Chapter 3: medication administration & nursing process

The physician ordered 8 mg of morphine sulfate IM. Morphine sulfate is available as 10 mg in a 1-mL vial. How many milliliters will the nurse administer to this patient?

0.8 L

A prescriber has written an order for levothyroxine sodium 50 mg per day by mouth. The nurse knows that the standard dose is 50 mcg. What action should the nurse take? a) call the prescriber and question the order b) administer 50 mcg instead c) consult the pharmacist about the order d) ask the patient what he/she usually takes

a. In the event a medication is ordered with a potentially wrong abbreviation, the nurse should call the prescriber and question the dosage. Also, it is essential to write out micrograms or milligrams to prevent error.

The nurse has administered lacosamide to the wrong patient. What is the first action the nurse should take? a) assess the patient's vital signs and level of consciousness b) notify the physician c) fill out an incident report d) call the respiratory therapist for administration of oxygen

a. The nurse first assesses the client's vital signs and level of consciousness. Then, it is necessary to notify the physician, implement orders per the physician's direction and fill out the incident report

During an initial nursing assessment, the patient reports that he is allergic to a particular medication. What should the nurse ask the patient? a) what symptoms occurred when you had the allergic rxn? b) did you need to take epinephrine [adrenalin]? c) did your physician think this information needed to be communicated? d) have you ever overdosed on this medication?

a. The nurse should inquire what symptoms occurred that prompted the client to say he was allergic to the medication. Sometimes clients state that they are allergic to a drug when they actually have had an adverse rxn such as nausea. If clients are truly allergic, resulting in an anaphylactic rxn, then it is imperative they not receive the medication.

If a dose of a medication is missed, what do most authorities recommend? a. Double the dose the next time that the medication is due b. Take the medication if it is close to the administration time c. Increase the next two doses to maintain the drug's level in the system d. Take the medication as long as there are 2 hours between doses

b

If a dose of a medication is missed, what do most authorities recommend? a. Double the dose the next time that the medication is due b. Take the medication if it is close to the administration time c. Increase the next two doses to maintain the drug's level in the system. d. Take the medication as long as there are 2 hours between doses.

b

Mrs. Hone asks the nurse to open her Effexor XR capsule and mix the contents in applesauce to make it easier to swallow. How should the nurse respond? a. "Not a problem; I will mix the medication for you." b. "I am sorry, but opening the capsule may cause you to absorb too much medication too quickly." c. "The physician gave you this form of your medication because it is easier to take by mouth." d. "Effexor XR may only be mixed with food with a physician's order."

b

what statement would indicate that a mother is administering the incorrect dosage of liquid medication to her child? a. i use a calibrated medication cup to administer the medication b. i use the measuring teaspoon that I cook with c. i give the medication at the times indicated on the prescription d. i use a household tsp

b

The patient receives regular insulin 5 units subcutaneously. To what degree is the syringe held for the injection [Select all that apply.] a) 30 degrees b) 45 degrees c) 60 degrees d) 90 degrees

b, d. Subcutaneous injections of insulin are administered at 45 or 90 degrees with a 25-gauge needle.

What should the nurse keep in mind when evaluating a pt's response to drug therapy? a) few drug cause adverse effects b) drugs may cause virtually any symptom or problem c) pts always report adverse effects d) therapeutic effects are more important than adverse effects

b. It is important to know that drugs may cause virtually any symptom or problem.

A patient is to receive an intramuscular injection of ketorolac. Which of the following muscles should be avoided? a) deltoid b) dorsogluteal c) ventrogluteal d) vastus lateralis

b. Many health care facilities do not permit the dorsogluteal muscle to be used for the administration of intramuscular injections.

A physician writes an order using the abbreviation MS. The order states "MS 10 mg IV push every 6 hours as needed for pain". According to The Joint Commission's "Do Not Use" list, what is the potential problem in this order? a) the order does not include a dosage b) the drug could be magnesium sulfate or morphine sulfate c) the potential problem is minimal, and the order is unclear d) the order does not include the route

b. The use of the abbreviation MS in an order is inappropriate. It is possible to interpret it as either magnesium sulfate or morphine sulfate.

Mrs. Hone has a new order for Effexor XR. She asks the nurse why she doesn't hve to take the medication as frequently as her other antidepressant. As part of the nurse's teaching plan, what does the nurse tell her? a. "XR means that the drug is extended release, which means that there are less consistent serum drug levels and you need to take it less frequently." b. "XR means that the drug is delayed release, which means that there are more consistent serum drug levels and you need to take it less frequently." c. "XR means that the drug is extended release, which means that there are more consistent serum drug levels and you need to take it less frequently." d. "XR means that the drug is extended release, which means that there are more consistent serum drug levels and you need to take it more frequently."

c

The nursing instructor is observing a nursing student give a subcutaneous injection of heparin to a patient. The nursing student would receive an unsatisfactory evaluation if the student performed what action? a. The student uses a 25-gauge needle to administer the medication b. The student inserts the needle at a 45-degree angle c. The student gently aspirates the medication before administering the medication d. The student applies pressure for a few seconds after removing the needle

c

The patient requests an oral pain medication. The nurse notes that the patient is NPO in preparation for laboratory tests. What is the nurse's best response to the patient? a. "You are not allowed to have any medication by mouth right now. I will five you this medication in an injection." b. "I will check with your doctor and see if it will be all right for you to take a pain pill." c. "I will contact your doctor and ask for an order for a different method of drug administration." d. "You will have to wait for this medication until you eat and drink again."

