117 - Lab Quiz 1

Read the label and find the following information: Strength of the drug ________ mg per tablet (Only enter the number, Round to the 10th place)

2.5 mg

Below is a list of data gathered during an assessment of a client, a young woman visiting your clinic with what she described as "maybe an ulcer." Label each item as either objective data (O) or subjective data (S). Partial credit will not be awarded for this question. 1. The client tells you that they smoke a pack of cigarettes a day. A. (s) Subjective B. (O) Objective 2. The client is 5 fee 5 inches tall and weights 135 pounds. A. (s) Subjective B. (O) Objective 3. The pulse rate is 68 beats/min and the blood pressure is 128/72 mm Hg. A. (s) Subjective B. (O) Objective 4. Stool was tested for occult blood by a laboratory technician; the resultsare negative. A. (s) Subjective B. (O) Objective 5. The client says that they do not experience nausea, but reports pain and heartburn, especially after eating popcorn. A. (s) Subjective B. (O) Objective 6. The client experiences occasional increased in stomach pain, a 'feeling of heat' in their abdomen and chest at night when they lie down, and increase incidents of heartburn. A. (s) Subjective B. (O) Objective All Answer Choices A. (s) Subjective B. (O) Objective

1. A (s) Subjective 2. B (O) Objective 3. B (O) Objective 4. B (O) Objective 5. A (s) Subjective 6. A (s) Subjective

A nurse is providing discharge teaching to the parent of a child who is prescribed diphenhydramine 25 mg elixir every 4 hr as needed. The amount available is diphenhydramine elixir 12.5 mg/5 mL. How many mL should the nurse administer per dose? (Only enter the number, Round to a whole number)

10 mL

Convert 3.4 kg to an equivalent amount in grams. (Only enter the number, Round to a whole number)

3400 g

Which of the following is part of a complete medication history? A. Use of "street" drugs B. Current laboratory work C. Past histories of surgeries D. Family history

A

Which phase of the nursing process requires the nurse to establish a comprehensive baseline of data concerning a particular client? A. Assessment B. Planning C. Implementation D. Evaluation

A

The physician orders a medication to be administered q8h. The first dose is given at 6:00 a.m. What times will this medication be given throughout the day in military time? A. 0600h - 1400h - 2200h B. 0600h - 1300h - 2200h C. 0800h - 1800h - 2400h D. 0200h - 1000h - 1800h

A Rationale: The medication was administered at 06:00 a.m., which is 0600h in military time. Adding 8 hours to 0600h would be 0600h + 0800h = 1400h in military time. The next dose would be given 8 hours later or 1400h + 0800h = 2200h. The times of administration are 0600h - 1400h - 2200h.

The nurse is assessing several patients. For which patient does assessment reveal a psychosocial history that may affect the patient's outcome? (Select All That Apply) A. Older adult who recently suffered a stroke, has an unsteady gait, and lives in a two-story home B. Middle-aged patient with Down syndrome living in a group home C. Recently divorced mother of three children with breast cancer D. Sixteen-year-old requesting birth control without parental consent E. Seven-year-old with asthma in a foster care home

A, B, C Rationale: A patient who had a stroke may not be able to return to a home that requires climbing stairs. A patient with Down syndrome needs additional care to ensure that treatment outcome is successful. The patient with breast cancer may be the family's sole provider and may have financial concerns. Many teens seek contraception without their parents' consent. This should not have a negative impact on outcome. Residing in foster care should not have a negative impact on outcome for the client with asthma.

The nurse is working very hard to prevent medication errors. What plans will assist the nurse in preventing most errors? (Select All That Apply) A. Plan to always check the patient's identification band prior to administration of medications. B. Plan to open all of the medications immediately prior to administration. C. Plan to tell physicians that verbal orders will not be accepted. D. Plan to record the medication on the medication administration record (MAR) immediately prior to administration. E. Plan to validate all orders with another nurse prior to administration of medications.

A, B, C Rationale: Ways to reduce medication errors include checking the patient's identification band prior to administration of medications, telling physicians that verbal orders will not be accepted, and opening all of the medications immediately prior to administration. Medications should be documented on the medication administration record (MAR) after they have been administered. All orders do not need to be validated with another nurse, only the orders that the nurse is unsure about.

