110 - Ch 1-11 + 46 +47 Test 1 - Questions - Basic Pharmacology For PN - TCR Fall 2017 not finished

Of the following needle gauge sizes, which is the largest in diameter? a) 18 b) 20 c) 22 d) 25

A. 18 Rationale: The gauge size of a needle is inversely proportional to the size of a needle's opening. The largest needles are used for blood administration and viscous solutions, and the smallest needles are used for subcutaneous or intradermal injections.

Which needle gauge size is best for the administration of subcutaneous medications? a) 25 b) 22 c) 18 d) 15

A. 25 Rationale: A 25- to 27-gauge needle is the most appropriate size for subcutaneous drug administration.

Of the following dosage amounts ordered for an adult patient, which one should the nurse question? a) 4 mL IM b) 5 mL IV c) 0.05 mL intradermal d) 1 mL subcutaneous

A. 4 mL IM Rationale: An IM amount of 4 mL exceeds the recommended amount of 0.5 to 2 mL, or a maximum of 3 mL, per injection. If larger amounts are required, they should be given in two separate injections at different sites.

black cohosh

Reduces symptoms of PMS, dysmenorrhea, menopause

echinacea

nonspecific immunostimulant not recommended in patients with autoimmune disorders or diseases affecting immunity A.I.D.S. may interfere with immunosuppressive therapy

feverfew

reduces frequency and severity of migraines

ginkgo

1. Treat short-term memory loss, headache, dizziness, tinnitus, emotional instability A. Vasodilator improves cerebral blood flow B. May help with intermittent claudication, ED, improve peripheral blood flow in diabetics C. Reduces platelet aggregation, monitor for bleeding 2. often used by geriatric patients

Ginseng

1. Unsubstantiated claims to increase resistance to stress and disease A. May affect platelet aggregation, monitor for bleeding B. Raises insulin levels in animals, monitor for hypoglycemia C. may affect platelet aggregation and blood coagulation.

garlic

1. lowers serum cholesterol and triglycerides 2. reduces platelet aggregation 3. used with extreme caution in patients receiving platelet inhibitors 4. monitor for bleeding

the seven rights

1. right patient 2. right drug 3. right indication 4. right time 5. right dose 6. right route 7. right documentation

When instilling ophthalmic drops, which step does the nurse take to minimize the risk of systemic absorption? a) Places a gloved finger against the inner canthus for 1 to 2 minutes b) Has the patient hold the eyes closed firmly for 5 minutes c) Has the patient lean forward and hold the head in a lowered position d) Positions the patient so the head is lower than the feet

A. places a gloved finger against the inner canthus for 1 to 2 minutes Rationale: By placing a finger with a tissue at the inner canthus, the drug will have less opportunity to drain from the eye and into the mucous membranes, where absorption into the systemic circulation could occur. This also keeps a greater concentration of the drug against the eye. The position of the head is irrelevant as it pertains to systemic absorption.

goldenseal

Antiseptic and astringent Some patients may believe (inaccurately) that goldenseal will prevent detection of drugs in urine

Which type of topical drug is more readily absorbed by infants? a. Fat-soluble b. Water-soluble c. Emollient d. Protective

B. water soluble Rationale: Topical administration with percutaneous absorption is usually quite effective in infants because the outer layer of skin is not fully developed. Because the skin is more fully hydrated at this age, water-soluble drugs are absorbed more readily.

When choosing a needle for an IM injection for an adult, which gauge range is most appropriate? a) 16 to 18 b) 18 to 20 c) 20 to 22 d) 23 to 25

C. 20 to 22 Rationale: Adult IM doses are commonly administered with 20- to 22-gauge needles.

Which form of liquid medication contains a base of alcohol? a) Syrup b) Emulsion c) Suspension d) Elixir

D. elixir Rationale: Elixirs have an alcohol base and thus are not recommended for children

Which form of medication is more easily administered for a toddler who requires a course of antibiotics? a. Enteric b. Capsules c. Tablets d. Liquid

D. liquid Rationale: Very small children are not able to swallow solids such as tablets or capsules. They should receive medications carefully measured in a calibrated dropper or oral syringe

The nurse is making rounds with a patient's physician when the physician gives the nurse a verbal order for a routine medication. What does the nurse do next? a. Enters the order when the nurse returns to the desk after rounds to chart b. Refuses the order c. Does not follow the order because it is not official d. Obtains the chart and asks the physician to enter the order

D. refuses the order. Rationale: The practice of verbal orders should be avoided whenever possible to prevent medication errors. Asking the physician to place the order communicates the need professionally and clarifies the unit policy. By refusing or not following the order, the patient's care may be compromised.

