Medications PREPU
The nurse is teaching a nursing student regarding safety of chemotherapeutic medication. Which statement by the nurse is correct? "Pharmacists usually administer chemo drugs." "Once the drugs are packaged in pharmacy, there are no risks in handling the medication." "Antineoplastic drugs can be absorbed through the skin." "Antineoplastic drugs only target cancer cells."
"Antineoplastic drugs can be absorbed through the skin."
The nurse is teaching a client about using two inhalers. Which client statement reflects that nursing teaching has been effective? "I should be careful to refrain from shaking the canisters of medication." "I will breathe in for about 10 seconds, and exhale quickly." "I must wait at least 1 full minute between inhalers." "I will wash the holder in warm water mixed with some bleach."
"I must wait at least 1 full minute between inhalers."
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 drink orange juice if I experience high blood glucose levels." "I will test my blood glucose levels immediately after I eat." "I will eat meals whenever I feel hungry."
"I will eat a meal within a half hour of taking my morning insulin."
Which statement by a relative indicates to the nurse that the teaching on the application of paste was effective? "I will not remove the last application before applying another." "I will not rotate the sites of medication placement." "I will not use gloves when applying the paste." "I will not apply the paste on a hairy skin."
"I will not apply the paste on a hairy skin."
What is the best response by the nurse when a client asks about the side effects of using nasal spray? "Long-term use of nasal sprays can cause difficulty in coordinating breathing." "Long-term use of nasal sprays can cause rebound nasal congestion." "Long-term use of nasal sprays can repair the nasal passage." "Long-term use of nasal sprays can cause an unpleasant taste."
"Long-term use of nasal sprays can cause rebound nasal congestion."
The nurse is teaching a client about metformin SA. When the client asks, "What does the SA mean?" what is the appropriate nursing response? "Sustained release." "Continuous release." "Extended release." "Sustained action."
"Sustained action."
An adult with diabetes receives 20 units of insulin each morning and evening. How will the nurse teach the client to administer the insulin? "Use a 1-mL syringe and give 0.4 mL." "Use a 5-mL syringe and give 0.40 mL." "Use a tuberculin syringe and give 4/10 mL." "Use an insulin syringe and give 20 units."
"Use an insulin syringe and give 20 units." Insulin doses are calculated in units. The scale commonly used is U100, based on 100 units of insulin contained in 1 mL of solution. The adult client is taught to measure by units, not mL.
A client is taking numerous eye drops to prepare for cataract surgery. Which teaching about ophthalmic application will the nurse provide? "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." "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."
"Wait 5 minutes between instillation of different types of eye drops."
A nurse is administering a subcutaneous injection to a client. What is the common maximum volume of a subcutaneous injection? 3 mL 0.01 mL 1 mL 0.05 mL
1 mL
The nurse is preparing supplies for a tuberculosis screening. The nurse should choose which syringes and needles? 1 mL syringe; ½-inch (1.25 cm), 26-gauge needle 10-mL syringe; 3-inch (8 cm), 18-gauge needle 5-mL syringe; 2-inch (5 cm), 20-gauge needle Insulin syringe; 1-inch (2.5 cm), 16-gauge needle
1 mL syringe; ½-inch (1.25 cm), 26-gauge needle For a tuberculosis screening, the nurse should choose a 1 mL syringe with a ½-inch (1.25 cm), 26-gauge needle. An insulin syringe is used for insulin administration.
The nurse is preparing to administer an allergy test intradermally. At what angle will the nurse plan to insert the needle into the client? 10-15 degrees 20-30 degrees 45 degrees 90 degrees
10-15 degrees
The nurse is preparing to administer a tuberculin test. At which angle is the nurse expected to instill the drug? 15-degree angle 45-degree angle 90-degree angle 120-degree angle
15-degree angle
A nurse is preparing to administer IV therapy to a client and selects a catheter with a large lumen. Which catheter would have the largest lumen? 18 gauge 20 gauge 21 gauge 22 gauge
18 gauge IV catheters are available in various sizes. The lumen size is measured in gauges; odd numbers designate winged infusion needles (19, 21, 23), whereas even numbers designate catheter sizes. The most common adult catheter sizes are 22, 20, and 18. As the numbers increase, the lumen size decreases; thus, a 22-gauge needle is smaller in diameter than an 18-gauge needle. Of the catheter gauges listed, 18 would be the largest.
