foundations final

A nurse should read the instructions stated on a vial container before reconstituting it and administering it to a client. Which instructions are stated on the label of a vial container? amount of diluent to be added type of needle to be used for withdrawal best site for administering the drug directions for administering the drug

amount of diluent to be added

The nurse is preparing a client newly prescribed digoxin for discharge. Which safety consideration should the nurse include in the client teaching? "Check your blood pressure daily." "Check your radial pulse before taking the medication each day." "Monitor your vitamin K intake." "Do not take the dose if your pulse is 80 beats/min or higher."

"Check your radial pulse before taking the medication each day."

A nurse is showing an older adult client the correct method of self-administering an insulin injection at home. Which statement best describes lipoatrophy and lipohypertrophy to the client? "Lipoatrophy and lipohypertrophy will not occur if you always inject the insulin in the same location." "Lipoatrophy and lipohypertrophy are conditions of the skin that can only occur when injecting insulin." "Lipoatrophy and lipohypertrophy are conditions of the fatty tissue that can occur from not rotating injection sites." "Lipoatrophy and lipohypertrophy are conditions of the muscle that can occur from not rotating injection sites."

"Lipoatrophy and lipohypertrophy are conditions of the fatty tissue that can occur from not rotating injection sites."

A client is newly prescribed a medication that must be taken on an empty stomach. Which statement by the nurse best describes why some medications should be taken before meals? "This is because decreased blood flow occurs after meals, which can affect the way your medicine works." "This is because your medication can cause nausea and that can affect the way it works." "This is because gastric acid is decreased after meals, which can affect the way your medicine works." "This is because food and some drinks can affect the way your medicine works."

"This is because food and some drinks can affect the way your medicine works."

A new prescription has been noted in the medical record for an adult client with chest pain to receive a medication that comes in the form of a transdermal patch. The nurse will consider which precaution(s) to ensure safety with this form of drug use? -Dispose of transdermal patches in the trash. -Apply patches at the same location for consistency. -Fold the patch in half before disposal. -Use a heating pad to increase absorption. -Monitor the client for early identification of adverse effects. -May cause injury with defibrillation. -Assess for fever prior to application. -Remove the patch prior to magnetic resonance imaging (MRI).

-Fold the patch in half before disposal. -Monitor the client for early identification of adverse effects. -May cause injury with defibrillation. -Assess for fever prior to application. -Remove the patch prior to magnetic resonance imaging (MRI).

A nurse is caring for a client who has been prescribed codeine, an opioid medication to relieve severe postoperative pain. Which responsibility does the nurse have to complete when handling opioid medications? Select all that apply. -Place the medication in the container with other prescribed medications. -Maintain an accurate account of the use of the medication. -Record each medication used from the stock supply. -Count each opioid medication at the change of each shift. -Place the medication with other medications on the nursing unit.

-Maintain an accurate account of the use of the medication. -Record each medication used from the stock supply. -Count each opioid medication at the change of each shift.

The nurse is providing education to a client on self-administration of insulin. When asking the client to demonstrate the skill, the nurse will stop the client to correct a knowledge deficit when which action(s) is observed? Select all that apply. -The client chooses a low-dose insulin syringe to administer 90 units of insulin. -The client injects insulin within 1 in (2.5 cm) of the belly button. -The client injects at a 90-degree angle into a 2-in (5-cm) fold of skin. -The client substitutes the insulin syringe with a subcutaneous syringe. -The client rotates around the abdomen injection site only.

-The client chooses a low-dose insulin syringe to administer 90 units of insulin. -The client injects insulin within 1 in (2.5 cm) of the belly button. -The client injects at a 90-degree angle into a 2-in (5-cm) fold of skin. -The client substitutes the insulin syringe with a subcutaneous syringe.