A new nurse on the orthopedic floor makes a medication error. Which statements by the nurse manager foster a safe environment in which nurses will report medication errors? (Select All That Apply) A. "Many of us have made a medication error in our careers. The most important issue is to identify why the error occurred." B. "I know you could not feel any worse than you already do. We need to discuss how this error happened and how we can prevent it from happening again." C. "It's really good that your patient is OK and did not suffer any harmful effects of this error. We should discuss why this error occurred and how it can be prevented in the future." D. "Because you are a new nurse, we should sit down and discuss the procedure you followed to see what you could have done to prevent this error." E. "We need to sit down as soon as possible and write up an incident report describing everything you did wrong that caused this error."

A, B, C, D Rationale: All errors should be investigated with the goal of identifying why they occurred. This investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear of punishment. An incident report will need to be written, but the nurse who made the error should feel the report will identify factors contributing to the error rather than place blame.

The nurse makes a medication error, but the patient is not harmed. The patient's family asks the nurse manager what is considered a medication error. Which are potential responses by the nurse manager? (Select All That Apply) A. Failure to follow health care provider's orders B. Failure to give the right medication C. Failure to give a medication at the ordered time D. Failure to call the pharmacy and report that the medication has been given E. Failure to give the right dose of the medication

A, B, C, E Rationale: A medication error occurs if the patient does not receive the drug as the health care provider intended it to be given, the patient does not receive the drug the health care provider intended to be given, the patient does not receive the drug at the time the health care provider intended it to be given, or the patient does not receive the dose of the drug the health care provider intended to be given. The delivery of the medication is recorded on the medical administration record (MAR); the nurse does not report to the pharmacy each time a medication has been given.

A nurse on the medical-surgical unit is caring for several very ill patients. One patient says, "I was supposed to get my medications an hour ago." The nurse recognizes that medication errors can have what repercussions? (Select All That Apply) A. Medication errors can potentially extend the patient's length of hospital stay. B. Medication errors can result in expensive legal costs to the facility. C. Medication errors can damage the facility's reputation. D. Medication errors can be physically devastating to nurse and patient. E. Medication errors cause preventable deaths during hospitalizations.

A, B, C, E Rationale: Medication errors can cause harm, which can extend the patient's length of stay. If a medication error causes a patient harm, it can result in expensive legal fees for hospital defense. If the incidence of medication errors is publicized, it can cause the facility to be seen as unsafe or to be delivering substandard care. Medication errors are the most common cause of morbidity and preventable death within hospitals. Medication errors can be physically devastating to patients but would be emotionally devastating to the nurse.

A patient returns to the clinic for follow-up after taking a newly prescribed medication for a month. The nurse recognizes medication teaching was successful when the patient makes which statement? (Select All That Apply) A. "I've been taking my medication on an empty stomach like the prescription label said to." B. "I take my medication first thing in the morning, just like you said." C. "I have been able to decrease my medication to every other day and that saves me some money." D. "I switched all my medications to one pharmacy like you suggested." E. "Did you say I need to take this medication with water or milk?"

A, B, D Rationale: Statements about taking medication as directed indicate the patient is adhering to instructions. Changing dosage schedule without direction indicates failure to follow instruction. Asking if medication should be taking with water or milk indications that the patient is unsure of instructions. If the patient is unsure of instructions, it is less likely that the correct administration technique is being followed.

The risk management department is using a root-cause analysis to improve a nursing unit's medication administration accuracy. What questions will be used to develop this tool? (Select All That Apply) A. What kind of errors are occurring? B. What is the current medication administration accuracy rate? C. How do the unit nurses rank in the number of errors committed? D. What do the nurses think can be done to prevent errors from continuing? E. What is the impact of changes made to improve accuracy?

A, B, D, E Rationale: The current medication administration accuracy rate helps to determine, "What happened?" Asking what kind of errors are occurring helps to answer the question, "Why did it happen?" Asking nurses for suggestions helps to answer the question, "What can be done to prevent it from happening again?" The final question is "Has the risk of recurrence actually been reduced?" which can be answered by asking what the impact of interventions has been. Ranking the nurses in order of number of errors is punitive and is not part of the risk management process.