Nicotine can be administered by which delivery system for an antismoking program? a. Intravenously b. Sublingually c. Enterally d. Transdermally

D. transdermally Rationale: Nicotine transdermal patches may be used to deliver a measured amount of nicotine to a patient through the skin. The dose can be gradually reduced to wean the patient from nicotine dependence.

Which type of container system allows for the greatest accuracy for drug preparation? a) Mix-O-Vial b) Glass ampule c) Rubber-topped vial of a liquid drug d) Powdered drug for reconstitution

a. Mix o vial Rationale: A Mix-O-Vial has premeasured amounts of the drug and its diluent, which are activated by pushing down a rubber stopper into the vial to mix the medication. This reduces the risk of drawing up the wrong amount of diluent or choosing the wrong amount of drug. The other methods require precision in measurement and concentration by the nurse.

ginger

alleviates nausea and vomiting

chamomile

anti-inflammatory and antispasmodic effects

Which injection site must not be used in children younger than 3 years because of underdeveloped muscle? a) Rectus femoris b) Dorsogluteal c) Ventrogluteal d) Deltoid

b. dorsogluteal Rationale: The dorsogluteal muscle is not yet well-developed from walking in children younger than 3 years and should be avoided. The ventrogluteal and rectus femoris muscles may be used for children under 3 years, with the rectus femoris being the more convenient of the two.

Which source of information is best for the nurse to obtain drug information? a. Physicians' Desk Reference P.D.R. b. Nursing journals c. United States Pharmacopeia U.S.P. and National Formulary N.F. d. Electronic databases

d. electronic databases Rationale: All can be sources of drug information, but keeping information current is extremely important. Reliable electronic databases can provide the most up-to-date information to health care providers, unlike printed resources that are published only periodically.

Computer-controlled medication dispensing systems are being used in many hospitals. Which statement about this type of system is true? a. It is a safer way to dispense controlled medications. b. It eliminates the need for the pharmacist to be involved. c. It is more costly to operate in dispensing drugs than distributing to floor stock. d. It is a less efficient means to control access to and distribute narcotics.

A. it is a safer way to dispense controlled medications Rationale: An electronic system still needs a pharmacist to verify the order. This system controls the access to medications and allows for a detailed account of controlled substances, including who has access to the drugs. It controls the medications better than if many people have access to a shelf of medications. They also save time by eliminating the need for nurses to count every controlled drug at the end of each shift and be responsible for keys to the narcotics cupboard.

How does a nursing diagnosis differ from a medical diagnosis? a. A nursing diagnosis concerns a disease that impairs physiologic function. b. A nursing diagnosis evaluates a patient's response to actual or potential health problems. c. A nursing diagnosis determines the rate of Medicare reimbursement. d. A nursing diagnosis does not consider potential future problems.

B. A nursing diagnosis evaluates a patient's response to actual or potential health problems. Rationale: A nursing diagnosis takes the form of a three-part statement relating to a patient's response to actual or potential health problems and life processes. It is constantly changing, whereas a medical diagnosis is frequently unchanged during a patient's hospitalization.

The nurse is to administer a dose of insulin subcutaneously to an adult with a very thin build. After prepping the intended injection site and bunching the skin, at what angle of entry does the nurse inject the drug? a) 15 degrees b) 30 degrees c) 45 degrees d) 90 degrees

C. 45 degrees Rationale: For a very lean adult or a child, a 45-degree angle should be used as stated by the American Diabetes Association Clinical Practice Recommendations. A 90-degree angle is typically used for average-sized adults

When administering insulin to a patient, what must the nurse do first? a) Gently roll the vial to ensure any drug that has settled to the bottom is mixed. b) Draw up the shorter-acting insulin before the longer-acting insulin, if mixing in same syringe. c) Prepare for injection into the patient's subcutaneous fatty tissue. d) Check thoroughly for complete drug order information.

D. check thoroughly for complete drug order information Rationale: Before administering insulin, the nurse must know the patient's blood glucose level and the correct type and amount of insulin to administer.

