Pharm Ch 3
A nurse caring for a patient is describing steps for carrying out nursing activities that will assist in achieving patient goals. At which step of the nursing process is the nurse? Evaluation Implementation Assessment Planning
Planning
Order: Enoxaparin 30 mg subcutaneously Available: Lovenox 60 mg/ 0.6 mL How many mL will the nurse administer?
0.3
A male client has been admitted to the hospital because of poor adherence to his medication regimen at home. He was taking Cardizem, a calcium channel blocker, twice per day. The health care provider orders Cardizem CD, a sustained-release medication. When teaching the client about the medication, which statement would indicate he needs additional teaching? "I will have to take the medication only once per day." "The medication dosage is higher than my previous prescription, but this is okay because it is released over time." "I will take the medication as I was taking it prior to being admitted to the hospital." "I need to take the medication at the same time daily to prevent adverse effects."
"I will take the medication as I was taking it prior to being admitted to the hospital."
A client recently discovered that she is pregnant. She currently takes herbal medications to control her diabetes and the symptoms related to pregnancy. She asks the nurse if it is safe to take herbal medications while she is pregnant. What would the nurse tell this client? "Most herbal and dietary supplements are safe during pregnancy and are used by many cultures to control the symptoms of nausea." "Herbal and dietary supplements will cause premature labor." "Most herbal and dietary supplements should be avoided during pregnancy or lactation." "Dietary supplements are high in fat and protein; they are safe to take during pregnancy and help to maintain health during lactation."
"Most herbal and dietary supplements should be avoided during pregnancy or lactation."
A client who just picked up a prescription at the pharmacy asks the nurse why the client was prescribed a medication for mental health issues when the client sought treatment for allergies. What is the nurse's best response? "Tell me the name of your prescription please." "What symptoms of allergies do you have?" "Have you been experiencing any hallucinations lately?" "The prescriber probably wanted to treat any anticipated depression you may experience."
"Tell me the name of your prescription please."
The nurse is providing care for a client who has been prescribed a diuretic to treat hypertension. The client states that the effects of the drug are problematic, causing the client to wake up numerous times during the night to urinate. What assessment question should the nurse prioritize? "Have you increased your fluid intake since starting the drug?" "What is the dosage of your medication?" "Are you taking any herbal medicines?" "When are you taking your medication?"
"When are you taking your medication?"
A client is going to have bowel surgery in the morning. The physician orders 500 mL of GoLYTELY PO to be administered at 17:00. How many liters should the nurse administer? Round to one decimal place.
0.5
A client is prescribed a 12.5-mg dose of metoprolol for the treatment of high blood pressure. The nurse should administer how many 25-mg tablets? 1 2 0.5 1.25
0.5
A client has been prescribed 15 mL of an oral liquid potassium supplement. The nurse should administer how many ounces? 3 oz 1 oz 0.5 oz 2 oz
0.5 oz
A child with a urinary tract infection who is prescribed cephalexin 25 mg/kg/day in 3 divided doses. Knowing that the child weighs 15 kilograms, the nurse should administer how many mg with each dose?
125
The health care provider prescribes ascorbic acid 0.5 g daily. The drug label reads ascorbic acid 250 mg/tablet. The nurse would administer how many tablets? 1 4 3 2
2
The health care provider prescription reads prednisone 20 mg orally in the morning and at bedtime. The label on the drug reads 20-mg tablets. The nurse would expect the client to receive how many tablets in 24 hours? 2 1 4 3
2
A client's prescriber has suggested 10 mL of guaifenesin (Robitussin) PO q4h as needed. What dose using household measurement will be given?
2 tsp
An adult client with renal cancer, weighing 95 kg, is to receive vincristine 25 mcg/kg/day IV. What is the dosage of vincristine that the client is to receive daily? 2,375 mcg 1,250 mcg 2,500 mcg 4,750 mcg
2,375 mcg
The nurse determines that a newborn weighs 6 lb 7 oz. What would be the equivalent of this weight in grams? 2,980 g 3,200 g 3,000 g 2,920 g
2,920 g
A postmenopausal client has been prescribed Ibandronate (Boniva) 3 mg intravenously every 3 months. Boniva is available 1 mg/mL. How many mL should the nurse administer?