The nurse is reviewing the plan of care for several clients who have prescriptions for intravenous medications. The nurse understands that which client is at the highest risk for greater effect of the IV medication? 35-year-old client diagnosed with migraines 16-year-old client diagnosed with left radial fracture 45-year-old client diagnosed with lung cancer 73-year-old client diagnosed with liver disease

73-year-old client diagnosed with liver disease

Which medication interaction illustrates a synergism? A client was told not to take tretinoin topical if she is pregnant because it may be teratogenic. A client takes acetaminophen to help her sleep. She also takes an oxycodone for pain related to recent hip surgery, which makes her even more drowsy. A client is taking metoprolol for her blood pressure and metformin for her diabetes. Her provider has told her that these are safe to take together. A client is taking doxycycline, an antibiotic, for rosacea. She takes this with her morning vitamins, which includes calcium carbonate. She has not noticed a change in her symptoms.

A client takes acetaminophen to help her sleep. She also takes an oxycodone for pain related to recent hip surgery, which makes her even more drowsy.

The nurse is preparing medications and is notified that a health care provider is on the phone. What is the nurse's appropriate response? Ask another nurse to finish gathering medications and take the call. Speak to the provider while finishing medication preparation. Ask the unit clerk to take a message from the provider. Leave medication preparation and take the call.

Ask the unit clerk to take a message from the provider.

The client asks the nurse how to administer medication purchased over the counter for relief of arthritis pain. The nurse reviews the medication and determines that it is to be applied topically. Which instructions should the nurse provide? Using sterile gauze, apply to the affected area with gloves and cover with a bandage. Clean the area with alcohol and apply a quarter size of medication to the affected area. Apply a small amount of the medication to the affected area then repeat after initial dose has dried. Apply the medication to clean, dry skin of the affected area using gloves.

Apply the medication to clean, dry skin of the affected area using gloves.

A nurse is administering a hepatitis B shot intramuscularly. What would be the appropriate site for administration? Deltoid Ventrogluteal Scapula Vastus lateralis

Deltoid

A nurse needs to administer an intramuscular injection to a client. The site that the nurse has chosen contains the sciatic nerve. Which action should the nurse perform first to locate the appropriate landmarks and avoid damaging the sciatic nerve? Divide the buttock into four imaginary quadrants. Palpate the sciatic nerve before proceeding with the injection. Place one hand above the knee and the other at the top of the thigh. Palpate the lower edge of the acromion process.

Divide the buttock into four imaginary quadrants.

The health care provider has prescribed an enteric-coated naproxen for arthritic pain to a client who typically prefers a liquid or chewable medication. Which instruction should the nurse provide the client to ensure the medication is taken appropriately? Particles of the crushed medication can be inhaled causing respiratory irritation. Do not chew the medication as disrupting the enteric coating can cause irritation in the lining of the stomach. The potency of the medication will be increased due to early exposure to gastrointestinal acids if crushed or chewed. Crushing or chewing can cause the medication to be ineffective for pain relief.

Do not chew the medication as disrupting the enteric coating can cause irritation in the lining of the stomach.

During the discharge process the client states "I am confused about how to store my insulin." Which statement is the best response by the nurse? Extra vials insulin should be kept at room temperature, but the vial you are currently drawing from should be refrigerated. All insulin vials should be refrigerated. Extra vials of insulin should be kept in the refrigerator, but the vial you are currently drawing from should be kept at room temperature. All insulin vials should be kept at room temperature.

Extra vials of insulin should be kept in the refrigerator, but the vial you are currently drawing from should be kept at room temperature.

A nurse is administering medications through an enteral tube to a client with swallowing difficulties due to a cerebrovascular accident (CVA). Which action should the nurse perform to prevent gastric reflux? Help the client into a Fowler position. Check for drug allergies in the client's history. Add diluted medication to the syringe. Administer the medication over several minutes.

Help the client into a Fowler position.

The nurse is caring for a client who is taking nitroglycerin. Which client statement requires immediate nursing intervention? "I will apply this as frequently as prescribed." "I am taking tadalafil in addition to nitroglycerin." "I will wear gloves when applying this." "I understand that this drug may lower my blood pressure."

I am taking tadalafil in addition to nitroglycerin.

The nurse is preparing to administer prescribed intravenous antibiotics to a client. While assessing the medication lock, the nurse notes that there is resistance when administering the saline flush solution. What would be the best action by the nurse? Insert a new IV medication lock and remove the old one. Call the health care provider to request oral antibiotics. Flush the lock with heparin solution. Administer the prescribed antibiotics as prescribed.

Insert a new IV medication lock and remove the old one.

