Unit 2 Medication Administration Adapt. Quiz

Benztropine 2.5 mg by mouth is prescribed. Medication available in 1-mg scored tablets. How many tablets would the nurse administer?

2.5 tablets

Which instruction would the nurse include when teaching a client to self-administer eye drops? A) "Lie on unaffected side for administration." B) "Instill drops onto pupil to promote absorption." C) "Close eyes tightly after administering the eye drops." D) "Apply pressure to nasolacrimal duct after instillation."

Apply pressure to nasolacrimal duct after instillation Rationale = applying pressure prevents absorption of medication into the duct. Lying on unaffected side is indicated for ear drops.

How could the nurse evaluate the effectiveness of albuterol? A) Auscultating breath sounds B) Collecting sputum sample C) Conducting brief neurologic exam D) Palpating chest excursion to gauge promotion of intercostal contractility

Auscultating breath sounds Rationale = Albuterol is an adrenergic drug that stimulates B-2 receptors, leading to relaxation of smooth muscles of airway. Lungs should be auscultated to evaluate the effectiveness of this medication. Albuterol doesn't affect intercostal contractility. Chest excursion is not the appropriate assessment. Albuterol doesn't affect consistency of pulmonary secretions. Albuterol will not cause CNS stimulation.

Which side effect would the nurse monitor for in client who is prescribed metoprolol? A) Hirsutism B) Bradycardia C) Restlessness D) Hypertension

Bradycardia Rationale = Beta blockers block stimulation of beta 1 (myocardial) adrenergic receptors, which decreases HR and BP. Client should be monitored for bradycardia. Excessive growth of hair or presence of hair in unusual places doesn't occur w/ this medication. Absence of loss of hair (alopecia) may occur. Side effect of this medication is fatigue, not restlessness. May produce hypotension, not hypertension.

Which technique would the nurse use to administer ophthalmic medication to a client? Select all that apply A) Clean the eyelid and eyelashes B) Place dropper against eyelid C) Apply clean gloves before beginning procedure D) Instill solution directly onto the cornea E) Press on nasolacrimal duct after instilling solution

Clean eyelid and eyelashes, apply clean gloves before beginning procedure, press on nasolacrimal duct after instilling Rationale = medication is to be instilled into the lower conjunctival sac

Which responsibility does the nurse have when administering prescribed opioid analgesics? A) Count client's respirations B) Document intensity of client's pain C) Withhold medication if pt reports pruritis D) Verify number of doses in locked cabinet before administering the prescribed dose E) Discard medication in client's toilet before leaving room if medication is refused

Count client respirations, document intensity of pain, verify the number of doses in the locked cabinet before administering the prescribed dose. Rationale = Opioid analgesics can cause respiratory depression. Nurse must monitor respirations. Intensity of pain must be documented before and after giving.

According to nursing process, which action would the nurse take after administering pain medication to a post op patient? A) Administer nonpharmacologic comfort measures B) Inform HCP of nursing action C) Create care plan that addresses client's pain level D) Determine whether pain medicine relieved client's pain

Determine whether pain medication relieved client's pain Rationale = After implementation of a nursing action, the nurse must evaluate the intervention's effectiveness. Administering nonpharmacologic comfort measures is a different intervention and does not occur as result of pain medication. Nurse doesn't need to inform the provider of the nursing action. Nurse creates plan of care before administering pain medication, not after.

Which response does the nurse expect the client to exhibit when a therapeutic effect of digoxin is achieved? A) Diuresis and decreased pulse rate B) Increased BP and weight loss C) Regular pulse rhythm and stable fluid balance D) Corrected heart murmur and decreased pulse pressure

Diuresis and decreased pulse rate Rationale = Digoxin slows HR. Also increases kidney perfusion, which promotes urine formation, resulting in diuresis and decreased edema. Digoxin will DECREASE blood pressure. Although digoxin produces diuresis as result of improved cardiac output, which increases fluid output, it doesn't regulate an irregular pulse. Digoxin will not correct heart murmur or decrease pulse pressure.