The nurse is in the medication room preparing unit-dose medications for patients. Before leaving the medication room, what does the nurse do? a) Places the medications as they are into a medication cup for each patient b) Empties each medication packet into a medicine cup for each patient c) Checks the label information once to be sure the drugs are correct d) Offers to help carry additional medications to a patient's room for another nurse

A. places the medications as they are into a medication cup for each patient Rationale: Unit-dose medications should always stay in the original packet clearly identifying the drug and dose. This maintains medication safety by ensuring the drugs are not mixed up or dropped. The patient may refuse a medication if he or she chooses, and the drug will be clearly identifiable. Drug labels are checked three times: twice in the medication room and a last check at the patient's bedside.

A patient reports postoperative pain, and the nurse administers morphine (a narcotic analgesic) intravenously to ease the pain. Fifteen minutes later, the nurse notes that the patient is very drowsy, respirations are slow and shallow, and oxygen saturation is low. The nurse administers another drug that decreases the action of the morphine. What is this effect called? a. Displacement b. Antagonistic c. Interference d. Synergistic

B. antagonistic Rationale: The morphine had a greater-than-desired effect on the patient. Because the drug was given intravenously, it is impossible to remove the drug from the patient's bloodstream. Therefore, the nurse does the next best thing and administers another drug that interferes with the action of the first, otherwise known as an antagonistic effect. The result is a decrease in the action of the original drug. The second drug is sometimes referred to as the antidote to the first.

A patient is being instructed on the use of a dry powder inhaler (DPI) for newly diagnosed asthma and has successfully demonstrated an ability to use the DPI. The patient asks the nurse how to tell when it is time to replace the inhaler. How does the nurse respond? a) "When you don't notice symptom improvement after using the inhaler." b) "When you don't feel pressure or taste the drug when administering it." c) "Before the gauge on the canister nears zero." d) "When you float the canister in water and it floats levelly."

C. "before the gauge on the canister nears zero." Rationale: Dry powder inhalers have a dose counter on the device to show the amount of remaining doses. The patient should plan ahead and obtain a renewal prescription before the dose counter is allowed to near the empty point.

The Centers for Disease Control and Prevention (CDC) estimate that what percentage of needlestick injuries could be prevented if health care institutions used the safer needleless systems for medication administration? a) 34% to 52% b) 56% to 72% c) 62% to 88% d) 86% to 94%

C. 62% to 88% Rationale: Needleless systems, if properly used, can reduce the risk of accidental injuries by 62% to 88%.

A patient is being started on a new drug that has been used safely by many people for years. The patient has no known allergies, and the nurse administers the drug correctly. Suddenly the patient experiences cardiac arrest. What is this type of reaction called? a. Allergic b. Mutagenic c. Idiosyncratic d. Therapeutic

C. idiosyncratic Rationale: Because the drug was a known safe drug and the patient had no known reason not to receive it, the response to the drug in this case was totally unexpected, or idiosyncratic. An allergic response is typically preceded by such reactions as rash, hives, tingling, or swelling.

When caring for a patient with a central venous catheter, unused ports must be flushed on a regular basis to maintain patency. Institutional policy dictates solution protocol, but which size syringe is recommended for use? a) 1 mL b) 3 mL c) 5 mL d) 10 mL

D. 10mL Rationale: The smaller the syringe, the greater the pressure created within the vessel, so a syringe size of 10 mL MINIMUM should be used.

Which is an independent nursing action? a. Orders medications based on the patient's medical diagnosis b. Orders laboratory tests depending on the medications ordered c. Chooses an alternate route for medications if indicated d. Verifies the correct route of medication administration

D. Verifies the correct route of medication administration Rationale: Verification of the correct route of administration is an independent nursing action that is required as part of the "six rights" of administration. Ordering drugs or labs and changing a route of administration are not within the scope of practice for a nurse

All drugs are processed in the body through pharmacokinetics. What is the correct order that drugs pass through the body? a. Absorption, distribution, metabolism, excretion b. Distribution, metabolism, absorption, excretion c. Biotransformation, distribution, absorption, excretion d. Excretion, distribution, absorption, metabolism

A. absorption, distribution, metabolism, excretion Rationale: All drugs go through four stages after administration, which can be remembered with the acronym A.D.M.E.