During which phase of the nursing process does the nurse Prioritize the nursing diagnosis? A. Assessment B. Planning C. Implementation D. Evaluation

B

Which of the following must occur for a goal statement to be patient centered? A. Family input must be considered in developing the goal. B. The client must be involved in establishing the goal. C. The nurse must develop the goal. D. The physician must be involved in establishing the goal

B

What is the most significant role for nurses as defined by state nurse practice acts and by regulating bodies such as The Joint Commission? A. Planning care B. Teaching C. Assessment D. Evaluating care

B Rationale: State nurse practice acts and regulating bodies such as the Joint Commission consider teaching to be a primary role for nurses, giving it the weight of law and key important accreditation standards. Assessment, planning, and evaluation are important but not the most significant roles of the nurse according to state nurse practice acts and Joint Commission.

Medication reconciliation has been started for a newly admitted patient. At which points would the nurses and others caring for this patient complete a medication reconciliation? (Select All That Apply) A. At each time that medications are administered to the patient. B. When admission orders are received. C. When the patient is transferred to a different unit within the hospital. D. When the patient is discharged. E. If any medication error occurs.

B, C, D Rationale: This list of medications the patient takes at home should be checked against admission orders and should be checked upon any transfer or discharge. Medication reconciliation sheets are not the same as medication administration records (MARs). There are many situations where a medication error might occur in which it is not necessary to check this list.

Prescribed medications are prepared and administered during which phase of the nursing process? A. Assessment B. Planning C. Implementation D. Evaluation

C

The Joint Commission documented that patient education was deficient on several medical-surgical units of a local hospital. A nursing committee was formed to address this problem and focused on what likely nursing intervention? A. Providing educational pamphlets about medications to the patients. B. Asking the physicians to provide medication education to the patients. C. Discussing medications each time they are administered to patients. D. Requesting more frequent pharmacy consults for the patients.

C Rationale: Discussing medications each time they are administered is an effective way to increase the amount of education provided. Medication education is considered to be a responsibility of the nurse, not the physician or pharmacist. Educational pamphlets can be effective but are not as effective as the nurse providing education to the patient.

Which concepts should the nurse use when formulating a nursing diagnosis? (Select All That Apply) A. Base the nursing diagnosis on the medical diagnosis B. Focus on what the nurse needs to help the patient return to health C. Include the patient in the identification of needs D. Consider the patient's response to the current health problem E. Be certain the diagnosis is measurable

C, D Rationale: A nursing diagnosis is a clinical judgment concerning human response to health conditions and should be patient focused. Including the patient in the formulation of nursing diagnoses encourages more active involvement in working toward meeting identified goals. It is not dependent on the medical diagnosis. Goals and outcomes need to be measurable, not nursing diagnosis.

The nurse may revise or eliminate unrealistic goals during which phase of the nursing process? A. Assessment B. Planning C. Implementation D. Evaluation

D

What is the trade name of the following medication? A. Granules B. AbbVie C. Clarithromycin D. Biaxin

D Rationale: Biaxin - Trade names of medications will have the trademark symbol beside it OR have the first letter of the name in an uppercase letter.

The nurse makes a medication error and a patient dies. In court, the attorney for the family of the deceased patient asks the nurse if she followed standards of care in administering the medication. How would the attorney phrase this question? A. "Did you follow agency guidelines as in previous circumstances?" B. "Did you follow the physician's orders and double-check them before administration?" C. "Did you do the three checks and follow the five rights as taught in school?" D. "Did you do what another nurse would have done under similar circumstances?"

D Rationale: Standards of care refer to the actions that a reasonable and prudent nurse with equivalent preparation would do under similar circumstances. Standards of care do not refer to following physician orders. Standards of care do not refer to following agency guidelines. Standards of care do not refer to doing three checks or five rights.

Which situation demonstrates ethical reporting of a medication error? A. The nurse does not report the error, because the error was caught and corrected prior to drug administration. B. The nurse does not report or document the error, since the error did not result in any harm to the patient. C. The nurse reports the error to the physician and the charge nurse but does not document the error due to possible legal action. D. Informs the patient, documents the error as per hospital policy, and notifies the physician.

D Rationale: The nurse should report and document all medication errors whether the patient was harmed or not. It is essential to report and document medication errors to identify possible system failures, even when the error is caught prior to administration or has potential for legal action.