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? 73-year-old client diagnosed with liver disease 16-year-old client diagnosed with left radial fracture 35-year-old client diagnosed with migraines 45-year-old client diagnosed with lung cancer
73-year-old client diagnosed with liver disease
Which client would most likely require placement of an implantable port? A 58-year-old woman with stage 3 breast cancer requiring weekly chemotherapy. An 18-year-old man s/p gunshot wound in the ICU requiring multiple blood transfusions. A 12-year-old girl with sickle cell anemia requiring frequent pain medication administration. A 45-year-old man with a history of colon cancer that is currently in remission.
A 58-year-old woman with stage 3 breast cancer requiring weekly chemotherapy. This client needs frequent IV access. A central port is easily accessed for chemotherapy sessions, then the access is discontinued even though the port remains in place subcutaneously. A central port also allows for the infusion of chemotherapy into a central vessel; this is important because chemotherapy is caustic and severely damages peripheral vessels.
Which medication interaction illustrates a synergism? 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 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 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 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 synergistic reaction is one in which one drug increases the effect of another drug. Acetaminophen and oxycodone have a synergistic relationship. Doxycycline and calcium carbonate have an antagonistic relationship
A nurse is caring for a client who is being tube fed. What care should the nurse take when administering medications through an enteral tube? Add medications to the formula. Mix all the medications together in 15 mL of water. Use cold water when mixing powdered medications. Avoid crushing sustained-release pellets.
Avoid crushing sustained-release pellets.
A medication order has ac written after the medication dosage. What does ac stand for? Before meals After meals Before After
Before meals
A nurse needs to administer a prescribed medication to a client using IV push. In which way is the medication being administered to the client? Continuous drip Bolus administration Gravity infusion Electronic infusion device
Bolus 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? Bolus administration Electronic infusion device Continuous administration Secondary administration
Bolus administration
The nurse has inserted a peripheral intravenous catheter into a client. What is the appropriate action when a blood return is not obtained? Insert the IV catheter further. Begin infusing the IV fluid. Change the site of catheter insertion. Pinch IV tubing to prohibit initial infusion.
Change the site of catheter insertion.
A nurse is administering an antihypertensive drug to a hospitalized client. Which action should the nurse take to identify the client prior to administration? Call the client by name. Check the client's ID bracelet. Check the client's record. Check the client's name with family or significant others.
Check the client's ID bracelet.
An oral medication has been ordered for a client who has a nasogastric tube in place. Which nursing activity would increase the safety of medication administration? Check the tube placement before administration. Have the client swallow the pills around the tube. Flush the tube with 30 to 40 mL saline before medication administration. Bring the liquids to room temperature before administration.
Check the tube placement before administration.
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? Administer drug as ordered. Ask another nurse to verify the order. Assume that provider meant to order buspirone. Contact health care provider for order clarification.
Contact health care provider for order clarification.
When administering a subcutaneous injection to a client, the needle pulls out of the skin when the skin fold is released. What would be the appropriate next action of the nurse in this situation? Pull out and discard the needle. Discard the equipment and start the procedure from the beginning. Engage safety shield on needle guard and discard needle appropriately. Document the incident and inform the primary care provider.
Engage safety shield on needle guard and discard needle appropriately. The needle needs to be disposed of properly after engaging the safety guard because the needle cannot be reinserted due to contamination. A new needle can be attached to the syringe and the remainder of the medication administered after cleansing the site again. The incident does warrant notifying the primary care provider.
A nurse is caring for a client who has a PICC line. Which nursing action is recommended? Use clean technique when changing dressing. Flush using normal saline and/or heparin solution according to facility policy. Keep external portion of catheter coiled on top of dressing. Change catheter caps every 10 days or as per facility policy.
Flush using normal saline and/or heparin solution according to facility policy.
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's 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's position.
The nurse is providing teaching to an older adult with arthritis and an implanted catheter. What living arrangements does the nurse anticipate in the discharge plan of care? assisted living arrangements long-term care facility admission home nursing visits continued inpatient admission
Home nursing visits
A client is being started on total parenteral nutrition (TPN). When initiating the therapy, the nurse gradually tapers up the infusion rate as ordered to prevent which potential complication? Hyperglycemia Infection Air embolism Pneumothorax
Hyperglycemia Metabolic complications also may present a problem for the client receiving TPN. Most commonly, clients experience hyperglycemia if they are unable to tolerate the high glucose content of the TPN solution. When therapy is initiated, the infusion rate is usually tapered up over a period of a day or two. Using strict aseptic technique during catheter manipulations, dressing changes, and tubing and bottle changes helps to reduce the risk for infection. Air embolism and pneumothorax are potential complications that are associated with central line placement, not TPN administration.