Which substance is said to increase resistance to stress and strengthen overall vitality? 1. Ginseng 2. St. John's wort 3. Saw palmetto 4. Garlic

A. ginseng Rationale: Ginseng is said to increase the body's resistance to stress, improve the body's defense against disease, and strengthen general vitality. It is not used to cure disease, but is an "adaptogen" in maintaining health. Much of the literature is anecdotal.

Which drug schedule indicates drugs with the highest risk for abuse? A. Schedule I B. Schedule II C. Schedule III D. Schedule IV E. Schedule V

A. schedule 1 Rationale: Schedule I drugs have the highest potential for abuse. They are not currently accepted for medical use in the United States.

Which piece of information obtained during a patient assessment is a subjective finding? a. Patient states, "I have pain in my abdomen." b. Temperature of 38.5º C c. 400 mL of clear, yellow urine d. Blood pressure of 116/74 mm Hg

A.Patient states, "I have pain in my abdomen." Rationale: A subjective finding is one which the nurse makes using physiologic parameters. A patient's report of pain is a subjective finding because people experience pain differently. An objective assessment is clearly measurable and consistently reportable.

How is a patient positioned for the administration of an enema? a) Supine, on the back b) Prone, on the stomach c) Left side-lying d) Right side-lying

C. left side lying Rationale: Positioning the patient on the left side with the right leg drawn up is the best position for enema administration. This position allows for gravity to assist with the dispersion of the liquid into the patient's rectum and colon.

Which name(s) of a drug should the nurse use when teaching a patient with a new prescription? a. Trade b. Generic and trade c. Generic and chemical d. Official

B. generic and trade Rationale: Drug prescriptions may be filled with a trade-name drug or a generic equivalent. If the nurse teaches only one name, it may lead to confusion for the patient when he or she receives a drug with a different name.

A patient's IV order calls for a primary IV to run continuously with a secondary set or piggyback setup for intermittent antibiotic infusions every 6 hours. Which equipment setup does the nurse choose? a) Hang the primary bag higher than the secondary. b) Hang the secondary bag higher than the primary. c) Hang both bags at the same level. d) Clamp the primary bag while the secondary bag is running.

B. hang the secondary bag higher than the primary Rationale: When hanging an IV piggyback medication, gravity dictates which bag flows first. The higher bag will flow first, and when it has emptied, the lower bag will take over the flow without the nurse needing to change any setup. Thus the secondary bag is hung higher and the primary bag lower. The size of the bags does not dictate which will flow first. It is not necessary to clamp the primary bag because the system is designed to allow the flow of the secondary bag and return to the primary flow system without the nurse needing to be present to open the primary bag again.

Due to the decreased protein-binding capacity in preterm infants, what adjustment in dosage of protein-binding drugs would need to made? a. The dosage should be decreased. b. The dosage should be increased. c. The dosage should be kept at the same level. d. Protein-binding drugs are not administered to infants.

B. the dosage should be increased Rationale: Drugs that are relatively insoluble are transported in the bloodstream bound to plasma proteins like albumin and globulins. There is a decreased affinity for binding in infants, especially preterm infants. These drugs are then distributed over a wider area of the neonate's body. They will therefore require a higher dosage of these medications in order to achieve a therapeutic effect.

How many years on average does it take for a drug to be brought to market from the time of its conception? a. 2 to 3 b. 4 to 7 c. 8 to 15 d. 12 to 18

C. 8 to 15 Rationale: It takes 8 to 15 years and can cost up to $1 billion to get a drug to market. This amount of time and money is necessary to adequately test the drug for safety before releasing it to the general population.

Of the following IV solutions, which one is the most hypertonic? a) 0.9% NaCl b) 0.45% NaCl c) D5/0.9% NaCl d) D5/0.2% NaCl

C. D5/0.9% NaCl Rationale: D5/0.9% NaCl has an osmolality of 560. Normal blood osmolality is between 295 and 310 mOsm/L. Solutions with an osmolality less than 295 are considered hypotonic, and those above 310 are hypertonic.

The nurse receives the following order: Tylenol #3 1 tablet as needed for incisional pain. This is an example of which kind of order? a. Standing b. Routine c. PRN d. Stat

C. P.R.N. Rationale: This is an example of a P.R.N. order, or one that will be administered only if the patient is having pain. If the patient is comfortable, the medication will not be given.