c

The patient requests an oral pain medication. The nurse notes that the patient is NPO in preparation for laboratory tests. What is the nurse's best response to this patient? a. "You are not allowed to have any medication by mouth right now. I will give you this medication in an injection." b. "I will check with your doctor and see if it will be all right for you to take a pain pill." c. "I will contact your doctor and ask for a different method of drug administration." d. "You will have to wait for this medication until you eat and drink again."

c

The physician orders NPH U100 insulin 16 units SC every AM for Mrs. Styles. The nurse prepares the insulin dose, and, to ensure safety, what does the nurse do? a. Give the insulin to the patient b. Bring the vial c. Ask another nurse to double-check the measurement d. Encourage the patient to administer her own insulin

c

a patient refuses a PRN medication; the nurse documents the season for the refusal on the back of the medication administration record and disposes of the medication according to facility policy. by documenting the patient's refusal and reason for declining the medication, the nurse is adhering to which "rights"? a. dose b. medication c. documentation d. patient

c

the charge nurse on the unit transcribes a physicians order onto the MAR. she writes "Digoxin 0.25 mg PO qod X3d" on the MAR. how should the order be written to prevent medication error? a. Digoxin 0.25 mg PO every other day x3d b. Digoxin 0.25 mg PO qod for three doses c. Digoxin 0.25 mg by mouth every other day for three dosesd. d. Digoxin 0.25 mg PO qod x3d

c

A patient is to receive lamotrigine 300 mg by mouth two times per day. The pharmacy has delivered 50 mg tablets. How many tablets should be administered each time? a) 2 tablets b) 4 tablets c) 6 tablets d) 8 tablets

c. 6 tablets

A nurse is administering an elixir. Which of the following measures is appropriate? a) microgram b) milligram c) milliliter d) kilogram

c. An elixir is a liquid medication that is measured in milliliters (mL).

The nurse is administering the first dose of an anti-infective agent. Which of the following assessments should the nurse make prior to administering the anti-infective agent? a) assess the patient's temperature b) assess the patient's level of consciousness c) assess whether the patient is allergic to any anti-infective agent d) assess whether the patient has taken the medication previously

c. Prior to administering any medication, the nurse assesses the client's allergies. Clients who are allergic to penicillins are also likely to be allergic to cephalosporins.

How do nursing interventions increase safety and effectiveness of drug therapy? a) by avoiding the use of nondrug measures during drug therapy b) by using multiple drugs to relieve most symptoms or problems c) by teaching patients about their drug therapy d) by avoiding excessive instructions

c. Teaching clients about drug therapy increases safety in drug therapy.

The nurse is preparing to administer medications via a patient's gastrostomy tube. The physician has ordered an extended-release medication. What is the nurse's most appropriate action? a. The nurse should open the capsule and empty the powder into 30 mL of water b. Crush the capsule and flush the medication with at least 60 mL of water. c. Do not administer the medication because it may clog the gastrostomy tube d. Call the physician and ask for an order for a different formulation of the medication.

d

A prescriber has written an order for an oral medication to a patient following a cerebrovascular accident [stroke]. Prior to administering the medication, which of the following nursing interventions is most important? a) allowing the patient to take the medication with thickened liquids b) placing the patient in the sitting position c) assessing the patient's bp and pulse d) assessing the patient's ability to swallow

d. A client who has had a cerebrovascular accident can suffer from dysphagia, the inability to swallow. The nurse must assess the client's ability to swallow prior to administering an oral medication. If the client has dysphagia and the medication is administered,, the client is at risk for aspiration and pneumonia.

How is medication delivered by piggyback administered? a) it is pushed into the IV line b) it is retrograded into the IV line c) it is injected intramuscularly after another medication d) it is mixed with 50 to 100 mL of IV fluid in a separate container

d. The medication is mixed in 50 to 100 mL of fluid in a separate container.

A nurse is preparing to administer a subcutaneous injection. What size needle should the nurse use to administer the injection? a) 18 gauge b) 20 gauge c) 23 gauge d) 25 gauge

d. The nurse administers a subcutaneous injection with a 25-gauge syringe.

Which of the following nursing actions will prevent adverse drug events? a) use only the trade name when documenting medications b) crush long-acting medications if the patient has dysphagia c) after receiving a verbal order, administer the medication and then write down the order d) use bar code technology according to institutional policy

d. Using bar code technology in the administration of medications will decrease medication administration errors.

T/F: Risk factors for HTN are not considered when taking care of people with hypertension

f

T/F: The Harrison Narcotic Act prohibits fraudulent claims of drug effectiveness

f

T/F: The trade or brand name is related to the chemical or official name and is independent of the manufacturer

f

T/F: When arterial blood pressure is elevated, the kidney excretes less fluid (dec. in urine output)

f

T/F: Alpha 1 cells are responsible for contraction, therefore increasing BP

t

T/F: Controlled drugs are categorized according to therapeutic usefulness and potential for abuse

t

T/F: Essential HTN has a large number of unidentified causes

t

T/F: Prescriptions for Schedule II drugs cannot be refilled

t