Chapter 35 Medication

The nurse determines that the effectiveness of a medication is not as great when provided to female clients as it is with male clients. The nurse suspects that this difference in effectiveness is because of: Standard Text: Select all that apply. 1. Occupation. 2. Hormones. 3. Fat amount. 4. Physical activity status. 5. Fluid level.

2,3,5

A client is diagnosed with liver disease. The nurse realizes that which element of pharmacokinetics will be affected in this client? 1. Absorption. 2. Distribution. 3. Biotransformation. 4. Excretion.

3

During the process of administering medications, the nurse checks the name band for the client's name. What should be this nurse's next action? 1. Administer the medication as ordered. 2. Initial the MAR that the medication will be given. 3. Double check the client's identification using a second method. 4. Educate the client regarding the medication to be given.

3

The client is to receive an intramuscular injection of a medication that is supplied in a 2-mL cartridge and a second medication that is supplied in a vial. The total amount to be administered of these medications exceeds the volume of the cartridge by 0.5 mL. How should the nurse proceed? 1. Administer the cartridge medication in one injection and the vial medication in a separate injection. 2. Call the pharmacy for advice on administering these medications. 3. Draw both of the medications up into a syringe for administration. 4. Add as much of the vial medication to the cartridge as possible prior to injection, giving the balance in a separate injection.

3

The nurse identifies that the ordered dose for a medication is twice the amount generally administered. What action should the nurse take? 1. Administer the medication as it was ordered. 2. Check to see if previous shift nurses gave the medication. 3. Collaborate with the prescriber about the order. 4. Administer only the standard dose of the medication.

3

The nurse is planning to administer a bitter-tasting oral medication to a 4-year-old client. What strategy should this nurse plan? 1. Give the medication in orange juice or milk to mask the taste. 2. Tell the child that the medication tastes good. 3. Ask the parents how they give medications at home. 4. Get another nurse to assist by holding the client down.

3

The nurse is preparing a small amount of medication for oral administration. Which nursing action is essential? 1. Draw up the medication in a syringe with a large-gauge needle. 2. Measure the medication at the top of the meniscus. 3. Label the syringe with the medication name, amount, and route. 4. Dilute the medication with water before measuring

3

The nurse is preparing to administer a medication to a 6-year-old client. What is the nurse's priority action? 1. Administer the exact dosage as ordered. 2. Give the dosage supplied by the pharmacy. 3. Verify that the dosage is within the safe range for this child. 4. Administer no more than one-half of the safe adult dosage.

3

The nurse is writing out the name of the drug morphine sulfate instead of using the abbreviation MS because: 1. The hospital has placed MS on its list of do not use abbreviations. 2. The Joint Commission requires that the abbreviation MS not be used. 3. Using the abbreviation MS puts the client at risk of medication error. 4. Computerized charting systems will not accept the abbreviation MS

3

The nurse who is to administer 2.5 mL of intramuscular pain medication to an adult client notes that the previous injection was administered in the right ventrogluteal site. In which site should the nurse plan to administer this injection? 1. The same site 2. The deltoid 3. The left ventrogluteal 4. The rectus femoris

3

While preparing to administer a transdermal estrogen patch, the nurse finds the previously applied patch in the client's bed linens. How can the nurse avoid this situation with the patch now being applied? 1. Shave the area where the patch is being applied. 2. Place a heating pad over the area where the patch is applied for 10 minutes after application. 3. Run a finger around the adhesive edges of the new patch before placing it on the client's skin. 4. Press firmly over the patch with the palm of the hand for about 10 seconds after applying it to the skin.

4

A client who has been prescribed a narcotic for chronic back pain is demonstrating signs of withdrawal. The nurse identifies these symptoms as being: 1. Physical dependence. 2. Psychological dependence. 3. Plateau. 4. Drug allergy.

1

1. Make sure it is the right client. 2. Make sure it is the right medication. 3. Make sure it is the right dose. 4. Make sure it is the right route. 5. Make sure it is for the right diagnosis.

1,2,3,4

The nurse is preparing to administer a subcutaneous injection to a client. When selecting the needle, the nurse should choose one with a: 1. Small gauge number. 2. Long shaft. 3. Long bevel. 4. Short beve

3

A client is prescribed an oral medication. When reviewing this medication, the nurse realizes it might not be the route of choice for this client because the client is experiencing: Standard Text: Select all that apply. 1. Nausea. 2. Anxiety. 3. Vomiting. 4. Pain from cuts and abrasions. 5. Irritated gastric mucosa.

?%

While reviewing a medication order, the nurse determines that it is written using the metric system because which of the following is included? Standard Text: Select all that apply. 1. Number of ounces. 2. Number of drams of the solution. 3. Number of milligrams of the medication. 4. Number of grains of the medication. 5. Number of milliliters of the solution.

?∴%

Before administering a medication to a client, the nurse checks the client's pulse, blood pressure, and laboratory values. The nurse is performing which "right" of medication administration? 1. Medication. 2. Assessment. 3. Route. 4. Dose.

