NUR 110 Taylor Chapter 28 - Medications

The nurse is caring for a client with a yeast infection. Which medication does the nurse anticipate will be prescribed? timolol bisacodyl oxymetazoline miconazole

miconazole The nurse anticipates that miconazole, a vagina cream, will be prescribed for a yeast infection. Oxymetazoline is a nasal decongestant used to alleviate congestion; bisacodyl is a rectal suppository used for softening stool; timolol is an eye drop used to treat glaucoma.

The nurse is caring for a client with diabetes. Which client statement reflects that nursing teaching has been effective? "I will eat a meal within a half hour of taking my morning insulin." "I will eat meals whenever I feel hungry." "I will drink orange juice if I experience high blood glucose levels." "I will test my blood glucose levels immediately after I eat."

"I will eat a meal within a half hour of taking my morning insulin." Teaching has been effective when the client recognizes that a meal should be consumed within a half hour of taking morning insulin. Further teaching is needed so the client knows that orange juice should be consumed when experiencing low blood glucose levels; that blood glucose levels should be tested before and 2 hours after meals; and that meals should be consumed three times daily (with appropriate snacks in between) at approximately the same time day to day.

Nurse A is having difficulty logging into the automated medication-dispensing system, and asks Nurse B to log in momentarily so that Nurse A is not delayed in administering client medications. What is Nurse B's appropriate response? "I can log in and give the medications for you." "I will get the hospital's information systems' phone number for you." "I will log in so that you can proceed with medication delivery." "I am giving you my password so you can log in."

"I will get the hospital's information systems' phone number for you." Passwords and logins should never be shared with anyone else, nor should a nurse use his or her own password or login information to allow another individual to access the automated medication-dispensing system. Nurse B will not log in and give the medications, but rather will provide a solution by offering contact information for information systems to Nurse A so that he or she can work through their login issue.

A client who has been prescribed an inhaler points to the spacer and asks, "What is this for?" What is the appropriate nursing response? "This is to decrease the amount of drug that you receive." "You will receive the medication faster as it goes through this device." "It makes the inhaler easier to hold in case you have arthritis." "Medication stays in the chamber so you can continue to inhale it."

"Medication stays in the chamber so you can continue to inhale it." A spacer provides a reservoir for aerosol medication. The client can take additional breaths (after the initial breath) to continue inhaling the medication held in the reservoir. The spacer does not decrease the amount of medication received, make the medication move faster, nor serve as a holding device.

The nurse is teaching a client about indomethacin SR (Indocin SR). When the client asks, "What does the SR mean?" what is the appropriate nursing response? "Sustained action." "Sustained release." "Extended release." "Continuous release."

"Sustained release." The nurse will clarify that SR means "sustained release." XR means "extended release;" CR means "continuous release;" SA means "sustained action."

A client with gastritis who is taking aspirin for cardiovascular prophylaxis asks the nurse whether there is benefit in buying the enteric-coated product. What is the appropriate nursing response? "The enteric coating will protect your stomach." "Enteric coated products are significantly more expensive." "There is no difference between the enteric-coated product and the regular one." "That is the only way that aspirin is sold."

"The enteric coating will protect your stomach." An enteric coating serve to protect the stomach from irritants. Other answers are incorrect.

A client is taking numerous eye drops to prepare for cataract surgery. Which teaching about ophthalmic application will the nurse provide? "Wait 5 minutes between instillation of different types of eye drops." "If you cannot instill these drops from the bottle, you will be unable to have surgery." "Dispose of these medications every 7 days due to possible bacterial contamination." "Rest the eye dropper on the inner canthus to make it easier to instill the drops."

"Wait 5 minutes between instillation of different types of eye drops." The nurse will teach the patient to wait 5 minutes between instillation of different types of eye drops to facilitate best absorption. The dropper should not touch the eye, as this increases the possibility of contamination. Devices are available to facilitate administration, if a client has trouble using the bottle. These types of drugs should be discarded after 28 days to prevent bacterial contamination.

When the client demonstrates a rash 30 minutes after taking a dose of penicillin, the nurse recognizes that the client is likely demonstrating which type of drug reaction? Allergy Idiosyncratic Antagonistic Anaphylaxis

Allergy Allergic reactions result from an immunologic response to a substance to which the client is sensitized.

