Davis Edge Medication Patients (Chp 25)

The provider has prescribed Demerol 25 mg IM now. You have a prefilled syringe of Demerol 50 mg in a 1 mL volume. How many mL will be administered to the client?

0.5 mL 50x = 25x = 25 divided by 50x = 0.5 mL

The provider has prescribed Phenergan 18.75 mg to be administered IM now and q4-6hr prn for nausea. You have on hand Phenergan 25 mg/mL. How many mL should be drawn for this client?

0.75 mL 25 x = 18.75 x = 18.75 divided by 25 x = 0.75 mL

Place the procedural steps in order for administering otic solutions. 1. Assisting the client, have him or her lie on the side with ear facing up. 2. Clean the external ear with cotton tip swab. 3. Warm the otic solution bottle in hand. 4. Gently tug on the ear. 5. Place a cotton ball, or a piece of cotton, in the opening for approximately 15 minutes. 6. Straighten the ear canal as appropriate for age. 7. Fill the dropper with the appropriate amount of solution. 8. Instill the designated number of drops. 9. Instruct the client to remain on the side for approximately 5-10 minutes.

3. Warm the otic solution bottle in hand. 1. Assisting the client, have him or her lie on the side with ear facing up. 2. Clean the external ear with cotton tip swab. 7. Fill the dropper with the appropriate amount of solution. 6. Straighten the ear canal as appropriate for age. 8. Instill the designated number of drops. 4. Gently tug on the ear. 9. Instruct the client to remain on the side for approximately 5-10 minutes. 5. Place a cotton ball, or a piece of cotton, in the opening for approximately 15 minutes. First, warm the otic solution bottle in the hands. Assist the client with lying on the side with ear facing up. Clean the external ear with a cotton tip swab. Fill the dropper with an appropriate amount of solution. Straighten the ear canal as appropriate for the age of the client. Instill the designated number of drops. Gently tug on the ear to be sure the drops go into the ear. Instruct the client to remain on the side for approximately 5-10 minutes. Place a cotton ball, or a piece of cotton, in the opening for approximately 15 minutes.

The pediatrician has ordered Erythromycin 30 mg/kg of body weight for a 32-pound client. What is the correct dosage for this client?

437 mg Convert the weight to kilograms by dividing 32 by 2.2: the child weighs 14.55 kg. Multiply the prescribed dose (30 mg) by body weight (14.55 kg): 30 mg 14.55 = 436.5 mg; round up. 437 mg is the dosage for a 14.55-kg child.

A nurse has just completed inventory on the controlled substances on the unit, has completed necessary documentation, and locked the cabinet. He or she walks away, leaving the locked cabinet on the counter in an open workstation. What step has the nurse not completed? 1. Double-locking the controlled substances 2. Putting them inside a cabinet 3. Having a second witness sign the documentation 4. Passing keys to the locked cabinet to the next charge nurse

Answer 1 Option 1: All controlled substances must be double-locked (stored in locked drawers, in a second locked area) Option 2: Controlled substances can be put inside a cabinet, but they should be secured appropriately. Option 3: A second signature is not needed unless the facility requires it. Option 4: Inventory typically is conducted at the beginning of the shift, so passing keys off to another nurse is not needed.

Which are examples of parenteral administration of medication? Select all that apply. 1. Intramuscular 2. Intravascular 3. Inhaled 4. Oral suspension 5. Topical application

Answer 1, 2 Option 1: Intramuscular medications are injected into a muscle, which is parenteral administration. Option 2: Intravascular medications are injected into a vein, which is parenteral administration. Option 3: Inhaled medication is not injected and is not parenteral administration. Option 4: Oral suspension is not injected and is not parenteral medication. Option 5: Topical application of medication is not parenteral, as it is not injected.

The pediatrician has ordered erythromycin 20 mg/kg of body weight for a 55-pound client. The medication on hand is 250 mg tablets. How many tablets will be administered to this client?

