Medication Safety

An elderly client is scheduled to take six medications each morning. The nurse administering these medications knows to do which of the following? Select one: a. Allow extra time to administer all of the medications b. Allow the client to take only the medications she can swallow. c. Crush all of the medications before giving them d. Leave the medication at the bedside so the client can take them slowly.

a. Allow extra time to administer all of the medications

The nurse is aware that drugs proven to be a risk to the human fetus are included in which FDA pregnancy category(ies)? (Select all that apply.) A. A B. B C. C D. D E. X

C. C D. D E. X

A nurse reads the following order: "Take one multivitamin qod." The nurse will A. administer 1 multivitamin every morning. B. give the patient 1 multivitamin every other day. C. call the prescriber to clarify the order. D. refuse to administer the multivitamin and document it as not administered.

C. call the prescriber to clarify the order.

Five Nursing Responsibilities

Right assessment Right documentation Right education Right evaluation Right to refuse

Kids ear drops

pull down and back

Adult ear drops

pull up and out

Five Rights of Medication Administration

right patient right drug right dose right time right route

What degree can you give a subsutaneous med?

45 or 90 degree depending on the patients size

The Z-track method is the preferred method of administration for which drug? A. Vitamin B12 B. Iron dextran C. Penicillin D. Morphine

B. Iron dextran

What is the primary purpose of self-medication administration? A. To cut down on the amount of staff needed in the health care facility B. To empower the patient to be more effective in management of the therapeutic regimen C. To decrease medication errors D. To decrease the time the patient needs to wait for the medication

B. To empower the patient to be more effective in management of the therapeutic regimen

Which statement about transdermal drugs is true? A. Transdermal drugs are preferred because they exert only a local effect. B. Transdermal drugs provide more consistent blood levels than oral and injection forms. C. For maximum effectiveness, transdermal patches should be reapplied to the same location when reapplied. D. For maximum effectiveness, the skin should not be cleansed with soap once it has been exposed to a transdermal drug.

B. Transdermal drugs provide more consistent blood levels than oral and injection forms.

An 18-year-old has an external ear infection to be treated with eardrops. The nurse correctly instructs the patient to angle the ear A. down and back. B. up and back. C. down and forward. D. up and forward.

B. up and back.

A nurse is planning to administer an intradermal injection to a patient. Which represents the appropriate technique for this route? A. 21-gauge needle at 33 degrees B. 20-gauge needle at 90 degrees C. 23-gauge needle at 45 degrees D. 26-gauge needle at 15 degrees

D. 26-gauge needle at 15 degrees

The nurse is required to chart the patient's response to all of the following groups of medications except A. opioids. B. antiemetics. C. sedatives. D.antihyperlipidemics.

D.antihyperlipidemics.

Routes of Med Administration

Sublingual buccal oral transdermal topical instillation (eyes, nose, ears) nasogastric suppositories parenteral (intradermal, subcutaneous, intramuscular intravenous)

A health care provider calls a nursing unit to leave a telephone order for a PRN antipyretic medication for a child. The provider tells the nurse to "give PO acetaminophen for a fever greater than 101° F per protocol." What will the nurse do next? Select one: a. Ask the provider to verify how many mg per kg per dose and how frequently to give the medication. b. Look up the protocol in the unit manual and write the drug order for the provider to sign. c. Provide the child's weight to the hospital pharmacist to write the order based on the protocol. d. Transcribe the verbal order to the order sheet as "give PO acetaminophen for a fever greater than 101.5 F per protocol."

a. Ask the provider to verify how many mg per kg per dose and how frequently to give the medication.

A child brings unlabeled medications in a plastic bag to the school nurse. What should the nurse do? Select one: a. Call the parent or guardian for the labeled pharmacy bottle. b. Administer the medication that day and send a note home. c. Administer the medication if the child can identify the medication d. Allow the student to take his or her own medication.

a. Call the parent or guardian for the labeled pharmacy bottle.

When giving a medicine through a nasogastric (NG) tube, the nurse will first do which of the following? Select one: a. Check placement of the tube b. Ask the patient if the tube is painful c. Flush the tube with 30 mL of water d. Take the vital signs

a. Check placement of the tube

Examples of medications that are given by enteral routes include which of the following: SELECT ALL THAT APPLY Select one or more: a. Oral capsules b. Liquid medications c. Oral tablets d. Total parenteral nutrition (TPN) solutions e. Rectal suppositories

a. Oral capsules b. Liquid medications c. Oral tablets e. rectal suppositories

Which of the following are correct practice when using needles to administer parenteral medications? Select all that apply. Select one or more: a. The nurse placed the needle directly into the sharps container after injecting the medication b. The nurse wipes the skin with alcohol and allows to dry before injecting medication c. The nurse recaps the needle when done injecting the medication d. The RN intervenes if she sees a student recapping a needle after giving an injection. e. The nurse leaves the needle unattended on the bedside table while she gets something

a. The nurse placed the needle directly into the sharps container after injecting the medication b. The nurse wipes the skin with alcohol and allows to dry before injecting medication d. The RN intervenes if she sees a student recapping a needle after giving an injection.

