Which action should the nurse take to waste the medication?

Waste the medication with another nurse witness present.

A community health nurse who provides care for numerous older adults is aware of the problem of polypharmacy among this population. Which individual is at greatest risk for polypharmacy?

a woman whose prescribed medication regimen includes many different drugs

A nurse has prepared an oral dose of acetaminophen for a client ano the client has taken the medication while the nurse remained at the bedside. At what point should the nurse document the fact that the client took the medication as ordered?

as soon as the nurse is able to document this

Which order includes information that may be confusing and is recommended by The Joint Commission not to be used?

aspirin gr X po prn q4h prn moderate joint pain

The nurse is administering medications for the client with the assigned medication administration record (MAR). It is 0845 on Tuesday. Which medication(s) will the nurse administer? Select all that apply.

atenolol furosemide pantoprazole

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 expiration date

The nurse is teaching a client about zolpidem CR for sleep. When the client asks, "What does the CR mean?" what is the appropriate nursing response?

continuous release

A medication order for a hospitalized client is written on the chart as follows: "cephalexin 500 three times a day for 10 days." The health care provider has signed the order. What should the order also include? Select all that apply.

date and time the order is written route of administration dose to be administered

The nurse is teaching a client about the combination drug dextroamphetamine saccharate-amphetamine aspartate monohydrate- dextroamphetamine sulfate-amphetamine sulfate XR. When the client asks, "What does the XR mean?" what is the appropriate nursing response?

extended release

The nurse is to administer an opioid. The prescribed dose is one half of a scored tablet. The nurse cuts the tablet in half and then:

has a second nurse witness the waste.

The client cannot swallow and just had an enteral tube placed for feeding and medications. Medications will have to be in liquid form or crushed for administration. The client has the following medications prescribed. Which medication will the nurse withhold and consult with the health care provider?

oxycodone extended release tablet