ATI safe dosage
A nurse is caring for a client who states that his provider told him he is at risk for anaphylaxis following administration of amoxicillin and that he does not understand what this means. Which of the following is an appropriate response by the nurse ?
"Anaphylaxis is a severe hypersensitivity or allergic reaction that is life threatening" explanation: anaphylaxis is a severe allergic reaction that can result in severe bronchoconstriction w/ laryngeal edema and precipitous drop in BP
practice: a nurse is asked to administer a med to client bc coworker must help with an emergency. The coworker gives the nurse a syringe labeled furosemide 20 mg. The label also includes the clients name and hospital identification number. Which of the following response is appropriate?
"ill go help with the emergency situation while you administer the medication"
a nurse is preparing to administer a time-critical med to a client at 0800. Which of the following times are appropriate for the nurse to administer the medication?
-0745 and 0830 explanation: within 30 minutes (before or after) designated time of 0800
*A nurse working in a med-surg unit is preparing to administer meds to a client. The nurse plans to use two forms of identification to verify that she has the right client. Which of the following actions can the nurse take the identify the client?
-Compare the name on the client's wristband with the name in the MAR (med administrator record) -Ask the client to state his date of birth -Ask the client to state his name [full name] -Use the bar code scan to identify the client
*a nurse is preparing to administer an oral medication. Which of the following actions should the nurse take?
-Provide client education about the medication (regarding name & purpose of each med) -Check the expiration date (should review package info before med administration) -Verify the dosage of med (should review package info before med administration) -Ask the client if they have any allergies
practice: a nurse is administering meds to client. which of the following actions should nurse perform during planning phase?
-calculating the dose -verify the dose explanation: vital signs are checked & allergies are noted during assessment or data collection. The dose of the medication is calculated & verified during the planning stage. The purpose of the med is explained during implementation phase. The. client is observed for adverse effects of med during evaluation phase.
practice: a nurse is preparing to administer med to client. Which of the following should be used to identify?
-client telephone number -client photograph -client assigned ID number explanation: place of birth and hospital room number are not appropriate identifiers.
practice: nursing is reviewing a new prescription by provider. The nurse should verify that which of the following components of prescription are present?
-date & time of prescription -dosage of med -route of administration -generic name of med [to ensure pt. receives correct med] -provider signature explanation: the prescription does NOT include client diagnosis
*a nurse is preparing to administer digoxin 225 mcg for a pediatric client who has heart rate over 90/min. Which of the following actions should the nurse take to ensure administration of the right dose?
-validate that the dosage is within safe range -confirm the medication amount is appropriate for child explanation: -validate safe range by using child weight & med reference text that indicates appropriate dosage parameters. Closely adhere to 6 rights of med administration -right dosage - 6 rights of med administration
practice: a nurse receives a telephone prescription from a provider. The provider states, "administer three-tenths of a milligram of nitroglycerin orally to client". How should nurse transcribe on MAR?
0.3 mg
A nurse is transcribing med prescription for a group of clients. Which of the following is appropriate way for nurse to record meds that require use of decimal point?
0.6 ml
a nurse is receiving a client's prescriptions. The nurse should contact the provider to clarify which of the following prescriptions?
Acetaminophen 325 mg every 6 hr PRN for headache explanation: this prescription contains name of med, dosage, frequency, and circumstance for administration, BUT NOT THE ROUTE
A nurse is caring for a client for reports severe back pain at 1400. The client's prescriptions include oxycodone extended-release 20 mg PO every 12 hrs (last dose received at 0600) and oxycodone immediate-release 5 mg PO every 4 hr PRN (last dose received at 2300 the day before). Which of the following actions should the nurse take?
Administer oxycodone immediate-release 5 mg PO now explanation: it has been 15 hrs since the previous dose of oxycodone immediate-release, and the medication is prescribed every 4 hr as needed, so the nurse should prepare to administer a dose now to treat the clients pain
A nurse is administering meds to 4 clients. The nurse should identify which of the following nursing actions as part of the evaluation phase of the nurse process?
Collecting info about a client's pain level following administration of a narcotic explanation: the nurse should identify that collecting info from client regarding a medications therapeutic response is part of the evaluation phase of the nursing process. The. nurse should include in the evaluation phase the client's therapeutic response, adverse effects, and client's adherence to the med therapy
A nurse is reviewing a client's prescriptions. The nurse should contact the provider to clarify which of the following prescriptions?
Morphine 2.5 mg IV bolus PRN for incisional pain *explanation: the prescription requires clarification because it is missing the FREQUENCY of medication administration
A nurse is caring for a client who received lisinopril 30 min ago and is now reporting dizziness and headache. Which of the following actions should the nurse take first?
Obtain the client's vital signs explanation: the first action the nurse should take when using the nursing process is to ASSESS the client. Therefore, the first action the nurse should take is to obtain the client's vital signs
practice: error prone abbreviation w/ correct way to write info on MAR
QD=once daily HS=at bedtime SC=subcutaneous IU=unit [international]
a nurse is transcribing a providers prescription for client. The prescription reads morphine 2 mg IV bolus at 1400. The nurse should recognize this as which of the following types of med orders?