A nurse at the health care facility needs to administer an otic application for a client with an earache. What should the nurse do after instilling the prescribed eardrops in the client's ear? Place a cotton ball in the ear to absorb excess medication. Instill the medication in the opposite ear if prescribed. Ask the client to maintain the position for some time. Briefly postpone the application in the second ear.

Ask the client to maintain the position for some time. After instilling the prescribed number of drops in the client's ear, the nurse should ask the client to maintain the position briefly until the solution travels toward the eardrum. When instilling the medication in the client's ear, the nurse first manipulates the client's ear to straighten the auditory canal. Tilting the client's head away, the nurse then administers the prescribed number of drops of medication. The client remains in this position briefly as the solution travels toward the eardrum. The nurse then places a cotton ball loosely in the ear to absorb the excess medication. The nurse then waits for at least 15 minutes before administering the medication in the opposite ear if prescribed. Briefly postponing the application within the second ear avoids displacing the initially instilled medication when repositioning the client.

The nurse has inadvertently administered medication ordered for Client A to Client B. What is the appropriate nursing action? Select all that apply. Assess Client B thoroughly. Complete an incident report. Do nothing, as long as Client B has no reaction. Contact the provider to report the error. Tell Client A that the wrong drugs were given to Client B.

Assess Client B thoroughly. Complete an incident report. Contact the provider to report the error. The nurse will assess and monitor Client B, complete an incident report, and notify the provider in case other orders may need to be given. It is ethically and legally inappropriate to refrain from taking action. Telling Client A about the error violates HIPAA.

What factor is used to calculate drug dosages for a child? Age Developmental level Ethnicity Body surface area (BSA)

Body surface area (BSA) Pediatric doses are calculated according to the child's weight or BSA. The BSA formula provides the most accuracy in calculating pediatric dosages because it considers both weight and height.

The nurse is preparing to give medications to a client with anxiety. The order indicates that the client is to have bupropion, 7.5 mg by mouth twice daily. What is the appropriate nursing action? Assume that provider meant to order buspirone. Contact health care provider for order clarification. Ask another nurse to verify the order. Administer drug as ordered.

Contact health care provider for order clarification. The nurse should contact the health care provider to verify the order. Bupropion and buspirone are drugs that have look-alike and sound-alike properties, but are different in indication. The nurse should not automatically administer the drug, nor ask another nurse to verify an order, nor assume what is meant by an order.

The nurse is preparing to give medications to a client with high blood pressure. The order indicates that the client is to have Adderal, 40 mg by mouth twice daily. What is the appropriate nursing action? Assume that provider meant to order inderal. Administer the drug as ordered. Contact the health care provider for order clarification. Ask another nurse to verify the order.

Contact the health care provider for order clarification. Before administering the medication, the nurse should immediately contact the health care provider to verify the order; no one else can verify the order. Adderal and inderal are drugs that have look-alike and sound-alike properties, but are very different in indication and dosage.

The nurse is assessing a client with diabetes who has poor vision. Which feature of the insulin pen makes it beneficial for this client? The insulin pen is easily transported on the client. It is easier to learn how to use an insulin pen than a syringe and vial. Each unit of insulin is accompanied by a clicking sound in the pen. With an insulin pen, a large variety of insulin types are available.

Each unit of insulin is accompanied by a clicking sound in the pen. Each unit of insulin is accompanied by a clicking sound in the pen. This is a beneficial feature for the client who has poor vision, as the sound will alert the client to count when selecting the prescribed dose. Being easily transported, being easier to learn, and having a variety of types available are all advantages for using insulin pens, but they do speak specifically to this client.

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? Check for drug allergies in the client's history. Help the client into a Fowler's position. Administer the medication over several minutes. Add diluted medication to the syringe.

Help the client into a Fowler's position. Assuming Fowler's position can help prevent gastric reflux when medications are administered through an enteral tube. The nurse checks the client's medical history for drug allergies to avoid potential complications. Adding diluted medication to the syringe as it becomes nearly empty prevents instilling air into the syringe. Administering the medication over several minutes has no effect on reflux.

A nurse preparing medication for a client is called away to an emergency. What should the nurse do? 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. Have another nurse guard the preparations.