Answer is 2 (DO NOT SAY TABLETS ON QUIZ AS IT WILL MARK IT WRONG... DUMB...) Convert weight to kg: 55 lb/2.2 kg = 25 kg Determine amount needed: 20 mg x 25 = 500 mg Determine how many tablets needed to get 500 mg: 500/250 = 2

Once the student nurse has researched the new antibiotic prescribed to treat the client's pneumonia, he or she feels more information is needed to plan nursing interventions based on side effects of the drug. What resource would be best suited to obtain this information? 1. Nursing drug handbook 2. The National Formulary 3. Physician's Desk Reference 4. A pharmacopoeia

Answer: 1 Option 1: A nursing drug handbook provides important information regarding the drug, how it is prescribed, side effects, and nursing interventions. Option 2: The formulary identifies the therapeutic value of drugs as well as their formulas and prescriptions, but may not be the best for nursing intervention recommendations. Option 3: While an excellent resource, the PDR contains information on dosing, routes of administration, and side effects, but does not include nursing interventions. Option 4: The Unites States Pharmacopoeia (USP) is a directory of drugs approved by the Food and Drug Administration (FDA) and includes a list of the physical and chemical composition of each drug.

A client has been prescribed an antibiotic that has side effects including nausea, vomiting, abdominal pain, and diarrhea. What nursing intervention would be appropriate for this client? 1. Instruct the client on side effects, what to report, and when. 2. Instruct the client on documenting bowel movements, consistency, and frequency. 3. Document that the client reports no nausea, vomiting, abdominal pain, or diarrhea. 4. State that the client will be free from side effects including nausea, vomiting, and diarrhea

Answer: 1 Option 1: As a primary nurse, the responsibility is to educate the client on possible side effects including what to look for, what to report to nursing staff, and when. Option 2: Having clients document bowel movements is not needed; if monitoring is needed, it should include the nursing staff. Option 3: Making statements regarding what has occurred is an evaluation. Option 4: Making a statement regarding what will or should happen is an outcome, not an intervention.

The student nurse is about to administer a rectal suppository to an older adult. What advice should the preceptor offer this student in regard to older clients and rectal suppositories? 1. Due to poor sphincter control, a bed pan should be used during the procedure. 2. Suppositories are only inserted ½ in. in older adults. 3. Suppositories may have to be pushed a little harder due to a tightened rectal sphincter. 4. The buttocks may need to be held together to ensure the suppository remains in place.

Answer: 1 Option 1: As older adults lose control over sphincter muscles, it is wise to use a bed pain while inserting the suppository in the event of loss of control. Option 2: In all adults, it is suggested to insert rectal suppositories 1 to 3 in. into the rectum, past the internal sphincter. Option 3: Suppositories should never be forced, as it could mean blockage due to fecal matter that will prevent absorption of medication. Option 4: Holding the buttocks together is suggested in pediatric clients, not for older clients.

Which describes the production of a fine spray, fog, powder, or mist from a liquid drug? 1. Reconstitution 2. Vaporization 3. Nebulization 4. Reformulation

Answer: 3 Option 1: Reconstitution refers to the mixing of two products to create a medication. Option 2: Vaporization is the release of liquid into the air. Option 3: Nebulization is fine particles of a liquid medication converted to an inhaled form. Option 4: Reformulation is the revision in formulating medication.

Which describes drugs with limited medical use and high potential for abuse or addiction? 1. Controlled substances 2. Prescription drugs 3. Narcotics 4. Placebo drugs

Answer: 1 Option 1: Controlled substances are available by prescription only and are used with caution. Option 2: Prescription drugs is a broad category of drugs only available with a medical order. Option 3: Narcotics are a category of potentially addictive drugs. They are, however, medically useful for pain control. Option 4: Placebo drugs have no effect and are given in some clinical trials. Their use is controversial and considered a violation of patient rights.

Why are lipid-soluble drugs used for sedation? 1. They can pass through the blood brain barrier. 2. They cannot be broken down by acids, preventing the medication from being diluted before it reaches the nervous system. 3. They release small amounts for absorption over several hours. 4. They are rapidly absorbed from the GI tract and take effect faster.

Answer: 1 Option 1: Due to the ability of fat-soluble drugs to attach to lipids, they can easily pass through the blood brain barrier and effect sedation. Option 2: Enteric-coated medication cannot be broken down by GI acids that prevent dilution before entering the intestines. Option 3: Time-released or sustained-release formulas release small amounts of the medication over a period of several hours, allowing for absorption over a longer period of time. Option 4: Water-soluble drugs are rapidly absorbed from the GI tract, which has a quicker effect.