Which information is appropriate for the nurse to include in the client's teaching of enalapril for the treatment of hypertension? A) Do not change positions suddenly B) Light-headedness is a common adverse effect that need not be reported C) May cause sore throat for first few days D) Schedule blood tests weekly for first 2 months

Do not change positions suddenly Rationale = Enalapril is an angiotensin-converting enzyme (ACE) inhibitor. Used to treat high BP (hypertension) and congestive heart failure. Can be used to treat disorder of ventricles. Angiotensin is a chemical that causes arteries to become narrow. ACE inhibitors help body produce less angiotensin, which helps blood vessels relax and open up which lowers BP. Changing positions slowly = minimizes orthostatic hypotension. Doesn't cause sore throat the first few days.

Which would the nurse incorporate into the plan of care for the older adult experiencing chronic pain? A) Exercise B) Distraction C) Heat therapy D) Trigger point massage

Exercise Rationale = Important nonpharmalogical activity for older adults experiencing chronic pain. Exercise promotes movement of joints & muscle strength - can promote relaxation.

Which medication would the nurse crush for a client w/ dysphagia? A) Extended-release potassium chloride B) Enteric-coated aspirin C) Sustained-release metoprolol D) Extra-strength acetaminophen

Extra-strength acetaminophen Rationale = Not coated or intended to be released slowly. Crushing this medication would not cause bolus of medication to be administered to the client.

Which test result would the nurse use to determine if client's daily dose of warfarin is therapeutic? A) International normalized ratio (INR) B) Accelerated partial thromboplastin time (APTT) C) Bleeding time D) Sedimentation rate

International normalized ratio (INR) Rationale = Warfarin initially prescribed day by day, based on INR blood test results. This test provides a standard system to interpret prothrombin times. APTT is used to evaluate effects of heparin, which acts on intrinsic pathway. Bleeding time is time required for blood to cease flowing from a small wound. Sedimentation rate is test used to determine the presence of inflammation of infection. Doesn't indicate clotting ability. WARFARIN RAISES INR

Which information would a nurse expect not to find when reviewing a newly admitted clients medication administration record (MAR)? A) Client height B) client allergies C) Body weight D) medical diagnosis

Medical diagnosis Rationale = Allergies should be listed on all MARs to prevent admin. of drugs to which the client is allergic. Height is part of the initial health history/physical assessment data. Weight is part of the initial health history/physical assessment data. Medical diagnosis is part of the initial health history/physical assessment data.

Client w/ diagnosis of uncontrolled diabetes began receiving furosemide 2 days ago. Which nursing action is MOST appropriate for nurse to take after client's potassium level is 2.8 mEq/L? A) Hold morning dose of the diuretic and have lab repeat test B) Continue to monitor level to ensure that it stays WNLs C) Notify the primary HCP of result, which is critically low. D) Anticipate prescription for increase in dosage of furosemide

Notify primary health care provider of result, which is critically low Rationale = HCP should be notified. Normal range for serum potassium is 3.5 to 5 mEq/L. Clients who are on diuretics require monitoring of serum electrolytes, especially potassium and sodium b/c they're also excreted w/ water. Nurse should not hold diuretic or repeat lab test unless ordered by PCP.

Which action should nurse implement to understand the nature of a client's pain? Select all that apply A) Cover area of discomfort B) Observe where client locates pain C) Refrain from touching area of tenderness D) Note whether the pain radiates to any other part of the body E) instruct client not to move so as not to increase pain.

Observe where client locates pain, note whether pain radiates to any other part of body Rationale = Nurse should notice where client points when telling nurse location of pain. Should also observe whether the pain radiates. Nurse should inspect area rather than cover it and palpate area of discomfort and tenderness to determine severity of pain. Nurse should note whether pain increases while client is moving or is relieved when client is at rest.

Which finding would the nurse include in the pain assessment of a client w/ chronic pain in the knee? Select all that apply A) Pain history including location, intensity, and quality of pain. B) Client's purposeful body movement in arranging the papers on bedside table. C) Pain pattern including precipitating and alleviating factors. D) VS such as increased BP and HR E) Client's family statement about increases in pain w/ ambulation

Pain history including location, intensity, and quality of pain, pain pattern including precipitating and alleviating factors

Which desired outcome would a nurse expect when administering a nonsteroidal antiinflammatory drug (NSAID)? Select all that apply A) Diuresis B) pain relief C) Antipyresis D) Bronchodilation E) Anticoagulation F) Reduced inflammation

Pain relief, antipyresis, reduced inflammation Rationale = Prostaglandins accumulate at site of injury, causing pain. NSAIDs inhibit COX-1 and COX-2, decreasing production of prostaglandins and contributing to analgesia. NSAIDs inhibit COX-2, which is associated w/ fever & leads to antipyresis. COX-2 also associated w/ inflammation and NSAIDs reduce inflammation. NSAIDs do not cause diuresis.

