Chapter 3: Medication Administration and the Nursing Process of Drug Therapy

The route of medication administration can change dependent on client factors. Therefore, the route of medication administration is:

always included in the "five rights" of medication administration.

The nursing student is studying drug dosage and has learned that there are three systems of measurement associated with drug dosing. What are these systems? (Select all that apply.)

metric system apothecary system household measurement system

Effectiveness of medication therapy is associated with which phase of the nursing process?

Evaluation

The nurse administered a scheduled dose of hydrochlorothiazide, a diuretic, 45 minutes ago. The nurse is now preparing to assess the client's blood pressure. In what phase of the nursing process should the nurse perform this action?

Evaluation

The anxiety experienced during drug administration depends on the following? Select all that apply.

Fear Severity of illness Lack of concern by the nurse

Which of the following factual knowledge should the nurse have prior to administering a drug? Select all that apply.

Normal dosage range Special precautions in administration Drug's most common adverse effects Drug's general action Reason for use of the drug

Which nursing intervention would the nurse expect to do during implementation?

Providing client teaching about a drug therapy regimen

When assessing a client before starting a drug regimen, how should the nurse best assess the client's ability to excrete medications?

Review laboratory values indicative of kidney function

When providing drug therapy to a client, what is a responsibility of the nurse?

Teach the client how to cope with the effects of the drug to ensure the best outcome.

The nursing student learns that the apothecary system was at one time used for weight but was recently eliminated for which reasons?

it produced a high rate of errors.

A client recently discovered that she is pregnant. She currently takes herbal medications to control her diabetes and the symptoms related to pregnancy. She asks the nurse if it is safe to take herbal medications while she is pregnant. What would the nurse tell this client?

"Most herbal and dietary supplements should be avoided during pregnancy or lactation."

A young mother asks the nurse why she cannot give her 2-year-old child an adult dose of acetaminophen. The nurse explains why this is unsafe. What statement would indicate that the mother needs further education?

"My baby's dose of acetaminophen is based on a healthy adult male."

The nurse is providing care for a client who has been prescribed a diuretic to treat hypertension. The client states that the effects of the drug are problematic, causing the client to wake up numerous times during the night to urinate. What assessment question should the nurse prioritize?

"When are you taking your medication?"

Mrs. Hone has a new order for Effexor XR. She asks the nurse why she doesn't have to take the medication as frequently as her other antidepressant. As part of the nurse's teaching plan, what does the nurse tell her?

"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."

The nurse is conducting client education for a newly diagnosed diabetic. The order is for 32 units of insulin. The insulin is supplied in a multidose vial that is labeled 100 units/mL. How many cc of insulin would be needed to treat this client?

0.32 cc

The health care provider has ordered 35 mg of Demerol IM for relief of a severe migraine headache. The package insert reads meperidine hydrochloride (Demerol) 50 mg/mL. How many milliliters would the nurse administer?

0.7

The health care provider 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 client?

0.8

Medication doses given to children are usually smaller than those given to adults. Doses for children can also be calculated based on the child's weight. Which would be correct when calculating a dose based on weight?

1 kg equals 2.2 pounds

The nurse should use which needle when administering a nonviscous solution by the intramuscular (IM) route for an adult?

1.5 inches (3.8 cm), 22 gauge

A nurse is to administer 175 mg of a medication intramuscularly. The label on the multidose vial states that the concentration is 100 mg/mL. What volume of the drug should the nurse administer? (Record your answer using two decimal places.)

1.75

The nurse multiplies and divides simple fractions when calculating drug doses for clients. Which fraction is a result of multiplying 2/5 by 5/8?

1/4

A client has not had a bowel movement for four days and has been prescribed milk of magnesia 2 teaspoons orally as needed for relief of constipation. How many mL should the nurse administer?

10 mL

The nurse is preparing medication for a 30-month-old with right otitis media. The child weighs 33 pounds. The health care provider has ordered cephalexin, 50 mg/kg/day in divided doses every 8 hours. The medication concentration is 250mg/5mL. How many milliliters should the nurse give the toddler?

5

A client's prescriber has suggested 10 mL of guaifenesin (Robitussin) PO q4h as needed. What dose using household measurement will be given?

2

The nurse is preparing to administer cefadroxil 1 g PO. The medication is supplied in 500-mg tablets. How many tablets should the nurse administer?