The nurse is contacting a health care provider to obtain a telephone order for a client who has nausea. When contact with the provider is made, what is the priority nursing action? Authenticate healthcare provider's identity. Identify self and the agency the nurse is calling from. Repeat back the order given for clarity. Provide SBAR information.
Identify self and the agency the nurse is calling from.
Which situation accurately describes a recommended guideline when administering oral medications to clients? Assume that the client is the authority on whether or not the medication was swallowed. If a pill is dropped, it should be briefly immersed in saline to remove any dirt or germs. If a client vomits immediately after receiving oral medications, readminister the medication. If a child refuses to take medication, crush the medication, if allowable, and add to a small amount of food.
If a child refuses to take medication, crush the medication, if allowable, and add to a small amount of food.
A nurse is caring for a client with severe lower back pain. The doctor orders administration of an analgesic as a stat dose. When should the nurse administer the medication? For a specified number of days Immediately Once As needed
Immediately
The Z-track technique is utilized during drug administration by which route? Intramuscular Subcutaneous Intradermal Intravenous
Intramuscular
A nurse is using an 18-gauge needle to administer a medication to a client. The nurse knows that when compared to a 27-gauge needle, an 18-gauge needle has which feature? shorter length greater length larger diameter smaller diameter
Larger diameter
To convert 0.8 grams to milligrams, the nurse should do which of the following? Move the decimal point 2 places to the right. Move the decimal point 3 places to the right. Move the decimal point 2 places to the left. Move the decimal point 3 places to the left.
Move the decimal point 3 places to the right.
A nurse is preparing to administer a transfusion of packed red blood cells to a client. Which solution would the nurse expect to use to administer the transfusion? Normal saline Lactated Ringer's Dextrose 5% and water Dextrose 50%
Normal saline When administering a blood transfusion, normal saline should be used to prevent cell hemolysis. Solutions containing dextrose cause hemolysis. Lactated Ringer's is not recommended.
A client has just had a central venous catheter inserted. What would the nurse do next? Obtain a chest x-ray. Confirm that the correct solution is available for infusion. Tape all connections to prevent accidental disconnection. Adjust the flow rate of the solution.
Obtain a chest x-ray. After all central venous catheter insertions, a chest x-ray verifies the position of the catheter before infusion of any solutions or medications. The chest x-ray also will detect pneumothorax. No other action should occur until catheter placement has been verified.
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.
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.
What is the name of the process by which a drug moves through the body and is eventually eliminated? Pharmacology Pharmacotherapeutics Pharmacokinetics Pharmacodynamics
Pharmacokinetics
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? 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. Send the vial with the remaining drug back to the pharmacy.
Place the date on the vial and retain for future use.
The chemotherapy client has been admitted for thrombocytopenia. Which blood product will the nurse anticipate administering? Platelets Fresh frozen plasma Whole blood Packed cells White blood cells
Platelets One common indication for platelet transfusion is thrombocytopenia following chemotherapy.
The nurse has confirmed the client's identity and provided a client with oral medications to take. What is the next appropriate nursing intervention? Leave the room. Assess for therapeutic effect of medications. Stay with the client while medications are taken. Document medication administration.
Stay with the client while medications are taken.
A client has been prescribed nasal medication. What care should the nurse take to avoid potential complications due to the administration of this medication? 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. Allow sufficient time to prepare the medication with minimal distraction.
Review the client's medication, allergy, and medical history.
A nurse is assessing a client's lower arm for insertion of an IV catheter. The nurse palpates the vein and notes that it feels hard. Which action by the nurse would be most appropriate? Select another site. Apply a warm compress for 5 minutes. Loosen the tourniquet slightly. Apply a topical anesthetic.
Select another site.
A client is prescribed an opioid analgesic. The nurse is teaching the client about the need to avoid ingesting alcohol with the drug to prevent an interaction which would potentiate the effects of the analgesic. The nurse is describing which event? Synergism Antagonism Incompatiblity Tolerance
Synergism
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 site is in close proximity to the sciatic nerve. The area is free of major blood vessels and fat. There is a high possibility of injecting into subcutaneous fat. The site lies close to the radial nerve.
The area is free of major blood vessels and fat
A client with chronic obstructive pulmonary disease (COPD) has been prescribed an inhaled bronchodilator. Which technique should the nurse implement in order to ensure safe and complete delivery of the prescribed medication? Use a spacer or extender with the metered-dose inhaler. Provide oxygen therapy 30 minutes prior to administration. Provide multiple puffs of the medication in rapid sequence. Place the inhaler as deeply into the client's mouth as is comfortable.
Use a spacer or extender with the metered-dose inhaler.
