Ch.35 EAQs

The nurse has been assigned to prepare a 1% solution of medication in distilled water. How much of the medication should the nurse dissolve in 100 mL of distilled water?

Ans: 1000 Rationale A 1% solution contains 1 g of the medication dissolved in 100 mL of the solution. Since the unit is mg, and 1 g is 1000 mg, the nurse should dissolve 1000 mg of the medication in 100 mL of distilled water.

A nurse is preparing to administer ibuprofen. What are the trade names of ibuprofen? Select all that apply. Advil Motrin Nuprin Paracetamol 2-(4 isobutylphenyl) propionic acid

Ans: A, B, C

In what forms can the nurse administer otic medications to a patient? Select all that apply. Extraocular disks Eardrops Injections Irrigations Ointments

Ans: B,D Rationale Medications that are instilled into the ear are called otic medications. Two types of otic medications are available: eardrops and irrigations. Eardrops are used to treat ear infections and to soften cerumen (ear wax). Irrigations are used to remove foreign bodies and clean the ear canal. Extraocular disks are used to treat eye infections. Injections are parenteral medications, not otic medications. Ointments are not used in the ear because they are difficult to clean and may cause problems with hearing; ointments can be topical or ophthalmic.

A patient has asthma and receives an inhaled medication. What is the desired local effect of this medication? Inflammation Rebound effect Bronchodilation Increased heart rate

Ans: C Rationale Respiratory disorders like asthma are caused by constriction of the bronchioles. Therefore, the patient requires inhaled medicines that dilate the bronchioles (bronchodilation) and open the lungs for oxygenation. Steroids are used to treat inflammation; medication would not be used to cause inflammation. The rebound effect and increased heart rate are systemic effects of nasal medications caused by sympathetic nervous system stimulation.

The nurse accidentally gives a patient a medication at the wrong time. The nurse's first priority is to: Complete an occurrence report. Notify the healthcare provider. Inform the charge nurse of the error. Assess the patient for adverse effects.

Ans: D Rationale Patient safety and assessing the patient are priorities when a medication error occurs.

Medications undergo vigorous testing before they are made available to the public. Which regulatory agency is responsible for ensuring this process is completed? Medicare program National Formulary United States Pharmacopeia Food and Drug Administration

Ans: D Rationale The Food and Drug Administration ensures that all medications available in the market undergo vigorous testing so as to ensure their safety and efficacy. The Medicare program does not ensure testing of drugs. The United States Pharmacopeia and the National Formulary set standards for medication strength, quality, purity, packaging, safety, and dose form.

Fill in the blank The nurse administers a 5-mg tablet of a medication to a patient who has osteoarthritis pain. The drug has a half-life of 4 hours. How much of the drug will remain in the blood after 12 hours? Record the answer to the third decimal place (one one-thousandths).

Ans: 0.625 Rationale If a drug has a half-life of 4 hours, after 4 hours the patient will have 50 percent, or 2.5 mg of the drug in the body. After 8 hours, the patient will have 1.25 mg of the drug in the body. After 12 hours, the patient will have 0.625 mg of the drug in the body. Continue to cut number in half every 4 hours since half life is 4 hours Test-Taking Tip: For the half-life of medication questions, say to yourself, "Half in 4 (or whatever the given half-life is), half again in 8 (or twice the half-life time), half again in 12 (or three times the length of the half-life)," etc. For this question, because the time is 12 hours, or three times the half-life, start with the total number of the dosage (in this case, 5 mg), divide it by half (= 2.5 mg), divide THAT by half (= 1.25 mg), and divide it by half a third time (= 0.625 mg). So you've divided by half, three times, because the time the question asks about is three times the half-life (12 hours = 3 times 4 hours).

A patient has to be given a bladder irrigation with 100 mL of medicated solution with 1/1000 dilution. How much of the medication should the nurse dissolve in 100 mL of solvent?

Ans: 100 Rationale 1/1000 solution means presence of 1 g of the medication in 1000 mL of solution. This means that each mL of the solution contains 1 mg of the medication. Since the nurse has to prepare 100 mL of the solution, the nurse should dissolve 100 mg of medication in 100 mL of solvent.

A medication has a minimum effective concentration of 25 mg/dL and the therapeutic range is 25-100 mg/dL. What is the plasma concentration above which the toxic effects of the drug may appear?

Ans: 100 Rationale The highest reading of a therapeutic range corresponds to the toxic range of plasma concentration. Any drug levels above this concentration are toxic. The highest value of the therapeutic range of the drug in question is 100 mg/dL, so plasma concentration of the drug above 100 mg/dL is toxic.

Fill in the blank A patient is taking albuterol through a pressurized metered-dose inhaler (pMDI) that contains a total of 200 puffs. The patient takes 2 puffs every 4 hours. How many days will the pMDI last?

Ans: 16

The nurse has been assigned to administer a medication in the dose of 10 mg/kg for a pediatric patient weighing 44 lb. What is the dose that the nurse should administer?

Ans: 200

A healthcare provider instructs the nurse to inject 2 mg/kg of a medication to a pediatric patient. The weight of the patient is 33 lb. How much of the medication should the nurse administer to the patient?

Ans: 30 Rationale The nurse has to convert the weight of the patient into kilograms; since 2.2 lb is equivalent to 1 kg, 33 lb is equivalent to 15 kg (33 / 2.2 = 15). The medication has to be administered in the dose of 2 mg/kg body weight; the amount of medication required for the patient is 2 x 15 = 30 mg.

If the half-life of a drug is 4 hours and the nurse administers 1 g of the drug to a patient, how many hours does it take to reach 250 mg of the original dosage? Record the answer using a whole number.

Ans: 8 Rationale If a drug has a half-life of 4 hours, 50 percent of the drug is eliminated from the body after 4 hours. Therefore, 500 mg will be present after 4 hours. After 8 hours, 25 percent of the original dose will be present in the body. Therefore, 250 mg of the original dose will be present in the body after 8 hours. Continue to cut in half every 4 hours since half-life is 4 hours

Fill in the blank A healthcare provider has instructed the nurse to administer 600 mg of amoxicillin to a pediatric patient. The bottle of the amoxicillin is labeled 400 mg/6 mL. How much of the medication should the nurse administer to this patient?

Ans: 9 mL Rationale The patient requires 600 mg of amoxicillin. The volume of medication (V) appropriate to this amount of amoxicillin is calculated by the proportion method. 400 x V= 600 x 6, which means 400 V = 3600, and V= 3600 / 400 = 9. Therefore, 9 mL of the medication contains 600 mg of amoxicillin.

The nurse is administering a sustained-release capsule to a new patient. The patient insists that he cannot swallow pills. What is the nurse's next best course of action? Ask the healthcare provider to change the prescription. Crush the pill with a mortar and pestle. Hide the capsule in a piece of solid food. Open the capsule and sprinkle it over pudding.