A patient with a significant cardiac history is in the hospital after a surgical procedure. At the time of intake and output collection at the end of the shift, the nurse notices that the IV bag which should have 500 mL left actually has 900 mL left. What does the nurse do? a) Increases the rate of flow to catch up to the amount that should have been infused b) Makes no changes but documents the amount c) Notifies the prescriber of the difference in amounts and obtains new orders d) Starts a new IV site because the current one does not seem to be working

C. notifies the prescriber of the difference in amounts and obtains new orders Rationale: The nurse should never speed up an IV flow rate in order to catch up when the volume to be infused has fallen behind. Speeding up the rate of flow could lead to dangerous consequences, especially for pediatric patients or those with cardiac, renal, or circulatory impairment. In this case, the patient has a significant cardiac history and may be adversely affected by an increase in rate. The nurse should contact the health care provider to report the situation and receive updated orders.

The main advantage of using barcode scanning devices is: a. allowing nurses to scan a patient's name band without reading it. b. being the sole means of maintaining safety in drug administration. c. causing increase in medication errors in the institutions using this technology. d. being the final safety check after the nurse has verified essential information.

D. being the final safety check after the nurse has verified essential information Rationale: Computerized handheld devices are gaining in popularity due to their ability to decrease the medication error rate in hospitals. The nurse holds the primary responsibility to see that patients receive the proper medications

Which form of liquid medication contains a base of alcohol? a. Syrup b. Emulsion c. Suspension D. Elixir

D. elixir Rationale: Elixirs have an alcohol base and thus are not recommended for children

Which herbal supplement is promoted as a weight-loss product, energy booster, aphrodisiac, and mental stimulant? A. Echinacea B. Black cohosh C. Feverfew D. Ephedra

D. ephedra Rationale: Ephedra is a Chinese herbal medicine that is used as a bronchodilator for asthma, as a nasal decongestant, and as a CNS stimulant. In recent years, popular culture has touted ephedra as a weight-loss product, an energy booster, an aphrodisiac, and a mental stimulant.

Which substance is said to increase memory by increasing cerebral blood flow? 1. Ginseng 2. St. John's wort 3. Saw palmetto 4. Ginkgo biloba

D. gingo biloba Rationale: A concentrated extract of ginkgo leaves, which is rich in flavonoids and terpenes, acts as a smooth muscle relaxant and vasodilator to improve blood flow in arteries and capillaries. It also acts as a free radical scavenger to prevent endothelial cell damage and provide platelet aggregation inhibition. Ginkgo biloba is said to increase cerebral blood flow and improve memory.

Which route of administration is used for allergy testing? a) Intravenous b) Intramuscular c) Subcutaneous d) Intradermal

D. intradermal Rationale: Intradermal injections are made with very small volumes of fluid that are placed just under the epidermal layer of skin, forming a bleb. The site is then observed for signs of reaction. The other forms of injection are not used for allergy testing.

Which route of administration has the fastest rate of distribution? a. Subcutaneous b. Intramuscular c. Transcutaneous d. Intravenous

D. intravenous Rationale: The I.V. route places the drug directly into the bloodstream and isn't slowed down by the need to first travel from the G.I. tract into the bloodstream.

What is an effect of ingesting gamma-hydroxybutyrate G.H.B.? A. Growth hormone stimulation B. Intoxication and sedation C. Memory enhancement D. Cholesterol reduction

B. intoxication and sedation Rationale: GHB is typically abused for its intoxicating, sedative, and euphoric properties. It is commonly known as the "date rape" drug because it is often slipped covertly into a victim's drink in a social setting. GHB occurs naturally in the brain, kidneys, heart, and skeletal muscle, and it is a metabolite of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter. It was formerly marketed as a growth hormone stimulator for bodybuilders. Despite adverse reactions and an FDA ban, it continues to be marketed as a dietary supplement through Internet sites.

Which method of medication administration is typically used to deliver 1 ounce of cough suppressant? a. Calibrated medication dropper b. Medicine cup c. Soufflé cup d. Teaspoon

B. medicine cup Rationale: A medicine cup is the most accurate measure of medications with a volume up to 30 mL. A medication dropper usually has only a 2- to 5-mL capacity. A soufflé cup is made of paper, has no measurement marks, and is not meant to measure liquids. A household teaspoon is an inaccurate measure, whereas a measuring teaspoon would work, but would require 6 teaspoons for a complete dose in this case.