The nurse is administering a sustained-release capsule to a new client. The client insists that he cannot swallow pills. The best course of action for the nurse is to: Select one: a. Crush the capsule and put it in applesauce b. Ask the physician to change the order c. Split it in half to make the capsule easier to swallow d. Chart that the client refused the medication

b. Ask the physician to change the order

The nurse is teaching the client about cautions when using over-the-counter medications while the client is taking prescription medications. What is the issue of concern? Select one: a. Drug-lab interactions b. Drug-drug interactions c. Drug-food interactions d. Adverse medication effects

b. Drug-drug interactions

Which of the following clients would be appropriate to participate in your facility's new Self Administration Program (SAM)? Select all that apply. Select one or more: a. A 90 year-old whose son usually gives him the medications b. An elderly client with Altzheimer's dementia who is confused often c. A 33-year-old male client who is recovering with a broken arm d. An elderly client who is alert to time, place and situation e. A 9-year-old newly diagnosed diabetic giving herself subcutaneous insulin for the first time

c. A 33-year-old male client who is recovering with a broken arm d. An elderly client who is alert to time, place and situation

The nurse is caring for a patient who will have surgery that morning. The patient usually takes an antihypertensive medication every morning. The patient has been NPO since midnight. What action will the nurse perform? Select one: a. Hold the medication until after the patient's surgery. b. Ask the patient to swallow the pill without water. c. Consult the provider and surgeon about giving the medication. d. Give the medication with a small sip of water.

c. Consult the provider and surgeon about giving the medication.

A patient who is diagnosed with atrial fibrillation is to begin taking warfarin (Coumadin). The patient refuses to take the medication because "it is rat poison." After the nurse provides teaching, the patient still refuses. What action will the nurse take? Select one: a. Hold the dose and document the patient's refusal. b. Put the medication in the patient's food. c. Hold the dose, notify the provider of the situation, and document these actions. d. Tell the patient that patient that they have to take the medication

c. Hold the dose, notify the provider of the situation, and document these actions.

When the nurse practices the "5-plus-5" rights of medication administration, what does it ensure? Select one: a. Informed consent for drug administration b. Cost-effective use of medications c. Safe administration of medications d. Adequate information is given

c. Safe administration of medications

An occupational health nurse works in a setting with standardized medication protocols. The protocol that should be questioned by the professional nurse is administering: Select one: a. ibuprofen for menstrual cramps. b. antacids for gastric upset. c. penicillin for signs of infection. d. acetaminophen for a fever.

c. penicillin for signs of infection.

A patient asks the nurse if an enteric-coated tablet can be crushed and put in pudding to make it easier to swallow. How will the nurse respond to the patient? Select one: a. "The tablet may be done if a small amount of pudding is used." b. "The tablet may be dissolved in liquid but not crushed and put in food." c. "Crushing the medication is safe and can prevent gagging on pills." d. "Crushing the medication can lead to a possibly toxic medication dose."

d. "Crushing the medication can lead to a possibly toxic medication dose."

A community health nurse is teaching a client about a new medication. The nurse is aware that it is important to advise clients and families that the therapeutic response from psychotropic drugs may not occur until after: Select one: a. 24 to 72 hours. b. 1 week. c. 2 weeks. d. 4 to 6 weeks.

d. 4 to 6 weeks.

A client is nauseated, and has been vomiting for several hours, and needs to receive an antiemetic (anti-nausea) medication. Which of the following is the best option? Select one: a. An instillation medication should be given b. Any medication will not be absorbed as easily because of the nausea problem c. An enteric-coated medication should be given d. A parenteral route is the route of choice

d. A parenteral route is the route of choice

The nurse is preparing to teach a patient about a newly prescribed drug therapy. What time is best for improving teaching effectiveness? Select one: a. Right after the health care provider has told the patient that the health problem cannot be cured. b. When the patient's spouse and 3 adult children are present so that the family can reinforce the teaching. c. During lunch so that the patient is not too hungry to learn d. After the patient wakes up from a nap and no visitors are present.

d. After the patient wakes up from a nap and no visitors are present.

The nurse is having difficulty reading a physician's order for a medication. The nurse knows the physician is very busy and does not like to be called. The nurse should Select one: a. Administer the same thing the client was ordered during the last admission because it is probably the same b. Ask the other nurses if they can read the handwriting c. Look up the hospital protocol for administering this drug d. Call the physician to request clarification

d. Call the physician to request clarification

The nurse is giving morning medications to patient who refuses to take an oral dose of docusate (Colace).What is the nurse's best response? Select one: a. Docusate will soften your bowel movements so that you do not strain b. This drug will help prevent constipation while you are on bed rest. c. Your prescriber ordered that you must take this drug twice a day. d. Can you tell me why you do not want to take the docusate?

d. Can you tell me why you do not want to take the docusate?