Ans: A Rationale Enteric-coated or sustained-release capsules should not be crushed; the nurse needs to contact the prescriber to change the medication to a form that is liquid or can be crushed.

A patient informs the nurse that he or she is taking an herbal supplement daily to control blood pressure. The nurse warns the patient of increased bleeding as its side effect. Which herb is the patient taking? Garlic Ginseng Feverfew Ginkgo biloba

Ans: A Rationale Garlic is an herb and a natural remedy to lower blood pressure and levels of cholesterol and triglycerides. This herb may also cause increased bleeding in a patient. Ginseng is also a natural herb which increases physical stamina and mental concentration, but it may increase blood pressure and heart rate. Feverfew helps in preventing migraines and relieves the pain of arthritis, but it causes increased bleeding. Ginkgo biloba improves memory and mental alertness, but it may also cause increased bleeding.

A patient has elevated cholesterol levels and wishes to use an herbal preparation. Which herbal preparation does the nurse encourage the patient to use to decrease the elevated cholesterol levels? Garlic Licorice Ginkgo biloba Saw palmetto

Ans: A Rationale Garlic is used to reduce elevated cholesterol levels and is found to be helpful in cardiac conditions. Garlic contains a sulfur compound with a cholesterol-lowering effect, which has been confirmed by research studies. Licorice is used to treat GI disorders, including gastric ulcers and hepatitis C. Ginkgo biloba is used for treatment of Alzheimer's disease and dementia. Saw palmetto is used to treat benign prostatic hyperplasia.

Which type of syringe and needle does the nurse select to perform a tuberculin test in a patient suspected of tuberculosis? 1-mL syringe, 1/2- to 5/8-inch needle 3-mL syringe, 1- to 2-inch needle 5-mL syringe, 1- to 2-inch needle 10-mL syringe, 1/2- to 5/8-inch needle

Ans: A Rationale The nurse performs a tuberculin test through an intradermal injection. These injections require a 1-mL tuberculin syringe with a short, 1/2- to 5/8-inch needle to avoid skin and tissue damage. This allows the easy administration of the medication and reduces pain. The nurse uses 5-mL and 3-mL syringes with a 1- to 2-inch needle for intramuscular injections to accommodate up to 2 to 5 mL of medication. The 1-mL syringe is sufficient to perform the test and therefore, the nurse need not use a 10-mL syringe. A 10-mL syringe would make it difficult to measure the medication accurately, which could lead to incorrect medication administration and inaccurate test results.

A patient who has a history of eczema complains of a rash on her arms. The nurse finds that the patient has been on warfarin for the past 6 months. What should the nurse do? Measure the INR (international normalized ratio) of the patient. Inform the patient that the rash is due to eczema. Advise the patient to take an antihistamine tablet. Direct the patient to the hospital immediately for admission.

Ans: A Rationale The nurse should be aware that clinical judgments should be patient-specific. Warfarin is an anticoagulant and an increase in its dose can cause a rash. Therefore, the nurse should measure the INR first to see if the dosing is appropriate. Both eczema and warfarin could be the cause of skin rashes. The nurse cannot conclude that the rash is eczema until relevant investigations are done. Taking antihistamines may relieve itching, but this would not decrease the warfarin levels, so that may not be an appropriate measure in this case. Hospitalization may not be needed.

A patient has a bleeding tendency due to hemophilia. What route of drug administration is appropriate for this patient? Oral Intradermal Intramuscular Subcutaneous

Ans: A Rationale The route of administration appropriate for a patient with a bleeding tendency is the oral route, as it does not involve the use of needles. Any mode of administration that uses needles may increase the risk of bleeding. Therefore intradermal, intramuscular, and subcutaneous routes should be avoided in this patient's case to prevent bleeding.

The nurse takes a medication to a patient, and the patient tells the nurse to take it away because she is not going to take it. What is the nurse's next action? Ask the patient's reason for refusal. Explain that she must take the medication. Take the medication away and chart the patient's refusal. Tell the patient that her healthcare provider knows what is best for her.

Ans: A Rationale When patients refuse a medication, first ask why they are refusing it.

The nurse works in a postoperative unit. In which situation does the nurse perform an assessment to determine if the patient needs medication? Prn order Stat order Standing order Routine medication order

Ans: A Rationale When there is a prn order, the nurse may use his or her own discretion for administering or withholding medication based on subjective or objective assessment. Stat orders refer to single doses of medication to be given immediately or only once. Standing orders and routine medication orders are the same; in either case, the nurse continues the medication as prescribed until the prescriber asks the nurse to stop the medication.

A nurse works on a geriatric unit. What physiologic changes affecting the metabolism of medication should the nurse be aware of in these patients? Select all that apply. Reduced liver function Reduced absorptive capacity Reduced functioning of brain receptors Shortening of half-life of drugs excreted through the kidney Reduced function of the immune system

Ans: A, B Rationale In elderly patients, liver function is grossly reduced, which affects the metabolism of drugs and prolongs the half-life of drugs. The absorptive capacity of the intestines also declines in elderly patients. The brain receptors become more sensitive, and the patients are very much susceptible to psychoactive drugs. The kidney function diminishes and the half-life of drugs excreted through the kidney lengthens. The efficiency of the immune system decreases with age, but the immune system does not affect the drug metabolism process.

Which questions does the nurse ask to assess a patient's medical history? Select all that apply. "What surgeries have you had?" "Do you have any ongoing illnesses?" "At what times do you take your medications?" "Can you tell me why you are taking this medication?" "Have you experienced side effects to your medications?"

Ans: A, B Rationale To understand a patient's medical history, the nurse asks about the patient's past surgeries and ongoing illnesses. This helps with diagnosis and in preventing drug interactions and allergic reactions. The nurse asks about medication timing to plan the medication schedule. The nurse asks the patient about the reasons for taking a medication in order to assess medication compliance. The nurse asks about a patient's experience of side effects to medications to assess medication response.

The nursing is teaching a group of parents about medication administration to their children. Which statements made by the parents indicate the need for further teaching? Select all that apply. "I will administer eyedrops inside the upper eyelid." "I will avoid removing the previously placed patch when applying a new patch." "I will mix the medication by shaking the bottle well before administration." "I will mix the medication with a favorite food before administering it." "I will use a calibrated dropper for the administration of liquid medications."

Ans: A, B, D Rationale Eyedrops must be administered into the pouch formed by the lower eyelid instead of upper eyelid to prevent corneal damage. A previously placed patch and any remaining medication are removed before the new patch is applied to prevent overdosing. Medications should not be mixed with a child's favorite food because the child may avoid these foods in the future if associated with the medication. Shaking the medication bottle well before administration helps to uniformly disperse particles and administer the correct dose to the patient. Administration through a calibrated dropper or medication cup ensures the accurate prescribed dose and allows the child to swallow the medications slowly.