A nursing responsibility in managing IV therapy is to monitor the fluid infusions and to replace the fluid containers as needed. What is an accurate guideline for IV management that the nurse should consider? As one bag is infusing, the nurse should prepare the next bag so it is ready for a change when less than 10 mL of fluid remains in the original container. It is the responsibility of the nurse to provide ongoing verification of the IV solution and the infusion rate with the health care provider's order. The nurse should use new tubing when attaching additional IV solutions. Generally, the nurse should change the administration sets of simple IV solutions every 24 hours.

It is the responsibility of the nurse to provide ongoing verification of the IV solution and the infusion rate with the health care provider's order.

Which contains all the components of a valid order? John Smith, enoxaparin sodium 120 mg, subcutaneously, periumbilical John Smith, warfarin, once a day, by mouth John Smith, atenolol 50 mg, twice a day, by mouth John Smith, 70 units, b.i.d., SL

John Smith, atenolol 50 mg, twice a day, by mouth

A nurse preparing medication for a client is called away to an emergency. What should the nurse do? Have another nurse guard the preparations. Have another nurse finish preparing and administering the medications. Lock the medications in a cart and finish them upon return. Put the medications back in the containers

Lock the medications in a cart and finish them upon return.

In preparing to administer a drug to a client, the nurse has pierced a multi-use vial of medication. What is the appropriate nursing action? Send the vial with the remaining drug back to the pharmacy. Discard the remaining drug. Place the date on the vial and retain for future use. Draw up the remaining medication to give at the next time of administration.

Place the date on the vial and retain for future use.

The nurse administers the client's scheduled morning medications. The previous dose of antihypertensive was held due to a blood pressure that was too low according the health care provider's parameters. What does the nurse do with this upcoming dose of scheduled unit-dose packaged antihypertensive medication? Teach the client to use the call bell whenever getting out of bed. Set the antihypertensive dose aside pending assessment. Place the dose in the medication cup with other medications. Ask the client to report any dizziness and lightheadedness.

Set the antihypertensive dose aside pending assessment.

The client has continuous enteral feedings through a nasointestinal tube. The client has a thyroid medication that is to be taken on an empty stomach. What action does the nurse perform? Withhold the thyroid medication. Mix the medication in the tube feeding and administer the tube feeding and medication together. Ask the health care provider to prescribe bolus feedings. Stop the infusion for 30 minutes before and after administration of the thyroid medication.

Stop the infusion for 30 minutes before and after administration of the thyroid medication.

A health care provider who just arrived on the unit gives a verbal order to the nurse regarding a nonemergent client situation. What is the nurse's appropriate response? Input the order into the computerized provider order system. Tactfully request the provider to input the order into the computerized provider order system. Have another nurse witness and record the order into the medication administration record (MAR). Refuse to implement the order and notify the nurse manager.

Tactfully request the provider to input the order into the computerized provider order system.

A client is ordered to receive an intramuscular injection of medication. When preparing to administer the injection, the nurse selects the ventrogluteal site based on which reason? The area is free of major blood vessels and fat. The site is in close proximity to the sciatic nerve. The site lies close to the radial nerve. There is a high possibility of injecting into subcutaneous fat.

The area is free of major blood vessels and fat.

Which statement best describes the nurse's rationale for selecting the ventrogluteal site when using the Z-track technique for administering an injection? The ventrogluteal site provides a location with the capacity for depositing and absorbing the drug. The ventrogluteal site prevents tissue contact with the irritating drug. The ventrogluteal site determines whether or not the needle is in a blood vessel. The ventrogluteal site reduces the transmission of microorganisms.

The ventrogluteal site provides a location with the capacity for depositing and absorbing the drug.

