Pharm Assignment 2: Lifespan Considerations, Medication Concepts, Medication Reconciliation, Errors and Safety

A nurse is taking care of a 65 year-old patient who is on the recovery unit after having a right total knee arthroplasty. The nurse administers a dose of metformin (to control blood glucose) to the patient instead of the prescribed dose of metoclopramide (to control nausea). Which of the following actions should the nurse take first? A) Check the client's blood glucose B) Fill out an incident report C) Notify the provider D) Report the incident to the charge nurse

A) Check the client's blood glucose

Does the image (info) below meet all criteria to be a legitimate prescription? Outpatient Prescription: Patient Name: Coca Cola Date: 08-24-2020 - Lisinopril 5 mg, twice daily - #60, no refills Dr. Emory A) No B) Yes

A) No

Generic name of Acetaminophen

Acetaminophen

Chemical name of Acetaminophen

Acetyl-para-aminophenol

Brand name of Ibuprofen

Advil

A nurse is completing an incident report for a medication error. Which of the following information should the nurse include in the report? A) This could have been avoided if I had double-checked the medication administration record with the client's identification band B) Administered propranolol 80 mg PO at 1800 to the client who did not have a prescription for the medication C) While I rarely make medication errors, the client was given 80 mg of propranolol by mistake at 1800 D) It was easy to get confused because another client is receiving a similar sounding medication

B) Administered propranolol 80 mg PO at 1800 to the client who did not have a prescription for the medication

SELECT ALL THAT APPLY: When comparing neonatal vs adult pharmacokinetics, which of the following are true? A) Medications that are eliminated renally require more frequent dosing in infants due to increased excretion B) Infants are more sensitive to medication that act on the central nervous system (CNS) C) Infants require larger doses of hepatically metabolized drugs due to enzyme induction D) Lipid soluble drugs have a higher risk of reaching a breastfed infant E) A corticosteroid cream given topically will have slower absorption in a neonate

B) Infants are more sensitive to medications that act on the central nervous system (CNS) D) Lipid soluble drugs have a higher risk of reaching a breastfed infant

SELECT ALL THAT APPLY: A nursing student is leading a group discussion on controlled substances. Which of the following are true statements about controlled substances? A) Prescribers can write for any medication found under the DEA schedules B) Prescribers need a DEA license to prescribe controlled substances C) Controlled substances should be stored in unlocked containers for easy access in the case they are needed for emergent surgery D) Discarding a partially used syringe of a controlled substance requires a witness and appropriate documentation E) DEA Schedules are based on abuse potential, pregnancy risk potential and medical use

B) Prescribers need a DEA license to prescribe controlled substances D) Discarding a partially used syringe of a controlled substance requires a witness and appropriate documentation

A nursing student is preparing a presentation on medication reconciliation. Which of the following information should the student include in the teaching? A) Medication reconciliation at discharge is limited to the medication ordered at the time of discharge B) Medical reconciliation is limited to the name of the medications that the client is currently taking C) A transition in care requires the nurse to conduct medication reconciliation D) The client's provider is required to complete medication reconciliation

C) A transition in care requires the nurse to conduct medication reconciliation

A nursing student is caring for a 21-year-old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nursing student should advise the client that which of the following tests is required? A) Aspartate aminotransferase level B) 24-hr urine collection for protein C) Pregnancy Test D) Serum Creatinine

C) Pregnancy Test

Which of the following is INCORRECT about Risk Evaluation Mitigation Strategy Programs? A) Pharmacies are required to register for the REMS program to ensure appropriate patient monitoring B) Patients are required to receive appropriate counseling and medication guides if appropriate C) The program is designed only for pregnancy considerations D) Prescribers are required to periodically monitor patients for specific lab values or indications

C) The program is designed for only pregnancy considerations

Generic name of Ibuprofen

Ibuprofen

Outcome of crushing an Enteric Coated Tablet (EC)

Crushing may result in irritation to the stomach lining by the drug

Which of the following medications does not fall under the FDA reviewal process? A) Over the counter acetaminophen liquid suspension for pediatrics B) A product that is classified as a Schedule II drug C) A prescription blood pressure medication D) A homeopathic spray for asthma

D) A homeopathic spray for asthma

A nursing student is preparing to administer medications to a patient who tells the student 'I don't want to take my water pill until I go home this afternoon". Which of the following actions should the nursing student take? A) File an incident report with the risk manager B) Give the client the medication to take at home and document that it was administered C) Contact the pharmacist to pick up the medication D) Document the refusal and inform the client's provider

D) Document the refusal and inform the client's provider

A nurse receives a verbal order from the provider to administer morphine 5 mg every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)? A) MSO4 5mg SQ ever 4 hr PRM severe pain B) Morphine 5.0mg subcutaneously every 4 hr PRN severe pain C) MSO4 5mg subcut every 4 hr PRN severe pain D) Morphine 5mg subcutaneously every 4 hr PRN severe pain

D) Morphine 5mg subcutaneously every 4 hr PRN severe pain

Which of the following scenarios would involve the greatest risk to a developing fetus? A) The pregnant patient begins applying a topical cream to help with their dry hands B) The pregnant patient receives the annual influenza vaccine (Inactivated) C) The pregnant patient begins taking a large, hydrophilic, polar drug with some systemic absorption D) The pregnant patient begins taking a new oral medication that is known to reduce fetal blood flow during the first trimester

D) The pregnant patient beings taking a new oral medication that is known to reduce fetal blood flow during the first trimester

Isotretinoin is considered to be a "Category X" drug. What does "Category X' refer to? A) The DEA Schedule B) The REMS Classification C) Non-Prescription Drug (OTC) D) The Pregnancy Category E) Prescription Drug (Rx)

D) the Pregnancy Category

Chemical name of Ibuprofen

Isobutylphenyl propionic acid

Outcome of crushing an Extended Release Tablet (ER)

The drug absorption rate will be altered, causing unexpected, increased levels of the drug

Outcome of swallowing a Sublingual Tablet (SL)

The drug may not be absorbed by the G tract

Brand name of Acetaminophen

Tylenol

Outcome of crushing an Immediate Release Tablet (IR)

Will not have any drastic effect on absorption of the drug