A client presents to the emergency department with severe pain related to a kidney stone. In order to obtain adequate pain relief quickly, which is the most rapid and effective route to administer pain medications? 1. Intravenous 2. Intramuscular 3. Oral administration 4. Subcutaneous injection

Answer: 1 Option 1: Intravenous administration of medication directly injects the medication into the bloodstream, which has the fastest action. Option 2: Intramuscular injection must be absorbed into muscle tissue before being taken up by the bloodstream. This is not the fastest route. Option 3: Oral administration of medications must be processed through the stomach, and then absorbed into the bloodstream through the digestive tract. This is not the fastest route of administration. Option 4: Subcutaneous injections are absorbed into the soft tissues before being disbursed into the bloodstream.

To whom can a nurse delegate the administration of ophthalmic solutions? 1. LPN/LVN 2. NAP 3. PA 4. ANP

Answer: 1 Option 1: LPN/LVNs are authorized to administer ophthalmic solutions. Option 2: Nurses cannot delegate ophthalmic administration to NAPs, as it is not in their scope of practice. Option 3: A physician's assistant would not normally take direct orders from a charge or unit nurse. Option 4: Advanced nurse practitioners can delegate this responsibility, but they are typically not taking direct orders from a charge or unit nurse.

A client is brought into the emergency department in shock due to a trauma. What method would be the most effective route for administering emergency medications? 1. Intravenously 2. Intramuscularly 3. Sublingually 4. Orally

Answer: 1 Option 1: Shock reduces peripheral circulation, so administering medication directly into the bloodstream is the best method. Option 2: As peripheral circulation is reduced in shock, administering medications intramuscularly would not be effective. Option 3: Not all medications can be administered sublingually, so this would not be an effective method. Option 4: Oral medications take longer to take effect and therefore would not be the best method.

What is the benefit of using an automated dispensing system? 1. Allows for immediate availability and administration of newly prescribed and prn medications 2. Promotes independence and allows evaluation of a client's ability to manage medications safely and accurately before discharge 3. Saves nursing time and is the safest method 4. Automatic inventory of all unit medications

Answer: 1 Option 1: The computer database contains prescriptions, records, and counts of the medications for each client on the unit which allows for immediate availability of medications. Option 2: Self-administering of medications is the method that promotes independence and also gives the nurse an opportunity to evaluate for ability to self-medicate at home. Option 3: The safest method is the unit-dose method, as it involves a double-check system. Option 4: While an automated system keeps track of a client's medication and what is held within the system, this is not specifically a benefit.

Which is the usual dosing method of drugs for pediatric clients? 1. Milligrams per kilogram of body weight 2. Ounces per pound of body weight 3. Milligrams per pound of body weight 4. Ounces per kilogram of body weight

Answer: 1 Option 1: The metric system is used for calculating drug dosages for pediatric clients. Option 2: Ounces and pounds are part of the apothecary system and are not used for pediatric dosing. Option 3: Milligrams is metric and pounds is apothecary. Two different methods should not be used in drug calculation. Option 4: Ounces is apothecary and kilogram is metric; this combination should not be used to calculate dosage.

The nursing outcome for a client with a nursing diagnosis of Risk for constipation r/t analgesic is as follows: Client will not experience constipation as evidenced by usual frequency of bowel movements; passage of soft, formed stool. Constipation is a common side effect of analgesics, so what is an appropriate nursing intervention to help address this? Select all that apply. 1. Instruct the client to increase intake of foods high in fiber. 2. Instruct the client to maintain a minimum fluid intake of 2,500 mL/day unless contraindicated. 3. Administer laxatives or cathartics and/or enemas if ordered. 4. Report a pattern of decreasing bowel sounds. 5. Expect an absence of abdominal distention and pain.

Answer: 1, 2, 3 Option 1: By teaching the client to increase intake of fiber, he or she can deal with possible side effects of constipation easier. Option 2: Increasing fluid intake will help minimize risk for the side effect of constipation. Option 3: If needed, laxatives or enemas can be used to relieve constipation. Option 4: Intervention of bowel sounds is not indicated by the nursing diagnosis and outcome. Option 5: Making a statement of what should or will occur is an outcome, not an intervention.

A client is scheduled for an annual PPD for work. What considerations should the nurse be aware of before administering this test? Select all that apply. 1. Pregnancy 2. Previous skin reaction 3. Use of topical anesthetic 4. Fever 5. Use of an antihistamine within past 4 hours

Answer: 1, 2, 3 Option 1: If client is pregnant, PPD should be deferred and the provider alerted. Option 2: Depending on the type of reaction, further testing may be needed and the provider should be informed. Option 3: If the client has used a topical anesthetic in the location, the test should be conducted on the other arm or rescheduled. Option 4: Fever is always a consideration in any type of medication administration but typically does not affect PPD testing. Option 5: Use of an antihistamine does not have any contraindications for the testing of PPD.