The nurse needs to administer an injection to a patient. What precautions should the nurse take to prevent infection during injection administration? Select all that apply. Cover the tip of the syringe with a cap. Clean the skin with an antiseptic swab. Draw the medication slowly from the ampule. Avoid touching the needle with the contaminated area. Swab the area for the injection from the periphery to the center.

Ans: A, B, D Rationale Injections cross the first line of defense of the body and may increase the risk of infection. To reduce the risk of infection, the tip of the syringe should be covered either with a cap or a needle. The skin should be cleaned in a circular motion with an antiseptic swab. This decreases the microbial count in the injection area. Care should be taken to prevent touching the needle to contaminated areas such as the outer surface of the cap, ampule, and tables. Drawing the medication from the ampule should be quick to minimize exposure. Swabbing has to be done from the center to the periphery to push germs away from the injection site.

What nursing measures are helpful in minimizing medication errors? Select all that apply. Patient identification Concealing medication errors Giving medications prepared by the person administering them Properly interpreting illegible prescriptions Double-checking doses

Ans: A, C,E Rationale There are many situations that can increase the risk of making a medication error and causing patient injury. Some of the safeguards for preventing medication errors are following facility policies regarding patient identification, giving medications prepared by the person administering them, double-checking doses, addressing patient questions about medication, and understanding why the patient is receiving a specific medication. Medication errors should be evaluated for their health impact and should be dealt with accordingly; concealing them is ethically unacceptable. Illegible prescriptions should be confirmed rather than interpreted.

A patient has been prescribed a low-molecular-weight heparin. What points should the nurse keep in mind when administering heparin? Select all that apply. The injection should be given in the abdomen. The injection should be given over a bony prominence. Air should be expelled from the syringe before administration. The injection site should be pinched while the needle is inserted. The injection should be given over large underlying muscles.

Ans: A, D Rationale Low-molecular-weight heparin is administered in subcutaneous tissue of the abdomen, at least 2 inches away from the umbilicus. The injection site has to be pinched as the needle is inserted. This helps ensure that the medicine is injected into the subcutaneous tissue. Subcutaneous injections are not to be given over bony prominences as doing so can cause injury. When administering heparin, air within the syringe should not be expelled, as doing so can affect the dosing. Subcutaneous injections should not be given over large underlying muscles, as the medicine can be accidentally injected into the muscle. Medication injected into a muscle is absorbed more quickly than from the subcutaneous tissue.

The nurse is assigned to administer a subcutaneous injection to a patient. What precautions should the nurse follow when administering the subcutaneous injection? Select all that apply. Inject medication slowly. Pinch skin with the nondominant hand. Aspirate when administering the injection. Inject the needle slowly at a 45- to 90-degree angle. Insert the needle with bevel up at a 5- to 15-degree angle.

Ans: A,B Rationale The technique of administering subcutaneous injection for an average-size patient involves pinching the skin with the nondominant hand and injecting the needle quickly and firmly at a 45- to 90-degree angle. The medication has to be injected slowly to minimize pain. The skin is pinched with the nondominant hand, because the dominant hand is used for administering the injection. Piercing a blood vessel during a subcutaneous injection is very rare, so aspiration is not necessary. Injecting the needle should be quick. Inserting the needle with bevel up at a 5- to 15-degree angle is done for intradermal injection.

A patient is prescribed a sublingual nitroglycerin drug. What instructions should the nurse provide to the patient? Select all that apply. Do not to swallow the medication. Place the medication under the tongue. Spit out the drug in case of irritation. Take the medication with water. Place the drug between your tongue and cheek.

Ans: A,B Rationale When administering medications through the sublingual route, the medication has to be placed under the tongue until it fully dissolves. The medication should not be swallowed. Swallowing can make the medication ineffective. The medication should not be spit out to prevent irritation; however, it may be spit out if the desired therapeutic effect is attained. The medication should not be taken with water, as this can alter its effectiveness. Sublingual medication should be administered under the tongue, not between the tongue and cheek.

A nurse instructs the patient to use eardrops at room temperature. What are the rationales for the nurse's instructions? Select all that apply. To reduce pain To prevent nausea To prevent loss of medication To prevent dizziness To ease removal of earwax

Ans: A,B, D Rationale The internal ear is very sensitive to temperature changes, so the nurse recommends using eardrops at room temperature. This reduces pain associated with ear infections, prevents nausea, and prevents dizziness. To prevent loss of medication, the ear pinna is released immediately after administration of the medication. Eardrops may be used to soften and help in easy removal of earwax; however ease of earwax removal is not associated with temperature.

A nurse is preparing a topical drug. Which topical drug forms provide a local effect to the patient when administered? Select all that apply. Spray Lotion Cream Powder Patch

Ans: A,B,C,D Rationale Lotions, creams, aerosol sprays, and powders are topical medications applied to the skin for a local effect. Transdermal patches have a sustained systemic effect.

A nurse is explaining to a patient about the side effects of a prescribed drug. Which statements related to side effects are appropriate? Select all that apply. Predictable Often unavoidable Occur after prolonged intake Occur at usual therapeutic dose Caused by defective drug excretion

Ans: A,B,D Rationale Every drug has a desired therapeutic effect and certain other effects, which are not desired. These effects of the drug are called side effects. These effects are usually predictable and often unavoidable due to the action of the drug on the organs other than the target organ. These side effects occur at the usual therapeutic dose, and dose adjustments may have little effect on them. Side effects are not due to prolonged intake or defective excretion of the drug. Prolonged intake and defective excretion of the drug may cause toxic effects due to drug accumulation.

Which interventions does the nurse implement to administer medication to a 3-year-old child? Select all that apply. Use a calibrated dropper for liquid forms. Use solid forms when administering any oral medications. Compliment the child after swallowing a medication. Never warn the child if the drug has an unpleasant taste. Sprinkle crushed medication over a small amount of favorite food.

Ans: A,C Rationale The nurse uses a calibrated dropper for infants and very young children, because the liquid form is preferred for children; this also helps to calculate the correct dosage. The nurse should praise the child after successful ingestion of the medication because this promotes the child's further cooperation. The nurse prefers liquid forms of medication to solid forms for easy and safe administration to infants and small children. The nurse tells the child if the drug has an unpleasant taste because it helps to facilitate a trusting, therapeutic relationship. The nurse does not sprinkle crushed or powdered medication over a child's favorite food because the child may avoid these foods in the future if associated with the medication.