3
The nurse is converting grams to milligrams. How would the nurse move the decimal point? 3 places to the right 2 places to the right 2 places to the left 3 places to the left
3 places to the right
The client is to be given ascorbic acid 1 g daily by mouth. The medication comes in a container labeled, "Ascorbic Acid 250 mg tablets." How much will the nurse give? 1/2 tablet 2 tablets 4 tablets 1 tablet
4 tablets
The nurse is preparing medication for a 30-month-old with right otitis media. The child weighs 33 pounds. The health care provider has ordered cephalexin, 50 mg/kg/day in divided doses every 8 hours. The medication concentration is 250mg/5mL. How many milliliters should the nurse give the toddler at each dose? 5.5 10 5 10.5
5
The nurse has consulted a drug guide to confirm the recommended dosage range of a drug. The nurse should expect to see an adjusted dosage for which clients? Select all that apply. 79-year-old male 22-year-old female 39-year-old male 6-month-old infant 2-day-old neonate
6-month-old infant 2-day-old neonate 79-year-old male
What action should the nurse perform during the implementation step of the nursing process? Question the client about financial resources. Administrations and documentation of medications. Determine the client's level of understanding. Obtain information about the client's chronic condition.
Administrations and documentation of medications.
A nurse is assigned to care for a client with a cardiac disorder. During assessment, which action would be most appropriate for the nurse to complete when obtaining objective data related to the client's condition? Inquire about the client's eating habits. Review the client's family history. Auscultate heart and lung sounds. Review the client's health history.
Auscultate heart and lung sounds.
A nurse is caring for client who states, "I dislike hospitals because people die in them." What is the major cause of 1 in 10,000 hospital deaths that occur each year in the United States? Computerized medication order entry Administration of a medication Bar coding systems Calculating a medication dose
Calculating a medication dose
The nurse has received this medication order: Amoxicillin 250 mg every 8 hours. What should the nurse do?
Call the health care provider for clarification
A client is experiencing difficulty swallowing a large oral tablet. What action by the nurse would be most appropriate? Contact the pharmacy to order the drug in liquid form. Ask the prescriber to change the medication to a parenteral form. Check to determine whether the drug can be crushed or mixed with food. Have the client drink a large glass of water to aid in swallowing.
Check to determine whether the drug can be crushed or mixed with food.
What must occur prior to initiating an effective therapeutic regimen? (Select all that apply.) Client must demonstrate ability to read. Client complies with other tasks of daily living. Nurse's assessment of the client's ability to understand medication regimen. Client verbalizes desire to manage the medication regimen. Assessment of client's educational level.
Client complies with other tasks of daily living. Nurse's assessment of the client's ability to understand medication regimen. Client verbalizes desire to manage the medication regimen. Assessment of client's educational level.
Which activity would the nurse expect to complete during the evaluation phase of the nursing process in drug therapy? Reconsider core drug knowledge and core client variables. Establish a baseline for the client's treatment and care. Compare the outcome expected with the actual client outcome. Ask questions to prepare an effective client education program.
Compare the outcome expected with the actual client outcome.
The nurse receives an order for 2.5 mg of diphenhydramine for a client with a mild allergic reaction. The nurse is aware that this is an unusual order. What is the nurse's best action? Complete an unusual incident form. Contact the pharmacy for clarification. Contact the prescriber for clarification. Document the potential drug error in the client's health record.
Contact the prescriber for clarification.
The charge nurse on the unit transcribes a health care provider's order onto the medication administration record. The nurse writes, "Digoxin 0.25 mg PO qod -3d" on the MAR. How should the order be written to prevent medication error? Digoxin 0.25 mg by mouth every other day for three doses Digoxin 0.25 mg PO every other day -3d Digoxin 0.25 mg PO qod -3d Digoxin 0.25 mg PO qod for three doses
Digoxin 0.25 mg by mouth every other day for three doses
The nurse is required to administer 4 mL of an intramuscular (IM) injection to the client. Which action would be most appropriate? Give the entire volume in one injection site. Use a larger-gauge, longer needle. Ask the health care provider to change the prescription. Divide the drug and give it as two separate injections.
Divide the drug and give it as two separate injections.
During the process of medication reconciliation, what is the primary function of the list of medications developed from the medication history? Provides the client's family with a comprehensive list of current medications Provides the primary health care provider with a written copy of current medications Helps minimize the risk of medication interactions with newly prescribed medications Assures quality nursing care by being placed in the client's medical record
Helps minimize the risk of medication interactions with newly prescribed medications
A 68-year-old female who was diagnosed with hypertension 2 weeks ago and was prescribed a new hypertension medication. The client has returned to the clinic for a follow-up visit. The nurse notes that the client's blood pressure is unchanged from her last clinic visit. When the client was asked if she was taking the new medication on a regular basis, she stated, "I thought that I was supposed to take the new drug when I had a pounding headache or was in a stressful situation, not all the time." The most appropriate nursing diagnosis for this client would be which? Confusion, Acute, concerning drug administration Knowledge, Deficient, due to the lack of understanding of treatment regimen Risk for injury, due to non-compliance Coping, Ineffective, due to forgetfulness
Knowledge, Deficient, due to the lack of understanding of treatment regimen
A nurse is beginning to apply the nursing process during a new client interaction. What activity should the nurse perform? Confirm or rule out nursing diagnoses. Identify potential client problems related to drug therapy. Educate the client about basic medication safety. Obtain a medication history.