Which are safety challenges related to medication self-administration in older adults? Select all that apply. 1. Opening medication containers 2. Remembering to take medications 3. Visualizing labels for correct dosing 4. Asking doctors for medications 5. Thinking medications are not needed

Answer: 1, 2, 3 Option 1: Medications for elderly adults should be provided in easy-to-open bottles. Option 2: An elderly person who has dementia may forget to take medications or forget that he or she has already taken a medication. Option 3: Elderly clients who have trouble seeing may not be able to accurately read a medication label. Option 4: Difficulty asking for medications is not associated with the elderly. Option 5: Thinking medications are not needed is not a consideration unique to the elderly.

A client has a medication, metoprolol (Lopressor), due at 0800, and the student nurse is not familiar with this medication. What information should be researched before giving this medication? Select all that apply. 1. Classification of drug 2. The use of the medication 3. Body system affected 4. All trade names 5. Chemical name

Answer: 1, 2, 3 Option 1: The classification of the drug is important in understanding how and why this medication is used. Option 2: Why the medication is prescribed is important to understand prior to administering. Option 3: The body system the medication will affect is important information. Option 4: It is not necessary to research all trade and brand names of medications for a specific client and medication. Option 5: The chemical name is not particularly important if the nurse has researched the drug classification.

What conditions are contraindicated in rectal suppository administration? Select all that apply. 1. Recent rectal surgery 2. Rectal bleeding 3. Cardiac disease 4. Hemorrhoids 5. Irritation

Answer: 1, 2, 3 Option 1: When a client has recently had rectal surgery, there may be issues with effectively administering rectal suppositories. Option 2: Rectal bleeding could indicate disease or other issues that could prevent effective medication absorption and administration. Option 3: The use of glycerin in clients with heart disease can cause irregular heart rates and other cardiovascular dysfunction. Option 4: Hemorrhoids are not considered a contraindication. Option 5: Irritation may make administration uncomfortable but is not considered a contraindication.

When preparing to administer an otic solution to a client, what should the nurse assess the client for? Select all that apply. 1. Redness 2. Cerumen 3. Drainage 4. Ear pain 5. Fever

Answer: 1, 2, 3, 4 Option 1: Erythema should be noted both inside and outside of the ear canal. Option 2: Wax buildup should be taken care of prior to administering medications. Option 3: Drainage should be noted, (color and amount) and may possibly need to be irrigated prior to administering medication in the ear. Option 4: Any ear pain the client is experiencing should be noted, and the provider will determine if the nurse is to proceed. Option 5: The client's temperature should be taken, but this is not a needed assessment directly related to administering ear medications.

How are medications detoxified from the body? Select all that apply. 1. Kidneys 2. Blood plasma 3. Intestinal mucosa 4. Lungs 5. Large intestine

Answer: 1, 2, 3, 4 Option 1: Kidneys filter and work to excrete waste, so metabolized medications from the liver can be removed here. Option 2: Blood plasma carries waste to be filtered and excreted, so metabolized medications from the liver can be removed here. Option 3: Intestinal mucosa has the ability to absorb metabolized waste from medication and transfer it to be carried for excretion. Option 4: The lungs act as a method of removing waste from the body, and metabolized medication waste can be removed this way as well. Option 5: The large intestine absorbs water but is not a viable manner for detoxifying medications from the body.

A nurse is scheduled to administer the following drugs to the client: (1) insulin subcutaneously for diabetes, and (2) morphine intravenously to relieve pain. What factors should be considered that will affect the pharmacokinetics of the drugs when administering these medications? Select all that apply. 1. Body mass 2. Gender 3. Pregnancy 4. Time of administration 5. Therapeutic effect 6. Location

Answer: 1, 2, 3, 4, Option 1: Medication dosage is based on an "average" weight for adults of 150 lbs, so anything over or under must be recalculated. Option 2: Men and women absorb medications differently due to differences in muscle mass, hormones, and fat distribution. Option 3: Pregnancy must be considered due to the teratogenic effect of some medications. Option 4: Time of administration must be considered, as some medications should be taken on an empty stomach, full stomach, and so forth. Option 5: The therapeutic effect is a factor of pharmacodynamics, not pharmacokinetics. Option 6: Route of administration is a factor; however, location is not a factor in pharmacokinetics.