Which method of medication administration is typically used to deliver 1 ounce of cough suppressant? a) Calibrated medication dropper b) Medicine cup c) Soufflé cup d) Teaspoon

B. medicine cup Rationale: A medicine cup is the most accurate measure of medications with a volume up to 30 mL. A medication dropper usually has only a 2- to 5-mL capacity. A soufflé cup is made of paper, has no measurement marks, and is not meant to measure liquids. A household teaspoon is an inaccurate measure, whereas a measuring teaspoon would work, but would require 6 teaspoons for a complete dose in this case.

What is the foundation for the clinical practice of nursing? a. Assessment b. Nursing process c. Planning d. Evaluation e. Implementation

B. nursing process Rationale: It takes all parameters of the nursing process, which include assessment, diagnosis, planning, implementation, and evaluation, to encompass the full care of a patient.

A 2-year-old child is being treated for an external ear infection. What is the correct ear position for the nurse to administer ear drops? a) Pull the affected ear up and back. b) Pull the affected ear down and back. c) Place the child on his or her abdomen with the affected ear facing the floor. d) Pull the affected ear down and forward.

B. pull the affected ear down and back Rationale: For children younger than 3 years, the ear should be pulled down and back to straighten the ear canal to prepare for the drops.

What is the primary use for melatonin? A. Nutritional supplement B. Sleep aid C. Immune system strengthener D. Antioxidant

B. sleep aid Rationale: The synthetic form of melatonin is used as a sleep aid, particularly for the treatment of jet lag. It is a human hormone synthesized from serotonin and secreted by the pineal gland. Its secretion is generally increased by the dark and suppressed by light through the retina

When applying a topical nitroglycerin ointment to a patient, what must the nurse be sure to do? a. Massage it thoroughly into the skin. b. Squeeze it onto the applicator paper and place it on the skin. c. Apply it to the medial aspect of the thigh. d. Shave the skin before application.

B. squeeze it onto the applicator paper and place it on the skin Rationale: Using applicator paper to apply topical nitroglycerin ensures that the correct amount is administered. It is applied to areas of the chest, shoulder, or back with little hair; it must not be massaged into the skin or the drug will be absorbed too rapidly; and skin is never shaved before administration because skin breakdown and uneven absorption through skin abrasions can occur.

An older adult patient is being prepared for discharge after experiencing a stroke with some residual damage. The patient and family are scheduled to receive a large amount of information from the nurse regarding proper care and safety at home. What is the nurse's best course of action? a. Present the patient and family with all of the information a few days before discharge. b. Present the patient and family with all of the information the day before discharge. c. Break the teaching content down into manageable sections and present them individually in the days before discharge. d. Have a home health nurse teach the patient and family at home a week after discharge.

C. Break the teaching content down into manageable sections and present them individually in the days before discharge. Rationale: Discharge teaching is an ongoing process and should not wait until the patient is ready to go home. The patient and family need to learn about home care before discharge, and the content should be presented in small sections and repeated as necessary because repetition enhances learning. The patient's readiness to learn and educational level also must be taken into consideration.

The nurse who is new to a large urban hospital has found that many of the hospitalized patients are of different cultural groups in the area. Which approach is best for the nurse to take in caring for these patients? a. Care for all patients the same way because it is more efficient. b. Ask not to be assigned to these patients due to the nurse's lack of experience. c. Develop a plan of care that is individualized to each patient's needs. d. Follow a more experienced nurse around for several months to gain more experience.

C. develop a plan of care that is individualized to each patient's needs Rationale: Nurses must be prepared to care for patients from different cultures and develop an awareness of and respect for cultural diversity. Many resources are available for education, and this should be a part of the orientation of new nurses. The nurse may find that asking individuals about preferences is helpful and respectful.

Which medication is not appropriate to administer via an NG feeding tube? a) Scored tablet b) Suspension c) Enteric-coated tablet d) Elixir

C. enteric coated tablet Rationale: The special coating on the enteric-coated tablet prevents it from dissolving in the patient's stomach, thus decreasing the risk of gastric upset. They are designed to dissolve in the alkaline environment of the small bowel and their action may be destroyed in the stomach. These tablets may not be crushed because it would alter the absorption rate of the drug, whereas scored tablets may be split in half or crushed without altering the quality of the drug. Suspensions and elixirs are in liquid form and are ready for feeding tube administration.