2

During administration of an intradermal injection, the nurse notices that the outline of the needle bevel is visible under the client's skin. How should the nurse proceed? 1. Recognize that this is an expected finding in a properly administered intradermal injection. 2. Withdraw the needle, prepare a new injection, and start again. 3. Insert the needle further into the skin at a deeper angle. 4. Turn the needle so that the bevel is down and inject the medication slowly, looking for development of a bleb.

1

A client is prescribed a medication to be administered through the parenteral route. The nurse would expect that this medication will be provided through: Standard Text: Select all that apply. 1. Subcutaneous injection. 2. Intramuscular injection. 3. The oral route. 4. Intradermal injection. 5. Intravenous infusion.

1,2,4,5

The nurse has provided an otic medication to a client. What should the nurse document about this medication's administration? Standard Text: Select all that apply. 1. Name of the drug. 2. The strength. 3. The appetite of the client. 4. The number of drops. 5. The response of the client.

1,2,4,5

A client tells the nurse that the pharmacy will not fill a prescription that was written by the physician. Upon closer examination, the nurse determines that what is missing from the prescription? Standard Text: Select all that apply. 1. Rx symbol. 2. Client's diagnosis. 3. Client's Social Security number. 4. Dispensing instructions for the pharmacist. 5. Number of refills.

1,4,5

A client is prescribed a new medication. The pharmacy notifies the nurse that the dosage is outside of route prescribing limits. The nurse is unable to reach the prescribing physician about the order. What should the nurse do? 1. Give the medication to the client as prescribed. 2. Withhold the medication. 3. Give one half of the medication dose prescribed. 4. Administer the medication through the oral route

2

At which point of preparing medication from an ampule does the nurse anticipate using a filter needle? 1. Filter needles are not used for this preparation. 2. When drawing the medication from the ampule. 3. When administering the medication to the client. 4. Both for drawing up the medication and for administering the medication.

2

The client who regularly uses a metered-dose inhaler four times a day tells the nurse that it is difficult to tell when the canister is empty. What instruction should the nurse give this client? 1. Place the canister in a bowl of water. If the canister floats, it is not empty. 2. When you get a new canister, divide the number of puffs that is listed on the label by four.That will tell you how many days the canister will last. 3. You can tell that the canister is empty when you can no longer smell the medication when you activate the plunger. 4. When you feel like you are no longer getting maximum effect from the medication, your canister is empty.

2

The hospitalized client has an order for Tylenol 325 mg 2 tablets every 4 hours prn temperature over 101°F. The client complains of a headache. Can the nurse legally administer Tylenol to treat the headache? 1. Yes, since Tylenol is used both for fever and headache. 2. No, not unless the client also has a temperature over 101°F. 3. Yes, but the nurse should document the reason why the medication was administered as a temperature elevation. 4. Yes, since the medication is available over the counter, an order is not required.

2

The nurse determines that an older client is experiencing an adverse effect from a prescribed medication because of: 1. Altered memory. 2. Altered organ responsiveness. 3. Decreased manual dexterity. 4. Decreased visual acuity.

2

A client diagnosed with diabetes asks the nurse about reusing insulin syringes. Assessment reveals that the client has poor personal hygiene and difficulty with fine motor skills. The nurse also knows the client has financial difficulties. What instruction should the nurse give this client? 1. "The American Diabetes Association advises that syringes are single use only." 2. "In order to save money, I advise you to reuse syringes up to three times or until the needle feels dull." 3. "Only people who practice good personal hygiene can reuse syringes." 4. "All clients are different, but I advise you to use a new syringe each injection."

4

An adult client is prescribed the hepatitis B vaccination. The nurse will administer this medication through which site? 1. Dorsogluteal. 2. Rectus femoris. 3. Vastus lateralis. 4. Deltoid

4

The nurse is administering a medication to a client at identified times in order to maintain a specific amount of the medication in the client's bloodstream at all times. The nurse is ensuring that which action is being maintained for this client? 1. Peak plasma level. 2. Drug half-life. 3. Onset of action. 4. Plateau.

4

The nurse is caring for a team of four clients who are seriously ill. One of the clients has just received a new cardiac medication. How should the nurse instruct the unlicensed assistive personnel (UAP) who is also caring for this client? 1. Have the UAP assess for any unexpected effects from the medication. 2. Tell the UAP to teach the client's family what to expect from the medication. 3. Have the UAP look the medication up in a drug reference book to read about drug actions and possible side effects. 4. Give the UAP specific instructions regarding what drug actions or side effects to report to the nurse

4

The client has required 2 sublingual nitroglycerine tablets that are gr 1/150 per tablet. How many mg of nitroglycerine did the client receive?

48 mg

The nurse is adding medication to an existing intravenous setup. Which nursing action is indicated? 1. Close the infusion clamp. 2. Ensure that the IV bag is full prior to adding medication. 3. Do not remove the IV bag from the pole. 4. Briskly shake the IV bag after injecting the medication.