Which are classification systems for drugs? Select all that apply. 1. Usage 2. How supplied 3. Body system 4. Chemical or pharmacological class 5. Manufacturer

Answer: 1, 3, 4 Option 1: Why the drug is used is a type of classification. Option 2: The form of the drug is not a classification system for drugs. Option 3: Drugs are classified according to the body system on which they act. Option 4: Drugs are classified by the class of chemical compound used. Option 5: Drugs are not classified by manufacturer.

Which would be an appropriate technique and preparation for administration of subcutaneous injection in a morbidly obese person? Select all that apply. 1. 25- to 27-gauge needle 2. 18- to 20-gauge needle 3. Inject substance at a 45-degree angle 4. Inject at a 90-degree angle 5. Pull skin taut when administering

Answer: 1, 4, 5 Option 1: A small-gauge needle is appropriate for subcutaneous injection. Option 2: These needle gauges are too large for subcutaneous injection. Option 3: A 45-degree angle is too superficial in an obese person. Option 4: Injection into subcutaneous tissue should be performed at a 90-degree angle in obese clients. Option 5: Pull skin taut rather than pinching when performing a subcutaneous injection in obese clients.

Which are sources of discomfort associated with injections? Select all that apply. 1. The needle itself 2. Anxiety of the client 3. Movement of the client 4. Chemical irritation caused by certain drugs 5. Pressure of the volume of medication in the tissue

Answer: 1, 4, 5 Option 1: The sharp needle going through skin may cause momentary discomfort. Option 2: Client anxiety may increase the anticipation of discomfort, but it is not a cause of actual discomfort. Option 3: Movement of the client is rarely a case of discomfort. Option 4: Chemicals used in the constitution of drugs can cause irritation of tissues. Option 5: The volume of the drug injected into the tissues can cause local discomfort.

Which characteristics of a drug are part of pharmacokinetics? Select all that apply. 1. Absorption 2. Packaging 3. Dosage 4. Distribution 5. Excretion

Answer: 1, 4, 5 Option 1: This describes the movement of a drug from the site of administration into the bloodstream. Option 2: Packaging is not part of drug pharmacokinetics. Option 3: Dosage is not part of a drug's pharmacokinetics. Option 4: Distribution describes the movement of a drug in the body. Option 5: Excretion describes how a drug is processed and eliminated from the body.

Which are examples of the "rights of medication" administration? Select all that apply. 1. Right client 2. Right room 3. Right nurse assigned to administer 4. Right dose 5. Right time 6. Right route

Answer: 1, 4, 5, 6 Option 1: Making sure the right client is getting the medication is part of the five rights of medication administration. Option 2: The room number should not be used as part of identifying a client in safe medication administration. Option 3: The nurse assigned to the client is not part of the five rights of medication administration. Option 4: The right dose of medication is part of the five rights of medication administration. Option 5: Right time of administration is an important part of safe medication administration. Option 6: The route of administration is part of the five rights of medication administration.

Advil is an example of which type of drug name? 1. Generic name 2. Brand name 3. Official name 4. Chemical name

Answer: 2 Option 1: Advil is not a generic name; the generic name for Advil is ibuprofen. Option 2: Advil is a brand name for the generic drug ibuprofen. Option 3: The official name is the same as the generic name. Option 4: The chemical name is the drug's chemical composition and molecular structure contained in the medication.

Which is the correct meaning of the abbreviation IVPB? 1. Drop 2. Intravenous piggyback 3. Keep vein open 4. Teaspoon

Answer: 2 Option 1: Drop is the meaning of the abbreviation gtt. Option 2: Intravenous piggyback is the meaning of the abbreviation IVPB. Option 3: Keep vein open is the meaning of the abbreviation KVO. Option 4: Teaspoon is the meaning of the abbreviation tsp.

A student nurse is assigned to a client with a medical diagnosis of pneumonia who has been prescribed Levaquin. What is the generic name of this medication? 1. Fluoroquinolone 2. Levofloxacin 3. (-)-(S)-9-fluoro-2,3-dihydro-3-methyl-10-(4-methyl-1-piperazinyl)-7-oxo-7H-pyrido[1,2,3-de]-1,4-benzoxazine-6-carboxylic acid hemihydrate 4. Levaquin oral solution

Answer: 2 Option 1: Fluoroquinolone is the drug class of levofloxacin, not the chemical name. Option 2: The generic name of Levaquin is levofloxacin. Option 3: The chemical name of Levaquin is denoted by a combination of letters, symbols, and numbers. Option 4: Levaquin is the trade or brand name and oral solution is the form in which it is available.