The nurse is assigned to administer a medication via the intramuscular (IM) route. Which are the various sites that can be used for an IM injection? Select all that apply. Deltoid Brachioradialis Vastus lateralis Ventrogluteal Sternocleidomastoid

Ans: A,C,D

The nurse is reviewing a medication prescription for a patient. What are the components of medication prescriptions? Select all that apply. Dose and frequency Specific nurse in charge Route of administration Signature of the person writing the prescription Chemical name of medication

Ans: A,C,D Rationale A medication order from any healthcare setting must have several components to be a legally valid medication prescription: patient's name, the date and time the prescription was written, the name of the drug to be administered, the dosage of the drug, the route of drug administration, the frequency of drug administration, and the signature of the person writing the prescription. The chemical name and the nurse in charge are not components of the medication prescription.

The nurse is responsible for the storage and safe usage of drugs. What guidelines should the nurse follow for the safe use of narcotics? Select all that apply. Store narcotics in locked containers. Preserve unused portion of the drug. Frequently count narcotics, especially during shift change. Discrepancies in narcotic count should not be reported. Patient details should be documented and recorded.

Ans: A,C,E Rationale All controlled substances should be stored in a locked, secure cabinet or container to ensure safe storage. The narcotics should be counted with the opening of narcotic drawers and/or at shift change to ensure that narcotics are not missing. The patient's name, date, time of medication administration, name of medication, dose, and signature of the nurse dispensing the medication should be recorded. Documentation is necessary to keep a proper count of drug usage. Discrepancies in narcotic counts should be immediately reported as they may be a result of theft or illegal drug use. Unused portions should be disposed to prevent abuse.

The nurse has been assigned to administer a rectal suppository to an adult patient. Where should the nurse place the medication? Rectal wall 1 to 2 inches into the rectum Rectal wall 3 to 4 inches into the rectum Inner aspect of the anal orifice Just prior to the internal anal sphincter

Ans: B Rationale A rectal suppository for an adult should be placed against the rectal wall about 3 to 4 inches into the rectum. The inner aspect of the anal orifice is not the right position for suppository administration. The suppository has to be placed past the internal anal sphincter.

A patient with arthritis is planning to use feverfew. What precaution should be taken by the patient? Avoid using in conjunction with barbiturates. Avoid using in conjunction with anticoagulants. Avoid using in conjunction with antiandrogen drugs. Avoid using in conjunction with antihypertensive drugs.

Ans: B Rationale Feverfew is an herbal medicine used for the treatment of arthritis. It causes inhibition of serotonin and prostaglandins, and should be avoided when using anticoagulants. It causes interaction with anticoagulants. It has no adverse interaction with barbiturates, antiandrogen drugs, or antihypertensive drugs. Chamomile produces antiinflammatory effects and has the potential to interact with barbiturates. Saw palmetto is used to treat benign prostatic hyperplasia and is known to interact with antiandrogen drugs. Licorice is used for treating gastrointestinal disorders like gastric ulcers.

The nurse intends to use a medication that can give immediate relief to a patient. Which parameter of the drug should the nurse check for to find if the drug can provide immediate relief to the patient? Peak concentration Onset of action Plateau concentration Duration of action

Ans: B Rationale For providing immediate relief to the patient, a drug should have a faster onset of action. A drug with a slow onset of action may show a delayed effect. Peak concentration refers to the time taken to attain the highest effective concentration and does not provide information related to the onset of action. Plateau concentration is the plasma concentration attained and maintained after repeated fixed doses. Duration is the amount of time for which the drug produces its effect and does not provide information regarding onset of action.

A nurse is reviewing the different names for a drug. Which medication designation is assigned by the U.S. Adopted Names Council? Brand name Official name Trade name Chemical name

Ans: B Rationale Medications can have a maximum of four designations. The official name is assigned by the U.S. Adopted Names Council to ensure safety, consistency, and logic in the choice of names. The brand/trade name is a registered name assigned by the drug manufacturer to distinguish the product from those of other manufacturers. The chemical name is an accurate description of the substance composition.

After seeing a patient, the healthcare provider gives a nursing student a verbal prescription for a new medication. The nursing student first needs to: Follow ISMP guidelines for safe medication abbreviations. Explain to the healthcare provider that the prescription needs to be given to a registered nurse. Write down the prescription on the patient's order sheet and read it back to the provider. Ensure that the six rights of medication administration are followed when giving the medication.

Ans: B Rationale Nursing students cannot take prescriptions.

A patient who has diarrhea is dehydrated and needs 480 mL of oral rehydration solution. How can the nurse show the patient what 480 mL is using a household measurement? One cup is approximately equivalent to 480 mL. Two cups are approximately equivalent to 480 mL. Three cups are approximately equivalent to 480 mL. Four cups are approximately equivalent to 480 mL.

Ans: B Rationale One household cup is approximately equivalent to 240 mL. Therefore the patient would require 2 cups of oral rehydration solution (2 x 240 mL). Three cups are equivalent to 240 x 3 = 720 mL of the solution. Four cups would be equivalent to 240 x 4 = 960 mL of the solution.

The nursing student takes a patient's antibiotic to his room. The patient asks the nursing student what it is and why he should take it. Which information does the nursing student include when replying to the patient? Only the patient's healthcare provider can give this information. The student provides the name of the medication and a description of its desired effect. Information about medications is confidential and cannot be shared. The patient has to speak with his assigned nurse about this.

Ans: B Rationale Patients need to know information about their medications so they can take them correctly and safely.

If a patient who is receiving intravenous (IV) fluids develops tenderness, warmth, erythema, and pain at the site, the nurse suspects: Sepsis. Phlebitis. Infiltration. Fluid overload.

Ans: B Rationale Redness, warmth, and tenderness at the IV site are signs of phlebitis. STUDY TIP: Sometimes learning a "fun" fact can help you memorize information, such as the signs of inflammation. The cardinal signs of inflammation as established by early Greek and Roman physicians are the four "or's": rubor (redness), calor (heat—think "calorie"), dolor (pain), and tumor (swelling).

The nurse administers an opioid analgesic to a postoperative patient who reports pain at a level of 9 out of 10. Which vital sign does the nurse delegate to the unlicensed assistive personnel for frequent monitoring? Pulse Respiration Temperature Blood pressure

Ans: B Rationale Respiration should be monitored frequently after the administration of opioid analgesics, because these medications may decrease the respiratory rate. The pulse is measured frequently if the medication affects the heart rate. A patient's temperature is monitored after the administration of antipyretics. Blood pressure is measured frequently if the patient is on antihypertensive treatment.

A prescription states that a patient is to take a medication by mouth bid pc. What does "pc" stand for? Two times a day After meals Before meals Three times a day

Ans: B Rationale The instruction "after meals" is indicated by the abbreviation "pc." Before meals is indicated by "ac." "Bid" means twice a day. "Tid" means three times a day.