Lock the medications in a cart and finish them upon return. Once medications have been prepared the nurse must either stay with the medications or lock them in an area such as the medication cart. The medications should never be left unattended or placed back in their containers. Another nurse cannot administer medications that have been prepared by the first nurse.

A nurse has to administer a subcutaneous injection to a client. For which client can the nurse administer a subcutaneous injection at a 90-degree angle? Obese clients Children Infants Thin clients

Obese clients The nurse inserts the needle at a 90-degree angle to reach the subcutaneous tissue in a normal-size or obese client who has a 2-inch (5 cm) tissue fold when it is bunched. For thin clients who have a 1-inch (2.5 cm) fold of tissue, the nurse inserts the needle at a 45-degree angle. Bunching is preferred for infants, most children, and thin adults.

The nurse is providing discharge teaching about multiple medications to a client with mild dementia. Which nursing intervention is appropriate? Select all that apply. Obtain referral for skilled nursing visits at home. Teach family members about medication administration. Recommend use of a medication dispenser. Tell client that taking medication is a personal responsibility. Refrain from teaching client since information will not be retained.

Obtain referral for skilled nursing visits at home. Teach family members about medication administration. Recommend use of a medication dispenser. Skilled nursing visits at home can be helpful in dispensing medications and assessing adherence. Family members can assist with this process, as well. A medication dispenser can help the client organize medications. Telling the client that taking medication is a personal responsibility is nontherapeutic and may invoke extra stress which leads to further confusion. The nurse should continue to include the client in teaching at this stage of dementia.

The nurse is preparing to administer an oral medication to a client with xerostomia. Which nursing action is appropriate? Call the provider to change the order to the intramuscular route. Offer a sip of water before administering medication. Refuse to give the medication due to safety reasons. Administer the medication as usual and document.

Offer a sip of water before administering medication. Xerostomia, a condition of dry mouth, affects some older adults and clients taking certain kinds of medications. To prevent oral medications from sticking to the tongue, administer with a sip of water prior to taking the drug, or mix with a soft food such as applesauce. Other answers are incorrect.

Which route of medication administration is most commonly prescribed? Oral Topical Subcutaneous Intravenous

Oral Oral administration is the most commonly used route of administration. It is usually the route most convenient and comfortable for the client.

What is the name of the process by which a drug moves through the body and is eventually eliminated? Pharmacokinetics Pharmacodynamics Pharmacotherapeutics Pharmacology

Pharmacokinetics Pharmacokinetics is the process by which a drug moves through the body and is eventually eliminated.

The nurse has received a telephone order for a client from a health care provider. How will the nurse indicate in the documentation that the order was received via telephone? Tell the provider to sign the order as soon as possible. No extra documentation is necessary. Record "T.O." at the end of the order. Have another nurse cosign the order input.

Record "T.O." at the end of the order. Recording "T.O." at the end of the order indicates that this was a telephone order. Another nurse should not cosign. Reminding the provider to sign the order as soon as possible is helpful, but does not indicate that this was a telephone order.

While administering a medication via a syringe, a client sharply moves and the nurse accidentally encounters a needlestick. What is the priority nursing action? Request counseling on the potential for infection. Document the injury. Report the needlestick to the nurse manager. Obtain client's blood to be tested for HIV and HBV.

Report the needlestick to the nurse manager. Upon encountering a needlestick, the nurse's priority action is to report the injury. Other actions can take place after the injury has been reported.

A client has been prescribed nasal medication. What care should the nurse take to avoid potential complications due to the administration of this medication? Allow sufficient time to prepare the medication with minimal distraction. Read and compare labels on the medication with the medical record. Review the client's medication, allergy, and medical history. Administer medication within 30 to 60 minutes of the scheduled time.

Review the client's medication, allergy, and medical history. To avoid any potential complications, the nurse should review the client's medication, allergy, and medical history. The nurse should read and compare the label on the medication with the medical record at least 3 times (before, during, and after preparing the medication) to ensure that the right medication is given at the right time by the right route. Administering the medication within 30 to 60 minutes of the scheduled time demonstrates timely administration and compliance with the medical order. Allowing sufficient time to prepare the medication with minimal distraction promotes the safe preparation of medications.