When interpreting findings from pain assessment, which does a nurse consider the most significant influence on many clients' perception of pain? A) Age and sex B) Physical and physiologic status C) Intelligence and economic status D) Past experience and cultural values

Past experience and cultural values Rationale = Interpretation of pain sensations is highly individual and is based on past experiences, which include cultural values. Age and sex affect pain perception only indirectly b/c they generally account for past experience to some degree. Overall physical condition may affect ability to cope with stress, but unless nervous system is involved, it will not greatly affect perception.

Nurse should teach client to use which technique when self-administering sublingual nitroglycerin? A) Place pill inside cheek and let it dissolve B) Place pill under tongue and let it dissolve C) Chew pill thoroughly and then swallow it D) Swallow pill w/ full glass of water

Place pill under tongue and let dissolve Rationale = Sublingual medication is placed under tongue and is quickly absorbed through mucous membranes into blood. Buccal route requires placing medication between cheeks & gums. Chewing and then swallowing may be done for oral administration of some large-size pills but not w/ sublingual route of admin. Taking pill w/ water is required w/ PO route of admin but not w/ sublingual. In addition, a full glass of water may be an excessive amt of fluid to swallow one pill.

Which lab result would nurse monitor for in a client taking a corticosteroid for exacerbation of emphysema and furosemide for BP management? A) Calcium B) Chloride C) Potassium D) Magnesium

Potassium Rationale = Corticosteroids may enhance loss of potassium when taken concurrently w/ furosemide as it's a potassium-wasting loop diuretic and the serum potassium level should be monitored during therapy. Calcium, chloride, and magnesium are not as significantly altered by this concomitant drug therapy.

Which action would the hospice nurse take when a client using fentanyl transdermal patches passes away? A) Tell family to remove and dispose of the patch B) Leave patch in place for mortician to remove C) Have family return patch to pharmacy for disposal D) Remove and dispose of patch in appropriate receptacle.

Remove and dispose of patch in appropriate receptacle

Which nonpharmacologic nursing intervention is effective in helping relieve postoperative pain? A) Ambulation B) Repositioning C) Purse-lipped breathing D) Deep-breathing and coughing

Repositioning Rationale = Acute post op pain always requires use of analgesics, but nonpharmacologic interventions such as repositioning pt can help relieve pain. Ambulation not specifically used to decrease post op pain. Purse-lipped breathing primarily used to improve ventilation. Deep breathing & coughing are used to clear resp. tract.

Why would the nurse assess for before administering before each dose of oxycodone prescribed for post op pain? A) Respiratory rate and LOC B) Color, character, and amt of urine output C) IV site and patency of intravenous catheter D) Amt and character of drainage in portable drainage system

Respiratory rate and level of consciousness Rationale = oxycodone depresses the CNS, resulting in decreased LOC and depressed respirations.

List the steps, from beginning to end, on how the nurse teaches the client to follow when using a metered dose inhaler (MDI) 1. Shake inhaler for 30 sec 2. Hold inhaler upright in mouth 3. Exhale slowly and deeply to empty the air from lungs. 4. Start breathing in and pressure down on the inhaler once.

Shake inhaler for 30 sec, exhale slowly and deeply to empty air from lungs, hold inhaler upright in mouth, start breathing in and press down on inhaler once.

After surgery, 12 year old child is receiving morphine for pain control by way of a patient-controlled analgesia (PCA) infusion. Bolus of morphine can be delivered every 6 minutes. Parent will be staying with the child. Which statement by the parents indicates instructions about the PCA pump have been understand? A) I'll make sure she pushes the PCA button every 6 minutes B) She needs to push PCA button whenever she needs pain meds C) I'll have to wake her up on a regular basis so she can push the PCA button D) I'll press the PCA button every 6 minutes so she gets enough pain medication while she's sleeping

She needs to push the PCA button whenever she needs pain medication(s) Rationale = Morphine relieves pain. When control of pain is given to the child, anxiety and pain are usually diminished, resulting in decreased need for the analgesic. Only the child should press the button. Having the child press button every 6 min is unnecessary. Although pain medication can be delivered as often as every 6 minutes, it should be used only if needed.