Single order explanation: a single (one time) order stipulates the administer the med one time either at specific time the provider indicates or as soon as possible
*A nurse is teaching a new RN about crushing meds. The nurse should explain that which of the following meds can be crushed?
Sucralfate tablets explanation: the nurse should explain that certain meds, such as those that are scored, can be safely crushed and mixed w/ food or water for a client who has difficulty swallowing. The nurse should check w/ pharmacist before crushing a med to make certain that it can be safely crushed
a nurse is preparing to administer a high-alert pain med to a client. which of the following actions should the nurse perform during the planning stage of medication administration?
Verify the dosage calculation with another nurse explanation: to ensure client safety and prevent harm, the nurse should always have another nurse verify dosage calculations prior to administering a high alert med. This occurs during the PLANNING stage of med administration
a charge nurse is teaching a newly licensed nursing about medication reconciliation. Which of the following info should the charge nurse include in the teaching?
Vitamins, supplements, and over the counter (OTC) medications should be included in a medication reconciliation explanation: the nurse needs to include a list of all meds that the client takes, both prescribed and OTC. Medication reconciliation can identify potential interactions b/w meds and help avoid possible adverse effects
A nurse is preparing to administer medication to a client who has a prescription for docusate sodium 50 mg capsule PO twice daily. This client refuses to take the med because of nausea. Which of the following actions should the nurse take?
Withhold the medication explanation: the nurse should withhold the med due the client's nausea and notify the provider. If nausea persists, the nurse should contact the provider to prescribe an antiemetic
*a charge nurse is reviewing the types of prescriptions with a new RN. Which of the following prescriptions should the nurse include as an example of standing prescription?
acetaminophen 60 mg by mouth every 6 hr for temperature greater than 38.4C (101.2F) explanation: a standing prescription is protocol-based and contains directions for administration based upon specific situations, such as development of fever
practice: a nurse in a urgent care facility is preparing to administer a stat dose of med to toddler who is accompanied by parent. The child is not wearing an identification band. How should the nurse identify the client?
ask the parent to identify the client by name
A nurse is preparing to administer a medication to a newly admitted client. The nurse should identify which of the following actions as part of the assessment phase of the nursing process?
asking the client about a history of medication allergies explanation: the nurse should identify that data collection is part of the assessment phase. The nurse should collect data regarding the client's prior adverse reactions to medications, lab data, use of other meds, and pertinent vital signs as part of the assessment phase to ensure safe med administration
A nurse discovers a medication error in which client received twice prescribed amount of med. which of the following actions should nurse take first?
assess the client explanation: when using nursing process, the first action after discovering med error is to assess client status. This ensures that any adverse effects of med error are identified and that relevant interventions are implemented
a nurse manager is reviewing a client's med record and discovers that the client received a double dose of prescribed med. Which of the following actions should nurse manager take first?
assess the client of adverse effects explanation: when using nursing process, first step is assessing. By checking the client for adverse effects, the nurse can provide prompt treatment to minimize harm to the client
a nurse of medical unit is assisting with orientation of new RN. The nurse should remind the new RN to have a 2nd nurse review the dosage of which of the following meds prior to administration?
heparin explanation: nurse should have a 2nd nurse check dosage of high-alert med, such as heparin, b/c serious client harm can occur if dosage is excessive. High-alert med classes include CNS drugs, chemotherapeutic agents, and anticoagulants
a nurse is preparing to administer insulin subcutaneously to a client. The nurse document the administration of. the med immediately after which of the following actions
injecting the insult explanation: the nurse should document interventions, such as med administration, immediately after they occur. the nurse. should not delay documentation b/c this could lead to errors, such as omission of the doc or administration of 2nd dosage of med to client by another nurse. THE NURSE SHOULD NEVER DOCUMENT AN ACTION PRIOR TO IMPLEMENTATION
*a nurse is providing teaching regarding med administration to a group of new RNs. which of the following is a legal responsibility of a nurse?
reporting medication errors explanation: a nurse is legally responsible for reporting medication errors according to facility policy
A nurse is caring for a client who is to receive topiramate XR 100 mg PO daily. The client tells the nurse that the capsule is too hard to swallow. Which of the following actions should the nurse take?
request extended release sprinkles from the pharmacy explanation: the nurse can administer topiramate XR in sprinkle form, if available. This is not changing the route of the medication. The sprinkle capsule can be opened and mixed with food for ease of swallowing while still remaining extended release
A nurse is assessing a client following administration of an antibiotic. The nurse should identify that which of the following findings is a manifestation of an anaphylactic reaction to medication?
swollen lips explanation: the nurse should identify that swollen lips is a manifestation of anaphylactic reaction. Other manifestations include stridor, dyspnea, wheezing, urticaria [hives], and pruritus. The nurse should notify the rapid response team, elevate the clients head of the bed, apply high-flow oxygen, and prepare to administer epinephrine