2

The nursing student is studying drug dosing with liquids. The student knows that a specific amount of drug will be in a given volume. A particular drug label reads "Augmentin 125 mg/5 mL." Which is the correct volume?

5 mL

The nurse is converting grams to milligrams. How would the nurse move the decimal point? You Selected:

3 places to the right

A nurse is to give an intermittent infusion. Approximately how long will it take for the infusion to be given?

30 to 60 minutes

Order: Ibuprofen 150 mg. orally Available: Ibuprofen 100mg/ 5ml How many mL will the nurse administer?

7.5

For which of the following patients would a nasogastric tube most likely be considered to aid in the administration of medications?

A 78-year-old man who is unable to swallow following an ischemic stroke

A health care provider instructs a nurse to administer a drug to a client STAT. What should the nurse perform in this situation?

Administer the drug as instructed by the health care provider.

What action should the nurse perform during the implementation step of the nursing process?

Administrations and documentation of medications.

A nurse gives a client 0.25 mg of digoxin instead of the prescribed dose of 0.125 mg. What should the nurse do next?

Assess the client and notify the client's health care provider.

The nurse is preparing to administer a medication to an older adult. The nurse should consider what factor that could affect therapeutic dosing in an older adult?

Changes in the gastrointestinal (GI) system can reduce drug absorption

Which must be included on the health care provider's order? Select all that apply.

Client's name Drug name Dosage form Route of administration Frequency of administration

During a medication pass, the nurse notices that the health care provider ordered a dose of medication that appears to be excessive based on the nurse's knowledge of the medication. The nurse calls the provider, and the provider instructs the nurse to administer the medication anyway. What should the nurse do?

Consult with the nursing supervisor, refuse to administer the medication, and notify the provider.

he nurse is required to administer 4 mL of an intramuscular (IM) injection to the client. Which action would be most appropriate?

Divide the drug and give it as two separate injections.

Which medication prescription by the health care provider will require the nurse to seek clarification?

Heparin 5,000 u SC every day

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?

I am sorry, but opening the capsule may cause you to absorb too much medication too quickly."

Assessment of a client receiving drug therapy reveals that the client has been experiencing gastrointestinal upset related to the drug. The client states, "My stomach has been so upset that all I've been able to eat is soup and dry crackers." Which nursing diagnosis would be most likely?

Imbalanced nutrition: Less than body requirements

The nurse is admitting a new client whose health history includes chronic kidney disease. How should the nurse best interpret and document this assessment data on the nurses notes?

The client's drug excretion may be slower than normal.

Which of the following is not a client right regarding his or her prescribed medication?

The right to refuse a court ordered medication

The nurse is conducting the evaluation phase of the nursing process. The nurse should perform evaluation primarily based on what data?

Whether the client is achieving health outcomes

After teaching a group of nursing students about the Joint Commission and National Patient Safety Goals (NPSG), the instructor determines that the teaching was successful when the group identifies that the NPSG is updated at which frequency?

annually

A nurse is caring for a client who is prescribed multiple medications. Which clients are most likely to have adverse drug reactions?

clients who are very young or very old

The nurse is preparing to administer medications and demonstrates knowledge of the 6th right by:

documenting the medication after administration.

The client has been prescribed an oral medication. Prior to administration of this medication, what should the nurse do first?

evaluate the client's ability to swallow.

Many clients who the nurse cares for in the hospital are also taking over-the-counter (OTC) medications. Which core client variable is needed to assess the client's OTC medication use?

health status

The nurse checks a client's temperature before administering a standing prescription for acetaminophen for temperatures over 100°F (37.8°C). The client's temperature is 98.9°F (37.2°C), so the nurse decides to withhold the dose of acetaminophen. Withholding the dose represents which phase of the nursing process?

implementation

What aspects of self-administration of drugs show that the client is deficient in knowledge of the subject? (Select all that apply.)

inability to remember cognitive limitation lack of interest in learning

A nurse in a nutrition clinic is to give 2 cups of organic prune juice to a client every night. The nurse is to document this on the nursing chart. What unit will the nurse use to document the amount of juice according to the metric system of measurement?

mililiter

After the formulation of nursing diagnoses, which phase of the nursing process would occur next?

planning

A group of students are reviewing information about the nursing process and drug therapy in preparation for an examination on the material. The students demonstrate understanding of the material when they state that the nursing process is a:

set of sequential steps that are dynamic in nature.