The nurse receives a prescription to start giving a loop diuretic to a patient to help lower her blood pressure. The nurse determines the appropriate route for administering the diuretic according to: Hospital policy. The prescriber's orders. The type of medication prescribed. The patient's size and muscle mass.

Ans: B Rationale The prescription from the provider needs to indicate the route of administration.

A nurse is preparing to administer an intramuscular injection for a 6-month-old infant. Which site should the nurse choose? Deltoid Vastus lateralis Dorsogluteal site Ventrogluteal site

Ans: B Rationale The selection of intramuscular injection site depends on the age of the patient. Intramuscular injections are administered into the vastus lateralis muscle for infants. Intramuscular injections are injected into the deltoid in children and adults. The dorsogluteal site is not recommended for infants, children, or adults. Intramuscular injections are injected into the ventrogluteal site in adolescents and adults.

A patient is admitted to the hospital for hernia surgery and is informed of his patient rights. What rights does this patient have in regards to medication administration? Select all that apply. The right to receive unnecessary medications. The right to know the name and purpose of medications. The right to refuse a medication regardless of the consequences. The right to receive unlabeled medications safely without discomfort. The right to order the medication himself.

Ans: B, C Rationale In accordance with the Patient Care Partnership and because of the potential risks related to medication administration, a patient has the right to know the name, purpose, action, and potential undesired effects of a medication, and can refuse a medication. The patient has the right not to receive unnecessary and unlabeled medications. The patient does not have the right to administer the medication himself, unless ordered so.

A diabetic patient has been switched from oral antidiabetic drugs to insulin. The patient has been prescribed regular insulin and NPH (intermediate) insulin. When teaching the patient about self-administration of insulin, what should the nurse instruct the patient regarding preparation of the insulin? Select all that apply. Shake the insulin vial before preparing. Roll the cloudy insulin vial between the palms of the hands. Prepare the regular insulin first and then draw up the NPH insulin. Presence of bubbles in syringe does not alter the insulin dose. Administer both insulins before a meal.

Ans: B, C, E Rationale Rolling cloudy insulin between the palms of the hands helps to resuspend the insulin in the vial. The regular insulin should be prepared first to prevent its contamination with the NPH (intermediate) insulin. The mixed insulin dose should be injected 15 minutes before a meal for its peak action during mealtime. Bubbles can form if the insulin vial is shaken, which can interfere with the correct dosing of insulin.

An elderly obese patient who has undergone total hip replacement surgery has been prescribed low-molecular-weight heparin (LMWH) enoxaparin. What complications of subcutaneous injections should the nurse monitor for? Select all that apply. Phlebitis Pain Infiltration Hypertrophy of the skin Sterile abscess

Ans: B, D, E Rationale Subcutaneous injections may be painful with irritating medication or if a large volume of medications is injected. Repeated injections at the same site may cause hypertrophy of the skin. The injected medication may collect at the site causing sterile abscess. Phlebitis is the inflammation of the veins. Infiltration happens when the intravenous fluid or medication accidently enters extravascular space.

The nurse is teaching a patient about insulin. Which sites does the nurse identify for a patient as the best sites for the self-administration of insulin? Select all that apply. Deltoid Abdomen Inner forearm Vastus lateralis Lateral aspects of the upper thigh

Ans: B, E Rationale Insulin is administered with an insulin syringe in the subcutaneous tissue. The common sites for subcutaneous injections are the abdomen, lateral aspects of the upper arm and thighs, scapular area of the back, and the upper ventrodorsal gluteal area. The deltoid is used for administration of some intramuscular injections in children and adults due to its adequate muscle mass. The inner forearm is the site for the administration of intradermal injections. The vastus lateralis is the best site for the administration of intramuscular injection in infants due to its adequate muscle mass. *not vastus lateralis bc thats the actual muscle, not location

An elderly obese patient who has undergone total hip replacement surgery has been prescribed low-molecular-weight heparin (LMWH) enoxaparin. What is the proper technique the nurse should use to administer enoxaparin? Select all that apply. Expel air bubble from the prefilled syringe. Insert the needle at a 90-degree angle. Administer the injection subcutaneously. Pinch the injection site as the needle is inserted. Use the right or left side of the abdomen at least 2 inches from the umbilicus.

Ans: B,C,D,E Rationale The needle should be injected at a 90-degree angle because the patient is obese. Enoxaparin is injected subcutaneously for gradual absorption. The injection site is pinched as the needle is inserted to ensure that the drug is injected into the subcutaneous tissues. Enoxaparin should be injected on the right or left site of the abdomen at least 2 inches from the umbilicus. The air bubble should not be expelled to avoid loss of drug.

The nurse is evaluating whether a patient is taking prescribed medications correctly. Which patient practice indicates the need for additional instruction? Select all that apply. "I always check my medication before I take it." "I use multiple medication cups to prepare a single dose." "I use a plastic spoon as a measuring device to take syrups." "I use a scored tablet if the dose must be divided." "I notice that a part of my medication is often left in the crusher."

Ans: B,C,E Rationale Multiple devices, nonstandard measuring devices, and incomplete intake of prepared dose may violate the right dose of medication administration rights. Using multiple medication cups to prepare a single dose may result in leaving a part of the dose in the cups and lead to underdosage. A plastic spoon is a nonstandard measuring device and may cause changes in the prescribed doses. Leaving part of the crushed medication in the device may also lead to administration of an incorrect dose. Always checking medication before taking is an appropriate action that does not violate the six rights of medication administration and does not need to be addressed. Breaking tablets that are scored or grooved into pieces does not violate the rights of medication administration.

A patient is prescribed lozenges for a cough. What instructions should the nurse give to this patient regarding the use of lozenges? Select all that apply. Advise crushing before swallowing. Allow for medication to dissolve in mouth. Dissolve in water before swallowing. The medication should not be ingested. Dissolve in juice before swallowing.

Ans: B,D Rationale Lozenges are slowly absorbed through the buccal mucosa; therefore, they should be kept in the mouth for adequate time to allow dissolution. Lozenges should not be ingested because they are more effective when absorbed through the buccal mucosa and not the gastric mucosa. The lozenges should not be crushed or dissolved in water or juice, as this can make them ineffective.

The nurse is administering prescribed medications to patients on the unit. When should the nurse compare the label of the medication container with the medication administration record (MAR)? Select all that apply. Comparison of the label with medication administration record (MAR) is not required. When verifying that the label of the medication matches the MAR, performing any dosage calculation, and checking the expiration date of the medication. Twice daily regardless of administration to patient. When preparing the medication and again when checking the medication label against the MAR. The nurse should recheck of the label on the medication before returning the medication to its storage place or perform a recheck of the medication label a final time against the MAR before opening the package at the bedside.