A nurse is caring for a client who has a nasogastric tube set to low intermittent suction. She has an order to administer a liquid medication through the tube. Which action should the nurse take prior to administration of the medication? 1. Increase the suction on the NG tube to empty the stomach. 2. Turn suction off on the NG tube and leave off for 30 minutes. 3. Turn suction off but return to low intermittent suction immediately after medication administration. 4. Leave the NG tube at low intermittent suction so that the medication is absorbed quickly.

Answer: 2 Option 1: NG tube suction should not be increased at any point when giving medication. Option 2: Turning the NG tube suction off and leaving off for 30 minutes will ensure the medication has gone through the stomach. Option 3: The suction must be off for at least 30 minutes after medication administration to pass through the stomach. Option 4: The NG tube should be turned off when administering medication. Leaving it on suction will result in the medication being aspirated out of the stomach.

Which can result as an increased response to repeated doses of a drug that occurs when the rate of administration is greater than the rate of metabolism and excretion? 1. Pharmaceutical effect 2. Cumulative effect 3. Side effect 4. Adverse effect

Answer: 2 Option 1: The pharmaceutical effect is the expected action of the drug on the body. Option 2: The cumulative effect occurs when a drug is administered in repeated doses and is not metabolized quickly. Option 3: A side effect is an unintended effect of a drug on a body. Option 4: An adverse effect is a negative, unintended effect of a drug on a body.

Which action describes the period when the concentration of medicine is highest in the blood? 1. Onset of action 2. Peak action 3. Duration of action 4. Therapeutic range

Answer: 2 Option 1: This is when levels are high enough in the bloodstream for effects to begin. Option 2: Peak action is when the concentration of medicine is highest in the blood. Option 3: This is the period of time in which the medication has a pharmacological effect. Option 4: The therapeutic range is the range of time of therapeutic concentration.

Which organ is the primary site for drug metabolism? 1. Kidneys 2. Bladder 3. Liver 4. Stomach

Answer: 3 Option 1: Kidneys filter any additional waste product from drugs, but are not the primary organs of metabolism. Option 2: The bladder stores urine until it can be passed from the body. It is not a site of metabolism. Option 3: The liver is the primary site of metabolism of drugs in the body. Option 4: The stomach holds drugs and other foods and ingested products, but it is not an organ of metabolism.

Which describes medications that are given through injection into tissues or the bloodstream? 1. Reconstituted administration 2. Syringe administration 3. Parenteral administration 4. Metered dose administration

Answer: 3 Option 1: Many injectable drugs are reconstituted prior to administration, but this is not a description of these drugs. Option 2: Injectable drugs are given through a syringe, but this is not a description of these drugs. Option 3: Drugs that are administered through injection into the tissues or bloodstream are given through parenteral administration. Option 4: Metered dose administration is a method of administering an inhaled medication.

Which describes the prescribed amount of drug a client receives at a single time? 1. Multidose 2. Divided dose 3. Unit dose 4. Adjusted dose

Answer: 3 Option 1: Multidose vials contain multiple doses of medications. These should only be kept in areas used for preparation of medications, such as hospital pharmacies. Option 2: A divided dose is a dose that is given in smaller increments over a period of time. Option 3: A unit dose is the prescribed amount of drug to be given at a single time. Option 4: An adjusted dose is a dose of medication that has been changed to accommodate an individual need.

A nurse is preparing oral medications. A client is concerned that the blood pressure pill is a different color than the one he or she takes at home. How should the nurse respond? 1. Return the medication to the pharmacy, as it is the wrong medication. 2. Reassure the client that this is what the doctor has prescribed. 3. Check the label and dosage and confirm that the medication and dosage is correct. Reassure the client that this is a different manufacturer. 4. Ask the client to bring his medications from home and he can take those.

Answer: 3 Option 1: The medication should be questioned and verified, but this should be done by the nurse. The medication is likely a different brand. Option 2: Reassurance without validation is not safe. The nurse should check the medication and ensure the appropriate medication is being given. Option 3: The nurse should confirm the medication dosage and use the five rights to verify the correct medication. If this is the correct medication, reassure the client that it is a different brand, but the same medication. Option 4: Clients should only bring medications from home under special circumstances, such as the hospital does not stock their usual medications.