Obtain a medication history.
After teaching a group of students about the nursing process, the instructor determines that the teaching was successful when the students explain that establishment of goals and expected outcomes is part of which phase? Assessment Planning Implementation Analysis
Planning
The nurse is establishing goals for a client related to a new medication administration. Which phase of the nursing process is characterized by goal setting? Implementation Planning Analysis Evaluation
Planning
The nurse is preparing to teach the client how to perform self-administration of insulin. This is what phase of the nursing process? Assessment Implementation Planning Analysis
Planning
When assessing a client before starting a drug regimen, how should the nurse best assess the client's ability to excrete medications? Weight the client and measure the client's abdominal girth Assess the client's nutritional and hydration status Review the client's AST, ALT, bilirubin and albumin levels Review laboratory values indicative of kidney function
Review laboratory values indicative of kidney function
A nursing mentor is monitoring a student prepare a prescribed drug for a client. The mentor determines the student is well prepared when which factors are verified? Select all that apply. Right drug Right documentation Right route Right client Right prescriber
Right drug Right route Right client Right documentation
A nurse is required to administer subcutaneous injections to a patient regularly. Which of the following interventions should the nurse perform in order to minimize tissue damage? Rotate the injection site regularly. Select the needle length based on the patient's weight. Insert the needle at the appropriate angle. Ensure that there is no hair on the injection site.
Rotate the injection site regularly.
The health care facility utilizes the unit-dose system in an effort to reduce medication errors. What would the nurse likely administer in this type of system? Select all that apply. A Phenergan suppository A prefilled Lovenox syringe One dose from a bottle of ibuprofen suspension Single-dose cup of Maalox One tablet from a bottle of aspirin 81 mg
Single-dose cup of Maalox A prefilled Lovenox syringe A Phenergan suppository
Which of the following factual knowledge should the nurse have prior to administering a drug? Select all that apply. Special precautions in administration Normal dosage range Reason for use of the drug Drug's most common adverse effects Drug's general action
Special precautions in administration Normal dosage range Reason for use of the drug Drug's most common adverse effects Drug's general action
Ms. Lisa Evans, age 35, is a patient about to be discharged from hospital care. Ms. Evans will self-administer her medications at home. Which method of self-administration would a nurse expect to be ordered for her? Tablets and syrups Z-track method Intrathecal administration Intravenous (IV) administration
Tablets and syrups
The nurse provides care in a setting where there is more contact between the client and the nurse than between the client and the physician. The nurse should anticipate what effect on drug therapy? The nurse can readily reduce drug dosage if the client's needs change. The nurse may be better able to select medications to treat the client's condition. The nurse can provide a second opinion for the client about the physician's decisions. The nurse may be better able to gauge therapeutic success of drug therapy.
The nurse may be better able to gauge therapeutic success of drug therapy.
A nurse is required to give an intramuscular (IM) injection to an 18-month-old toddler. The nurse would prepare which site for administration? Deltoid muscle Dorsogluteal site Ventrogluteal site Vastus lateralis
Vastus lateralis
The nurse is administering a subcutaneous injection and notices that there is blood in the syringe prior to injecting the medication. What is the nurse's best action? Withdraw the syringe and prepare a new injection. Call the health care provider for an order of oral medication. Withdraw the needle slightly and continue to administer the injection. Withdraw the syringe and inject into a new site using the same syringe.
Withdraw the syringe and prepare a new injection.
After teaching a group of nursing students about the Joint Commission and National Patient Safety Goals (NPSG), the instructor determines that the teaching was successful when the group identifies that the NPSG is updated at which frequency? quarterly monthly annually semiannually
annually
The nursing student is studying drug dosage and has learned that there are three systems of measurement associated with drug dosing. What are these systems? (Select all that apply.) Avoirdupois system Mercalli system apothecary system metric system household measurement system
apothecary system metric system household measurement system
The nurse is preparing to administer medications and demonstrates knowledge of the 6th right by: identifying the client prior to administering the medication. double checking the medication with the allergies listed on the clients chart. ensuring that the MAR matches the provider's order. documenting the medication after administration.
documenting the medication after administration
The client has been prescribed an oral medication. Prior to administration of this medication, what should the nurse do first? verify client understanding of the medication. obtain vital signs especially blood pressure. obtain temperature and evaluate hydration status. evaluate the client's ability to swallow.
evaluate the client's ability to swallow
In the metric system, what is the unit of weight? liter pound gram meter
gram
Many clients who the nurse cares for in the hospital are also taking over-the-counter (OTC) medications. Which core client variable is needed to assess the client's OTC medication use? life span health status lifestyle environment
health status