Ans: B,D,E Rationale Before actually administering a medication, the nurse carefully reads the medication record and does three checks with the labeled medication. The first check consists of verifying that the label of the medication matches the MAR, performing any dosage calculation, and checking the expiration date of the medication. The second check consists of preparing the medication and again checking the medication label against the MAR. The third check is a recheck of the label on the medication before returning the medication to its storage place or a recheck of the medication label a final time against the MAR before opening the package at the bedside.

The patient tells the nurse, "It feels like medications gets stuck in my throat." What does the nurse suggest to the patient? Select all that apply. "Use an alternate route." "Drink fluids after swallowing." "Take a smaller dose of the medication." "Crush certain medicines and add them to pudding." "Eat a small amount of soft food after swallowing medication."

Ans: B,D,E Rationale The nurse suggests that the patient drink fluids after swallowing, because this will prevent the lodging of the medication in the esophagus. The nurse may also suggest crushing a tablet and adding it to a small amount of food (pudding) to reduce difficulty in swallowing and obstruction. If the patient feels that medication is stuck in the throat, eating a small amount of soft food, such as oatmeal or a slice of bread, helps the medication move from the esophagus. The nurse may not be able to recommend an alternate route of medication because the medication may or may not be available in other dosage forms. The nurse cannot tell the patient to take a smaller dose of the medication; the primary care provider determines the dose, not the nurse.

Which instructions does the nurse give to patients when teaching them about safe application of a transdermal patch? Select all that apply. Select a bony prominence to apply the transdermal patch. Mark the patch with the date and time before applying. Massage the skin with gentle pressure after applying the patch. Rotate placement sites when applying the patch. Fold the old patch so it sticks to itself before disposing of it.

Ans: B,D,E Rationale Transdermal patches are medicated adhesive patches that are used to deliver medication into the bloodstream. When applying a new patch, the patient should mark it with the date and time. This helps to minimize medication errors, and serves as evidence should any legal issues arise. The nurse teaches the patient to change the placement site of the patch to prevent skin irritation. The patient should fold the used patch so that the sticky ends face each other; this may prevent adhesion to other surfaces and cross infection. The patch should not be applied to a bony prominence, as this may decrease the absorption and efficiency of the medication. Gentle pressure, not massage, is used when applying transdermal patches.

Which instructions does the nurse give to the patient after applying eye ointment? "Put your face over a basin." "Flush the eye until the ointment drains out." "Close and roll the eyes around." "Keep your eyes closed for 10 minutes after application."

Ans: C Rationale The nurse applies ointment from the inner canthus to the outer canthus and asks the patient to close and roll the eyes around. This helps to uniformly disperse drug particles and reduces the risk of eye infection. The nurse places a basin below the patient's face and provides a towel when washing a patient's eyes with eye irrigation solution. Ointment should not be drained after application, as this reduces the efficiency of the drug. The nurse may instruct the patient to close the eyes for a minute or two to help in ointment absorption, not for 10 minutes.

Which type of interaction occurs when a patient consumes an alcoholic beverage with an antihistamine? Side effect Toxic effect Synergistic effect Antagonistic effect

Ans: C Rationale A synergistic effect is the enhanced effect of one drug in the presence of another drug. Alcohol is a central nervous system (CNS) depressant, but the concomitant administration of alcohol along with the antihistamine drug causes the patient to experience greater CNS depression than normal. Side effects are predictable but unavoidable reactions to medications. Toxic effects refer to harmful effects of the drug, which may be lethal to the patient. Alcohol ingested along with antihistamines may increase a patient's drowsiness, but does not normally have a toxic effect. Antagonism refers to the mechanism of action of one drug inhibiting the actions of another drug. Alcohol and antihistamines do not interfere with each other; instead they enhance CNS depression by working synergistically with one another. STUDY TIP: The prefix "syn-" means "with" or "together". A synergistic effect, then, is the effect of two drugs taken with each other, taken together. Consider that syndrome is a set of symptoms that all appear together; or that syndactyly is the fingers or toes being fused together. Your clue for this question was that the alcoholic beverage was consumed with an antihistamine.

The nurse observes that a patient has itchy rashes on the body, inflammation and swelling of the nasal passages, and raised skin eruptions after intravenous drug administration. Which type of drug effect is the patient experiencing? Side effect Toxic effect Allergic effect Adverse effect

Ans: C Rationale Allergic reactions are unpredictable immune responses caused by antibody reactions to antigens. These include rashes, itching, inflammation and swelling of the nasal passages, and raised skin eruptions. Severe allergic reactions are also referred to as anaphylactic reactions. Side effects are predictable but unwanted and sometimes unavoidable reactions to medications. These side effects may be minor, harmless, or harmful. Toxic effects are serious physiologic effects caused by medication overdose or long-term use that may impair metabolism and excretion. Adverse effects are severe, unintended, and unwanted reactions that occur when one drug interacts with another or when a drug interacts with food or after one dose of a single drug. STUDY TIP: Find a medical terminology or dermatology text and look up "hives" or "wheals" or search for photos of hives or wheals on the internet. Once you see the irregularly shaped, raised rashes, you'll be able to identify them quickly in the clinical setting.

A patient develops skin rashes and hives after administration of penicillin. What is this phenomenon known as? Aggravation Amelioration Adverse reaction Therapeutic effect

Ans: C Rationale An adverse reaction is any unintended harmful action of any medication or therapeutic procedure. The development of hives is an adverse reaction to penicillin. Aggravation is an increase in the severity of existing symptoms. Amelioration is a decrease in the severity of existing symptoms. A therapeutic effect is the expected outcome of relief of symptoms.

A nurse is teaching self-administration of insulin to a patient. What instruction should the nurse include in the teaching? Shake the vial before drawing insulin. Administer regular insulin intramuscularly. Roll the insulin between your palms if the preparation is cloudy. Administer insulin after having meals.

Ans: C Rationale Cloudy insulin preparations should be rolled between the palms to resuspend them before drawing into syringes. The insulin vial should not be shaken, because shaking can create bubbles that can interfere with correct dosage administration. Regular insulin is given subcutaneously, not intramuscularly. If insulin is taken after meals, it cannot control the rise of blood sugar levels that occurs due to food intake.

The nurse is administering medications to a 4-year-old patient. After the nurse explains which medications are being given, the mother states, "I don't remember my child having that medication before." What is the nurse's next action? Give the medications. Identify the patient using two patient identifiers. Withhold the medications and verify the medication prescriptions. Provide education to the mother to help her better understand her child's medications.

Ans: C Rationale Do not ignore patient or caregiver concerns; always verify orders whenever a medication is questioned before administering it.