Which describes restorative effects of drugs? 1. Relieves signs and symptoms of disease but does not provide treatment for the disease itself 2. Destroys disease-causing microorganisms or body cells 3. Returns or maintains the body at optimal health 4. Supports the integrity of other body functions until other medicines or treatments are effective

Answer: 3 Option 1: This describes palliative effects. Option 2: This describes chemotherapeutic effects. Option 3: This correctly describes restorative effects. Option 4: This describes supportive effects.

Which is a safe volume of medication to be administered through the subcutaneous route? 1. 3 to 5 mL 2. 2 to 4 mL 3. 0.5 to 1 mL 4. 1.5 to 3 mL

Answer: 3 Option 1: This is too large a volume to be injected into subcutaneous tissues. Option 2: This is too large a volume to be injected into subcutaneous tissues. Option 3: Only small amounts of medication should be injected into subcutaneous tissues. Option 4: This is too large a volume to be injected into subcutaneous tissues.

Which is the primary danger when administering oral medications to children? 1. Giving the wrong dose 2. The child not responding as expected to the drug 3. Incorrect client identification 4. Choking and aspiration

Answer: 4 Option 1: If pediatric dosages are calculated correctly, dosage should be correct. Option 2: Children may respond differently to medications than adults, but this is not the primary danger. Option 3: Incorrect client identification should be avoided in all medication administration. Option 4: Children who may be unable or unwilling to swallow medications are at risk of choking.

A nurse is drawing up a medication through a syringe from a single-use vial. After the prescribed amount is drawn up, there is still approximately 5 mL of solution in the vial. Which action should the nurse take? 1. Draw up the remaining medication and administer to the client. 2. Place the vial in the medication room in case another nurse needs it for another client. 3. Place it in his or her pocket in case it is needed later. 4. Discard the remaining medication.

Answer: 4 Option 1: If the prescribed amount has been drawn up, additional volume of the medication should not be added. Option 2: Single-use vials should not be left for use on another client. Option 3: Single-use vials should not be used at different times or for more than one use. Option 4: The remaining volume of medication should be discarded.

Morphine 8 mg q3-4hr IM has been ordered for a client, and the nurse is monitoring to see if the client needs a PCA pump. Knowing that the half-life of morphine is 3 hours, if administered at 0800, what amount will be left in the body at the client's next dosage administration (1100)?

Answer: 4 mg Correct Feedback If the half-life of the drug is 3 hours, the client's next dosage in 3 hours would be ½ the original amount administered. 8 mg / 2 = 4 mg

When checking the medication administration record, the nurse notices it is time to prepare the next dose of antibiotics for IV administration. The nurse also notices the client received morphine for pain 1 hour ago. When you enter the room, you find the client sleeping and are unable to waken him or her to verify the need to proceed. What can be inferred from what is observed? 1. Possible adverse reaction 2. Toxic reaction 3. Allergic reaction 4. Idiosyncratic response

Answer: 8 Option 1: Adverse reactions and drug sensitivity can cause a reaction to the effects of the drug. Option 2: With morphine, a toxic reaction would be noted by depressed respiratory rate and depth. Option 3: Allergic reactions are an immune system response causing minor to severe manifestations ranging from urticaria to anaphylaxis. Option 4: Idiosyncratic responses are an abnormal reaction or response to a medication that is typically denoted by a lack of response or an opposing response.

The oncologist has prescribed Herceptin 4 mg/kg IV infusion over the next 90 minutes to a client weighing 114 lbs. After reconstituting. you have a multi-dose solution containing 21 mg/mL. How many mL should the nurse administer to the client?

Answer: 9.87 mL (DO NOT ROUND ON THIS ONE) The dose is weight-based. You need to determine the desired dose and then plug it into the formula Dose on HandQuantity on Hand=Desire DoseQuantity DesiredDose on HandQuantity on Hand=Desire DoseQuantity Desired Convert weight from lbs to kg: 114/2.2 = 51.8 kg Multiply dosage by weight to get amount to be administered: 4 mg x 51.8 = 207.2 mg Set-up your problem 21 mg1 mL=207.2x21 mg1 mL=207.2x Cross multiply and then divide to get amount to be administered (quantity desired) (9.87mL).