What would be considered a "right" of drug administration. (Select all that apply.) Right drug Right class Right documentation Right dose Right client

Right drug Right documentation Right dose Right client Clients have the right to expect safe and appropriate drug administration. Nurses must observe each of these rights to ensure that the administration is done accurately.

A nurse is preparing to administer a scheduled dose of enteric-coated ASA to a client who has a history of angina. When preparing the medication, the nurse is careful to check the five rights of medication administration. The five rights include which of the following? Right reason Right documentation Right time Right setting

Right time The five rights consist of the right client, right drug, right dose, right route and right time. It is prudent to be aware of the right documentation, setting and reason, but these are not considered to be among the five rights.

A client who has been receiving a secondary infusion of a new antibiotic for several minutes reports itching and a sensation of throat tightness. What is the priority nursing intervention? Open the airway. Activate the Rapid Response Team. Stop the infusion of antibiotic. Assess skin for rash.

Stop the infusion of antibiotic. The client may be experiencing a reaction to the antibiotic. Because intravenous administration occurs quickly, life threatening reactions can also occur quickly. The first nursing action is to stop the infusion. The nurse will proceed to assure that there is an open airway, assess the skin for rash, and activate the Rapid Response Team if needed.

Regarding medication administration, what must occur at the change of shifts? The medications for the division are counted. Only the LPNs on the division count medications. The client's medications must be drawn up. The narcotics for the division are counted.

The narcotics for the division are counted. Health care facility personnel perform a count of controlled medications at specified times (each shift or when removed from an automated dispensing machine).

A nurse is caring for a client at a health care facility who is undergoing nicotine withdrawal therapy and has been prescribed a nicotine patch. Which is true with regard to the application of a transdermal patch? A new patch is placed in exactly the same location as the previous one. The patch is applied to a skin area with adequate circulation. The patch is mostly applied to lower parts of the body. The drug becomes inactive immediately after the patch is removed.

The patch is applied to a skin area with adequate circulation. When applying a transdermal patch, the nurse should be aware that a patch is applied to a skin area with adequate circulation. Most patches are applied to parts of the upper body such as the chest, shoulders, and upper arms. Small patches can be applied behind the ear. Each time a new patch is applied, it is placed in a slightly different location. The drug may still be active for up to 30 minutes after removal of the patch.

Which statement best describes the rectus femoris site used to administer parenteral drugs? The rectus femoris site is one of the muscles in the quadriceps group of the outer thigh. The rectus femoris site is in the anterior aspect of the thigh. The rectus femoris site is located in the gluteus maximus muscle in the buttocks. The rectus femoris site is located in the lateral aspect of the upper arm.

The rectus femoris site is in the anterior aspect of the thigh. The rectus femoris site is in the anterior aspect of the thigh, in which the nurse places the injection in the middle third of the thigh and is often used for infants. Therefore, this description is correct. The deltoid site is located in the lateral aspect of the upper arm. The vastus lateralis site is one of the muscles in the quadriceps group of the outer thigh. The dorsogluteal site is located in the gluteus maximus muscle in the buttocks.

A physician 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 medication through a narrow channel with the help of inert gas a canister containing medication that is released when the container is compressed a propeller-driven device that spins and suspends a finely powdered medication a device that forces liquid drug through a narrow channel using pressurized air

a canister containing medication that is released when the container is compressed A metered-dose-inhaler is a canister that contains medication under pressure; the aerosolized drug is released when the container is compressed. A turbo-inhaler is a propeller-driven device that spins and suspends a finely powdered medication. An aerosol results after a liquid drug is forced through a narrow channel using pressurized air or an inert gas.

The nurse is caring for a client with pneumonia who requires administration of medications. When does the nurse document administration in the medication administration record (MAR)? when preparing medications for administration at the end of the nurse's shift during administration at the bedside after completion of administration of each drug

after completion of administration of each drug The nurse documents administration after giving medications each time. The nurse never documents administration of medications ahead of delivery, nor does the nurse document during the actual delivery time. Nurses do not wait until the end of shift to document medication administration.

Which client does the nurse recognize that will require intramuscular administration versus intravenous administration? client with sepsis who needs antibiotic therapy client who needs MMR vaccine booster client with 2nd degree burns to 50% of the body needing pain medication client with ovarian cancer who requires chemotherapy

client who needs MMR vaccine booster Vaccines are always administered intramuscularly. Other agents mentioned would be given intravenously.