A postmenopausal patient with high blood pressure suffers from flushing and irritability. This patient understands that high blood pressure may increase the risk of having a myocardial infarction. Which herb is likely to help the patient reduce blood pressure? Echinacea Ginkgo biloba Garlic Licorice

Ans: C Rationale Garlic lowers serum cholesterol and blood pressure, making it beneficial in management of blood pressure. Echinacea is helpful for respiratory infections. Ginkgo biloba is helpful for neurodegenerative diseases. Licorice soothes and helps in healing of peptic ulcers.

When a patient asks the nurse about the use of therapeutic herbs, which is the most appropriate response by the nurse? "Herbs have many qualities; some effects are good, and some are not." "I have heard many people have used some herbal remedies and had good results." "Herbs are not regulated and some herbs can have health risks, especially if used with prescribed drugs." "If you are getting relief from an herbal remedy, there is probably no harm in it."

Ans: C Rationale Herbs are not regulated. Some herbs can interfere with the therapeutic effects of some drugs, and can react unfavorably with anesthesia and surgical intervention. Herbs may have harmless as well as harmful qualities. If an herb is beneficial for one person, it does not mean that it would have the same effect on another person. If an herb has a good effect, it does not guarantee that it is safe.

A patient develops sudden onset of bronchiolar constriction, edema of pharynx and larynx, and shortness of breath following administration of a medication. What type of allergic reaction is the patient experiencing? Rhinitis Medication allergy Anaphylactic reaction Idiosyncratic reaction

Ans: C Rationale The sudden onset of bronchiolar constriction, edema of pharynx and larynx, and shortness of breath indicate the severe form of allergic reaction called anaphylactic reaction. Rhinitis is a minor form of allergic reaction that manifests as sneezing, swelling, and clear nasal discharge. Medication allergy is a nonspecific term and encompasses rhinitis, rash, urticaria, and pruritus. Idiosyncratic reaction is the onset of an unpredictable response in a patient.

A patient is receiving an intravenous (IV) push medication. If the drug infiltrates into the outer tissues, the nurse: Continues to let the IV run. Applies a warm compress to the infiltrated site. Stops the administration of the medication and follows agency policy. Should not worry about this because vesicant filtration is not a problem.

Ans: C Rationale When an IV medication infiltrates, stop giving the medication and follow agency policy.

Which interventions does the nurse implement while administering medications to older adult patients? Select all that apply. Teach the name and color of the medication. Place the medication between the gum and cheek. Administer the medication slowly. Crush the enteric tablets for a faster effect. Allow time for slower swallowing of medications.

Ans: C, E Rationale The nurse does not rush medication administration for older adults. These patients may need additional time to understand the treatment and swallow the medication. The nurse teaches the name and purpose of the medication instead of color, because the color of the medication may vary from one manufacturer to another. Placing medication between the gum and cheek is more appropriate for children taking liquid medication through a dropper. Enteric-coated tablets are used for sustained release. If they are administered in the crushed form, the drug is absorbed all at once, resulting in side effects.

How should the nurse position the patient who has to undergo administration of nasal medication? Select all that apply. Tilt the head forward so that the chin touches the sternum. Flex the neck laterally so that the ear touches the shoulder. Tilt the head slightly back. Turn the head towards the side of treatment. Have the patient lying in the supine position with the head tilted backward.

Ans: C, E Rationale To administer nasal medications, tilt the patient's head slightly back, or have the patient lying in the supine position with the head tilted backward.

A nurse who is responsible for dispensing medications understands that every patient requires a different dosage for a given drug. Various factors affect the absorption of drugs. Which factors influence absorption? Select all that apply. Total body weight Body temperature Route of administration Solubility Blood flow to the site of administration

Ans: C,D,E Rationale Absorption is the passage of a drug from the administration site into the bloodstream. Several factors affect absorption: route of administration, ability of the drug to dissolve or become soluble, blood flow to the administration site, body surface area, and patient age. Absorption of drugs depends on body surface area, not on body weight. Body temperature does not affect the absorption of drugs.

A nurse is teaching a patient about examples of over-the-counter (OTC) medications. Which medications are classified as OTC medications and should be included in the teaching session? Select all that apply. Diuretics Vasodilators Mild analgesics Cold medications Nutritional supplements

Ans: C,D,E Rationale OTC medications are those drugs that can be obtained without a prescription from a retailer. These drugs include mild analgesics, cold medications, and nutritional supplements. Analgesics are common medications used for reducing pain and promoting comfort. Cold medications are used to alleviate the symptoms of a common cold, such as a running nose and cough. Nutritional supplements include multivitamins, minerals, fiber, fatty acids or amino acids, and iron supplements. Diuretics and vasodilators can be obtained only with a primary health care provider's prescription and are referred to as prescription drugs.

The nurse administers a bronchodilator for a hypertensive patient with shortness of breath. Which findings does the nurse assess to determine the effectiveness of the medication? Select all that apply. Temperature Blood pressure Respiratory rate Oxygen saturation Auscultation of lungs

Ans: C,D,E Rationale The nurse completes a physical assessment before and after medication administration to determine the effectiveness of the medication. The nurse assesses the respiratory rate to identify any changes in vital signs, which will indicate the severity of the illness. The nurse assesses the oxygen saturation status to determine the percentage of oxygen in the body tissues, especially in the cardiovascular and respiratory systems. The nurse auscultates the lungs to identify any abnormal breathing sounds present in the patient due to the medication. The nurse assesses temperature if the medication has any effect on thermoregulation. The nurse assesses blood pressure in case of medications that elevate or decrease the blood pressure, such as antihypertensive medicines.

Which routes of drug administration should require the nurse to instruct the patient to avoid ingesting anything by mouth for a period of time afterward? Select all that apply. Oral Nasal Buccal Topical Sublingual

Ans: C,E Rationale In both the buccal and sublingual routes of administration, the drug diffuses from the tissues into the bloodstream. Therefore, the nurse instructs the patient not to eat or drink anything until the medication completely dissolves. The buccal cavity is the oral cavity between the cheeks and teeth. The sublingual route of administration is under the tongue. The nurse administers oral medications with the help of liquids for easy swallowing. Nasal medication is directly administered into the nose, and topical medications are directly administered on the skin. These routes of administration are not affected by subsequent oral intake.