1

The nurse is preparing to administer a medication that the agency designates as "high alert." What action should the nurse take? 1. Ask another registered nurse to verify the medication. 2. Call the pharmacist to check the efficacy of the medication. 3. Decline to administer the medication unless there is a physician present. 4. Request that the nursing supervisor administer the medication.

1

The nurse is providing medications to a client. After identifying the client, the nurse should: 1. Inform the client as to the intended action of the medication. 2. Administer the drug. 3. Document that the drug was provided. 4. Evaluate the effectiveness of the drug.

1

While preparing to administer an eye ointment, the nurse inadvertently squeezes the tube, discarding the first bead of medication. What action should the nurse take at this point? 1. Administer the eye ointment as ordered, as the first bead of ointment should be discarded anyway. 2. Notify the pharmacy and request a new, unopened tube of ointment. 3. Have a second licensed nurse witness the waste and sign the chart. 4. Continue to squeeze the tube until a clear line of ointment has been discarded from the tip.

1

The nurse has just injected insulin subcutaneously into the client's abdomen. What action should the nurse take at this point? 1. Massage the site to encourage absorption. 2. Leave the needle embedded in the client's skin for 5 seconds after administration. 3. Remove the needle rapidly by pulling it quickly from the skin. 4. Cover the injection site with a pressure dressing for at least 15 minutes or until the bleb disappears.

2

The nurse is planning to administer medications to a new client. What is the nurse's greatest priority in administering these medications? 1. Be certain the medications are given within 15 minutes of the time they are scheduled. 2. Before giving the medications, know what the intended effects are for this client. 3. Assess the client's knowledge of the action of the medications. 4. Document the administration accurately so the reimbursement is correct.

2

The nurse is providing discharge teaching for a client who is being dismissed with prescriptions for a bronchodilator inhaler and a corticosteroid inhaler. What information should the nurse provide regarding the dosage schedule for these two medications? 1. Always use the corticosteroid inhaler first. 2. Use the bronchodilator first. 3. It makes no difference which inhaler is used first. 4. Use the inhalers on alternate days, not on the same day.

2

Upon aspirating a saline lock prior to administering intravenous medication, the nurse notes that there is no blood return. What nursing action should be taken? 1. Discontinue this infiltrated lock and restart another site for medication administration. 2. Slowly infuse 1 mL of saline into the lock, assessing for infiltration. 3. Reinsert the needle into the lock and aspirate using more pressure. 4. Pull the intravenous catheter out 1/8 inch and attempt aspiration.

2

The nurse is concerned that an older client will have difficulty self-administering medications when what is assessed? Standard Text: Select all that apply. 1. Eats several servings of fruits and vegetables each day. 2. Altered memory. 3. Decreased visual acuity. 4. Decreased manual dexterity. 5. Limits red meat in the diet.

2,3,4

A client has a new order for a medication that does not have a termination date. The nurse would place this medication order under which classification on the client's medication administration record? 1. Standing. 2. PRN. 3. STAT. 4. Single

3

he nurse is reviewing a new medication order for a client, and determines that the order is incomplete when which of the following is missing? Standard Text: Select all that apply. 1. Client's address. 2. Dispensing instructions for the pharmacist. 3. Name of the medication. 4. Dosage. 5. Route of administration

3,4,5

The nurse is preparing to administer eardrops to a 6-year-old client. What nursing action is correct? 1. Pull the earlobe down and back to straighten the ear canal. 2. Insert the tip of the applicator into the ear canal. 3. Put the eardrops in the refrigerator for 10 minutes prior to administration. 4. Press gently on the tragus of the ear a few times after administration.

4

The nurse is to administer four oral medications to the client via a nasogastric tube. One of the medications is a tablet that has been crushed, one is a capsule that has been opened and the powder removed, and two are supplied in liquid form. How should the nurse administer these medications? 1. Flush the tube, mix the crushed tablet and the capsule powder into the two liquids for administration, and follow by flushing the tube. 2. Mix the crushed tablet and capsule powder in warm water and administer. Flush the tube and administer the mixed liquids. 3. Flush the tube with the mixed liquids first, then administer the crushed tablet and capsule powder mixed in cold water. 4. Mix the crushed tablet and capsule powder individually in warm water. Administer each medication separately, flushing the tube before and after each administration.

4

While administering an intramuscular injection, the nurse notes blood return in the syringe barrel after aspirating. What action should the nurse take? 1. Pull the needle out 1/4 inch and inject the medication. 2. Inject the medication as planned. 3. Notify the physician immediately. 4. Discard the medication and start over.

4

While hospitalized, a client was receiving 15 ml of an oral medication three times a day. When providing discharge instructions, the nurse should teach the client to take how much of this medication at home? 1. 2 teaspoons. 2. 1 teaspoon. 3. 2 tablespoons. 4. 1 tablespoon

4