The nurse has given medications to four clients. Which client will the nurse monitor most closely for possible life-threatening changes should a reaction occur? client with headache who received ketorlac intramuscularly for back pain client with infection who received a bolus of Lactated Ringer's solution client with headache who received acetaminophen client with congestion who received oxymetazoline hydrochloride for nasal congestion

client with infection who received a bolus of Lactated Ringer's solution Knowing that reactions are more likely to occur when something is given intravenously, the nurse will most closely monitor the client who received a bolus of Lactated Ringer's solution. The nurse will not monitor the other clients as closely.

A client at a health care facility has been prescribed scopolamine, to be administered transdermally. Which statement describes transdermal application? drugs placed against the mucous membrane of the inner cheek drugs placed under the tongue and allowed to dissolve slowly drugs within a thick base applied, not rubbed, into the skin drugs bonded to an adhesive and applied to the skin

drugs bonded to an adhesive and applied to the skin Transdermal applications are drugs that are bonded to an adhesive and applied to the skin. After application, the drug migrates through the skin and eventually is absorbed into the bloodstream. Pastes are drugs within a thick base that are applied, but not rubbed, into the skin. Sublingual applications are drugs that are placed under the tongue and left to dissolve slowly. Buccal applications are drugs that are placed against the mucous membrane of the inner cheek.

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

ever aspirate. When administering heparin subcutaneously, never aspirate before administration.

The nurse is preparing to administer a tuberculin test. Which route will the nurse select to administer this injection? intramuscular intravenous subcutaneous intradermal

intradermal The nurse will use the intradermal route, which is injecting the drug between the layers of the skin. The subcutaneous route is reserved for drugs to be injected beneath the skin, but above the muscle. The intramuscular route is reserved for drugs to be injected in the muscle. The intravenous route is reserved for drugs to be instilled into veins.

What type of order would a physician most likely write to treat a client whose pain levels vary widely throughout the day? Stat p.r.n. Standing One-time

p.r.n. The prescriber may write a p.r.n. order ("as needed") for medication. The client receives medication when it is requested or required. These orders are commonly written for treatment of symptoms. For example, medications used for pain relief, to relieve nausea, and for sleep aids are often written as a p.r.n. order.

A nurse is preparing to convert a client's IV to an intermittent infusion device. The IV is connected to extension tubing. Before disconnecting the IV tubing from the extension tubing, the nurse clamps the extension tubing for which reason? prevent blood loss during the disconnection maintain IV line patency secure the device in the proper position prevent air from entering the line

prevent air from entering the line When converting to an intermittent infusion device, the nurse clamps the extension tubing to prevent air from entering the line. The primary IV tubing is clamped to prevent blood loss when the IV and tubing are disconnected. Flushing maintains IV line patency. Taping the adapter device and extension tubing secures the device in the proper position.

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

removing prior application and any remaining residue from skin The nurse will remove one application and residue before applying another, as this prevents excessive drug levels when a new application is placed. The nurse will then proceed to squeeze the paste onto the paper, spread the paste over the paper, apply the paper, and cover it with a transparent semipermeable dressing.

The nurse is reviewing the plan of care for a client who has a newly placed implanted catheter and is to be discharged home. What is a priority for the nurse to include in the plan of care? how to access the port to keep a dressing over the port flushing the port with heparin signs of infection

signs of infection The priority for the nurse to teach the client would be the signs of infection. The other options would be done by the nurse.

A nurse is administering insulin to a diabetic client. What are three recommended times to check the label before administration? (Select all that apply.) when documenting administration of the medicine when reaching for the container or unit dose package after retrieval from the drawer and compared with the CMAR after giving the unit dose medication to the client when replacing the container to the drawer or shelf when comparing with the CMAR immediately after pouring from a multidose container

when reaching for the container or unit dose package after retrieval from the drawer and compared with the CMAR when replacing the container to the drawer or shelf "Three Checks" denotes that the label on the medication package or container should be checked three times during medication preparation and administration. The nurse should read the label: (1) When reaching for the container or unit dose package; (2) after retrieving from the drawer and comparing with the CMAR, or comparing with the CMAR immediately before pouring from a multidose container; and (3) when replacing the container to the drawer or shelf or before giving the unit dose medication to the client.