The patient has an order for 2 tablespoons of Milk of Magnesia. How much medication does the nurse give the patient? 2 mL 5 mL 16 mL 30 mL

Ans: D Rationale 1 tablespoon = 15 mL; 2 tablespoons = 30 mL

A nurse is administering an eye medication that removes secretions and cleanses and soothes a patient's eye. Which type of ophthalmic medication is the nurse administering? Extraocular disks Eyedrops Eye ointments Eye irrigation

Ans: D Rationale Eye irrigation or eyewash gently cleanses, removes secretions or foreign bodies, and refreshes (soothes) the eye. For continuous administration of medication, the primary health care provider may prescribe an extraocular disk, which is similar to a contact lens. The primary health care provider may prescribe eyedrops for the treatment of eye diseases or irritations. The primary health care provider may prescribe eye ointments if the patient has an eye infection or irritation.

The nurse is caring for a patient who uses several herbal preparations in addition to prescribed medications. What does the nurse need to understand about herbal preparations? They are regulated by the Food and Drug Administration (FDA); therefore, patients and providers should feel confident that they are completely safe. They are natural products and therefore are safe as long as they're used cautiously and prudently for the conditions that are indicated. They are covered by insurance, including Medicare, Medicaid, and private payers. They should be treated as though they were "drugs" of sorts because many have active ingredients that can interact with other medications and change physiologic responses.

Ans: D Rationale Herbal therapies are derived from plant materials and often contain the same active components as medications. Yet, they are viewed as dietary supplements and are not regulated by the FDA. The nurse should always explicitly ask patients whether they are taking supplements or other herbal remedies or vitamins when asking them about the medications they currently use during a health history. Many patients do not tell you about these products voluntarily because they do not view them as medications, they fear that conventional providers will not approve of these substances and they want to continue taking them, or they do not think that the nurse is interested in a substance that was not prescribed.

A patient is diagnosed with end-stage prostate cancer. The patient has developed a urinary tract infection. What dietary interventions could a nurse propose to provide additional comfort to the patient? Garlic Echinacea Ginkgo biloba Saw palmetto Feverfew

Ans: D Rationale Saw palmetto is helpful for prostatic enlargement and chronic pelvic pain. Garlic lowers serum cholesterol and blood pressure; hence, it is useful in the management of angina. Echinacea is helpful for respiratory infections. Ginkgo biloba improves memory and mental alertness. Feverfew helps prevent migraines and relieves the pain of arthritis.

A nurse instructs the patient to release the pinna and press on the tragus several times after instilling eardrops. What is the rationale for the nurse's instructions? Select all that apply. To prevent nausea To prevent dizziness To prevent ringing in the ear To prevent systemic effects To prevent loss of medication

Ans: D, E Rationale Releasing the pinna and pressing the tragus help to prevent systemic effects and loss of medication. Nausea and dizziness can be prevented by using eardrops at room temperature, not by releasing the pinna and pressing the tragus. Ringing in the ears is not prevented by these actions.

An elderly obese patient who has undergone total hip replacement surgery has been prescribed low-molecular-weight heparin (LMWH) enoxaparin. What should the nurse inform the patient about subcutaneous administration? Select all that apply. It produces no discomfort or pain to patient. The medication is absorbed faster due to a rich blood supply. The abdomen is not an appropriate site for subcutaneous injections. The injection site should not be near any bony prominence or large nerves. The medication is injected into the connective tissue below the dermis.

Ans: D, E Rationale The sites chosen for subcutaneous administration should be far from bony prominences. There should not be any big muscles and nerves underlying the site of injection. These tissues can get injured during administration of injection. The medication is placed into the connective tissue below the dermis for slow absorption. The subcutaneous tissue has pain receptors, therefore, the injection may cause pain and discomfort to the patient. The medication is absorbed slowly because the blood supply to the subcutaneous tissue is poor. The abdomen is a suitable site for subcutaneous injections.

The nurse is caring for an asthmatic patient who is on inhaled steroids. What is the rationale for the nurse instructing the patient to rinse the mouth and perform oral hygiene after each dose? Select all that apply. To prevent nausea To prevent bronchodilation To prevent dryness of the mouth To prevent oral fungal infections To prevent irritation in the oral mucosa

Ans: D,E Rationale Steroids generally depress the immune system, which may in turn increase the risk of opportunistic fungal infections. When the patient uses inhaled steroids, droplets of the drug are deposited on the surfaces of the oral cavity and may cause irritation of the oral mucosa. Therefore, the nurse instructs the patient to rinse the mouth and perform oral care after inhalation of steroid medications. The patient does not rinse the mouth to prevent nausea; antiemetics are medications to prevent nausea and vomiting. Steroids act by decreasing inflammation of the respiratory tract and facilitate easy breathing by bronchodilation. Mouth dryness can be reduced by sucking on sugar-free sweets, chewing sugar-free gum, or drinking plenty of water, not by rinsing.

The prescription is for 20 mg of a medication to a pediatric patient. The ampule has 40 mg/2 mL of the medication. What is the correct volume to be administered?

Ans:1

A nurse is preparing medications. Which form of medication is absorbed very rapidly? Inhalers Eardrops Eyedrops Coated tablets

Ans:A Rationale When an inhaler is used, the medication enters through the nose and mouth into the lower respiratory system, and the medication is absorbed very quickly. Eardrops and eyedrops are absorbed more slowly than inhaled medications. Coated tablets are absorbed from the colon, which means they have a delayed onset of action as they must pass through the digestive system first.

What should the nurse do if a patient's enteral feeding is still running when medication administration is indicated? Select all that apply Use 30 to 45 mL of water to flush the tubing. Keep the patient flat during administration. Perform gastric suction after administration. Count the water intake as output on the intake and output record. Flush the tubing with water before and after feeding.

Ans:A, E Rationale The nurse flushes the tube with 30 to 45 mL of water before and after the feeding. The nurse flushes the tube before and after administration of medications. Flushing before administration clears the tube of feed. Flushing after medication administration clears the tube of medication and prevents clogging. The nurse raises the head of the bed during and after the feeding to prevent aspiration. To allow absorption time, gastric suction should not be used for 20 to 30 minutes after administration. Note that water intake associated with medication administration is counted as intake on the intake and output record.

A diabetic patient has been switched from oral antidiabetic drugs to insulin. What information would help the patient to ensure correct self-administration of insulin? Select all that apply. Insulin is given as a subcutaneous injection. The insulin is absorbed more quickly when injected in the abdomen. The site of injection should be changed monthly. Once a site is chosen for injection, the same site should be used for further injections. The recommended sites of injection include the upper arm, thigh, abdomen, and buttocks.

Ans:A,B, ERationale Insulin is given as a subcutaneous injection for slower absorption. The rate of absorption of insulin differs in various sites. The abdomen has the quickest absorption. The recommended sites of insulin injection include upper arms, anterior and lateral part of thighs, buttocks, and abdomen. These sites have appropriate amount of subcutaneous tissue for absorption of insulin. The injection site should not be chosen again for a month. The site should be rotated with each injection. Repeated injection at the same site may lead to lipodystrophy.