The nurse has just finished injecting a medication intramuscularly, and needle is still in the client's arm. Which is the correct immediate next step? Withdraw the needle immediately Wait 10 seconds and then withdraw the needle Move the syringe slightly left and right to facilitate absorption of the medication Gently pull back on the syringe plunger and observe for blood in the syringe

Wait 10 seconds and then withdraw the needle

A health care provider at a health care facility suggests the use of a metered-dose inhaler for an asthmatic client. Which describes the mechanism of a metered-dose inhaler? a device that forces liquid drug through a narrow channel using pressurized air a propeller-driven device that spins and suspends a finely powdered medication a device that forces medication through a narrow channel with the help of inert gas a canister containing medication that is released when the container is compressed

a canister containing medication that is released when the container is compressed

A client has an intermittent infusion device inserted for the administration of antibiotic therapy every 6 hours. The nurse would expect to flush the device at which frequency? every 72 hours at least every 8 hours before and after each medication administration once daily

before and after each medication administration

A nurse is using an IV port when administering medication to a client. Which IV administration has the greatest potential to cause life-threatening changes? continuous administration electronic infusion device bolus administration secondary administration

bolus administration

Which client does the nurse recognize will require an intramuscular administration of the medication instead of an intravenous administration? client who is diagnosed as having sepsis and is prescribed antibiotic therapy client who is in the emergent phase of a 50% partial-thickness (second-degree) burn and requiring medication for pain client who is low risk for hemorrhage and prescribed the Hepatitis B vaccination client who is beginning treatment with chemotherapy following a diagnosis of ovarian cancer

client who is low risk for hemorrhage and prescribed the Hepatitis B vaccination

When administering heparin subcutaneously, the nurse should: gently massage the site. never aspirate. aspirate after the injection. aspirate before the injection.

never aspirate.

Which action describes buccal medication administration? placing a medication under the tongue and allowing it to dissolve placing a medication that is designed to be absorbed through the skin for systemic effects on the skin placing a medication underneath the upper lip or in the side of the mouth placing a medication through a nasogastric tube

placing a medication underneath the upper lip or in the side of the mouth

A nurse is using a volume-control set to administer a dose of prescribed medication to a client. The nurse opens the lower clamp until the tubing is filled with fluid and then reclamps it. Which of the following statements explains the nurse's action? removes colonizing microorganisms provides diluent for the medication purges air from the tubing mixes the drug throughout the fluid

purges air from the tubing

A hospital is in the process or replacing the current stock of conventional syringes and needles with new, redesigned models. What is the priority outcome that is sought by this change? reduction in nurses' risks of needlestick injuries increased accuracy of parenteral drug doses interchangeability of needles for subcutaneous and intramuscular injections reduction in clients' risks of nosocomial infections

reduction in nurses' risks of needlestick injuries

The nurse is preparing to apply nitroglycerin paste. After checking the prescription, washing hands, checking the client's identity, and applying gloves, what is the next nursing action? removing prior application and any remaining residue from the skin covering application paper with transparent semipermeable dressing squeezing prescribed amount of paste from tube onto application paper using wooden applicator to spread paste over the paper

removing prior application and any remaining residue from the skin

An acute care facility follows the unit dose supply method to supply medication to the clients. What is meant by the unit dose supply method? systems that contain frequently used medication for that unit self-contained packets that hold one tablet or capsule for individual clients a supply that remains on the nursing unit for use in an emergency a container with enough prescribed medications for several days for a client

self-contained packets that hold one tablet or capsule for individual clients

The nurse is caring for a client who has problems coordinating their breathing with the inhaler use. Therefore, the client is unable to receive the full dose. Which item will help maximize drug absorption in this client? spacer turbohaler nasal drops metered-dose inhaler

spacer

The nurse is preparing to administer nasal medication via a dropper to a client with severe congestion. Into which position will the nurse place the client? lithotomy prone supine oblique

supine

A hospital client has been experiencing agitation and has consequently been prescribed a one-time dose of lorazepam that is to be administered sublingually. The nurse knows that this route of administration will result in a rapid onset and peak because: the drug is rapidly absorbed by the rich blood supply under the tongue. saliva potentiates (increases) the therapeutic effect of the drug. the drug bypasses the effects of digestive enzymes. the drug is absorbed at a location that is close to the central nervous system.

the drug is rapidly absorbed by the rich blood supply under the tongue.

A nurse is bunching the tissue of a client when administering a subcutaneous injection to that client. What is the reason for bunching when injecting subcutaneously? to prevent needlestick injuries to avoid instilling medication within the muscle to ensure the accuracy of landmarking to facilitate blood circulation at the injection site

to avoid instilling medication within the muscle