Which patient has the greatest percentage of body water? a. Older adult b. Middle-aged person c. Infant d. Toddler

C. infant Rationale: An infant has a total body water percentage of 74%, whereas a premature infant has an even higher percentage at 83%. As we age, our total percentage of body water decreases and our percentage of total body fat increases.

A nurse working on a busy unit is passing the medication room when another nurse approaches, states she is needed in another room, and asks for help administering medications to her patients. She hands the nurse two syringes and three unit-dose tablets and says they are for the patient in room 386. What does the nurse do next? a) Takes the medications and proceeds to administer them to the patient in room 386 b) Refuses to administer the medications c) Offers to take care of the other patient situation and has the nurse administer her own medications d) Reports the situation to the charge nurse of the unit

C. offers to take care of the other patient situation and has the nurse administer her own medications Rationale: A nurse must not administer a medication that another nurse has drawn up. The nurse must always follow the seven rights of administration to ensure complete accuracy of medication administration. If a situation of unsafe nurse-patient ratio exists, then the charge nurse should be involved.

The nurse is preparing to teach a postsurgical patient who has a new colostomy about proper colostomy care. The patient says, "Just show me how to do it; let me try, and I'll learn what to do." Which domain of learning is indicated by this statement? a. Cognitive b. Affective c. Psychomotor d. Determined

C. psychomotor Rationale: The patient's willingness to see, hear, and do indicates a learning style in the psychomotor, or "doing" domain. Demonstration of the skill with a step-by-step, hands-on approach is usually the best way for this type of learner to be trained in a new skill.

A clinical judgment that a person is more susceptible to a particular problem than others in the same situation is defined as which type of nursing diagnosis? a. Actual b. Wellness c. Risk/high risk d. Syndrome

C. risk or high risk Rationale: A risk/high-risk nursing diagnosis is supported by risk factors that increase a patient's vulnerability beyond that of the same population. The patient can be at risk or at high risk for a particular problem.

It is important to maintain therapeutic levels of drugs to avoid the complications of being over- or undermedicated. If a drug level of 0.5 to 2 ng/mL is considered therapeutic, a drug level of 0.45 ng/mL is considered to be what? a. Toxic b. Therapeutic c. Subtherapeutic D. Tolerant

C. subtherapeutic Rationale: Drugs are therapeutic when maintained within the normal range for the drug. In this example, the level is below that indicated for the drug, or subtherapeutic. A subtherapeutic level would require increasing the dose for the patient to achieve the maximum benefit of the drug

The nurse is preparing a patient for discharge after a surgical procedure. Which method is best for teaching the patient about his or her prescribed drugs? a. Prescription blank handwritten by the physician b. Magazine ads featuring the prescribed medications c. Verbal explanations along with drug summary sheets d. Unit-dose packages from this morning's medications

C. verbal explanations along with drug summary sheets Rationale: Typically, verbal explanations are best as long as the patient is able to hear adequately. Drug summary sheets are prepared at a reading level appropriate for most people. Prescription forms are not a good teaching tool for medications; patients typically don't get to keep prescription forms after filling them at the pharmacy. Unit-dose packages are inappropriate because they may not represent the same manufacturer of the drugs that the patient will be taking, which may lead to confusion.

When the nurse administers a 50-mg dose of a drug with a half-life of 6 hours, how many milligrams will remain in the body at 24 hours? a. 25 mg b. 12.5 mg c. 6.25 mg d. 3.13 mg e. 1.56 mg

D. 3.13 mg Rationale: The half-life of a drug is the time required for 50% of the drug to be eliminated from the body. In this example at 24 hours, 6.25% or 3.13 mg of the drug would remain in the body.

The nurse is supposed to perform postoperative teaching for a patient who is scheduled to be discharged the next day. The patient appears fatigued, in pain, and irritable. The nurse knows that there will be little time for teaching on the day of discharge. What is the nurse's best course of action? A. Deliver the teaching now because there won't be enough time tomorrow. B. Allow the patient to nap, and return to perform the teaching in one hour. C. Teach the family member who is present, so he or she can share the information with the patient after discharge. D. Determine the patient's need for analgesia and rest, and return to perform the teaching after the patient feels better.

D. Determine the patient's need for analgesia and rest, and return to perform the teaching after the patient feels better. Rationale: After the patient's basic needs are assessed and met, he or she will be better able to focus on the educational material and be prepared for discharge. It is important for the patient to verbally demonstrate learning as well as perform any skill autonomously.