The nurse has withdrawn opioid pain medication into a syringe. When preparing to administer the medication, the client refuses, stating that pain is controlled currently at a level of 2 on a scale of 1 to 10. What is the appropriate nursing action? Administer the medication to control future pain. Waste the medication with another nurse witness present. Hold the medication in cargo pocket to give later. Squirt the medication down the client's sink while the client watches.
Waste the medication with another nurse witness present.
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 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 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
To which client would the nurse be most likely to administer a prn medication? a client who is reporting pain near the surgical site a client who requires daily medication to control hypertension a client who is experiencing severe and unprecedented chest pain a client whose asthma is treated with inhaled corticosteroids
a client who is reporting pain near the surgical site A report of "breakthrough" pain, especially postsurgery, would likely require the nurse to administer a prn analgesic. A new onset of chest pain would likely require a stat order, while longstanding treatment of hypertension and asthma would likely include standing orders for relevant medications.
The nurse is preparing to administer medication to a client with high blood pressure. When will the nurse document administration in the medication administration record (MAR)? after completion of drug administration during preparation of the medication for administration while administering the medication at the bedside at the end of the nurse's shift before giving report
after completion of drug administration
The nurse is administering an intramuscular injection to a client. Which action made by the nurse could assess whether the needle is in the client's blood vessel or not? aspirating for a blood return inserting the needle at a 90-degree angle withdrawing the needle and immediately releasing the taut skin waiting 10 seconds with the needle still in place and the skin held taut
aspirating for a blood return
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? removing prior application and any remaining residue from skin covering application paper with plastic 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 skin
Which client does the nurse recognize that will require intramuscular administration versus intravenous administration? client who needs MMR vaccine booster client with ovarian cancer who requires chemotherapy client with sepsis who needs antibiotic therapy client with partial-thickness or second-degree burns to 50% of the body needing pain medication
client who needs MMR vaccine booster Vaccines are always administered intramuscularly. Other agents mentioned would be given intravenously.
Which component of a syringe's needle does the nurse recognize that refers to width? lumen shaft bevel gauge
gauge
The nurse is preparing to administer a tuberculin test. Which route will the nurse select to administer this injection? subcutaneous intramuscular intradermal intravenous
intradermal
A client has an order for an intermittent infusion of 250 mL of 0.9 normal saline. The nurse understands that this type of infusion is used for which situation? medications that need to be infused over 20 to 60 minutes medications that are given over 1 minute for rapid therapeutic effect medications that can be given through a capped intravenous port medications that are toxic if given over short periods
medications that need to be infused over 20 to 60 minutes Intermittent infusions are used for medications that need to be administered for an intermediate length of time, usually 20 to 60 minutes. The intravenous push technique is used for medications that can be given over 1 minute for rapid therapeutic effect, and may be given into a continuously infusing IV set or into a capped IV port. The continuous infusion technique is used for medications that are toxic if given over short periods.
The nurse is caring for a client with a yeast infection. Which medication does the nurse anticipate will be prescribed? miconazole oxymetazoline bisacodyl timolol
miconazole
After administering medication to a client subcutaneously, the nurse removes the needle at the same angle at which it was inserted. Which explains the nurse's action? verifies correct injection of the drug minimizes tissue trauma to the client prevents needlestick injuries helps to control placement of the needle
minimizes tissue trauma to the client Removing the needle at the same angle at which it was inserted to administer medication minimizes tissue trauma and discomfort to the client. To verify correct injection of the drug, the nurse pushes the plunger and watches for a small wheal. To prevent needlestick injuries, the nurse covers the needle with a protective cap. Holding the client's arm and stretching the skin taut helps to control placement of the needle.
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 prevent air from entering the line maintain IV line patency secure the device in the proper position
prevent air from entering the line
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? signs of infection to keep a dressing over the port how to access the port flushing the port with heparin
signs of infection
When instructing a client regarding sublingual application, the nurse should inform the client that which action is contraindicated when administering the drug? swallowing the medication taking the medication on an empty stomach talking when taking the medication performing physical activities
swallowing the medication
A nurse flushes an intravenous lock before and after administering a medication. What is the rationale for this step? to keep the inside of the needle or catheter sterile to facilitate client comfort and decrease anxiety to clear medication and prevent clot formation to dilute the infusion and maintain homeostasis
to clear medication and prevent clot formation
What is the best explanation from the nurse as to why a client must return to the unit in 48 hours after having a tuberculin skin test intradermal? to determine the extent to which the client responded to the drugs to administer timely emergency treatment to implement measures to reduce the transmission of microorganisms to prevent interfering with test results
to determine the extent to which the client responded to the drugs
