PHARM CHAPTER 5 QUIZ

Match the concept to its definition. A.Encourages health care personnel who make errors to report them B.Encourages everyone in the organization to keep patients free from harm C.Unanticipated event that results in death or serious harm D.Identifies opportunities for learning

A. JUST CULTURE B. CULTURE OF SAFETY C. SENTINEL EVENT D. ROOT CAUSE ANALYSIS

Match the type of error to the example. A.Patient given written drug information but does not admit they cannot read B.Nurse administers an antihypertensive without checking blood pressure C.Nurse does not enter patient response to analgesic in EHR D. Nurse does not assess patient after administering PRN drug

A. errors in pt education B. Errors in baseline assessment C. errors in documentation D. Error in evaluation of Pt response to drug

The nurse is performing medication reconciliation during a [patient's admission assessment. Which question by the nurse reflects medication reconciliation? A."Do you have any medication allergies?" B."What pharmacies do you use when you fill your prescriptions? C."Do you need to take anything to help you sleep at night?" D."Do you have a list of all of the medications, including over-the-counter (OTC), you are currently taking?

ANSWER : D "DO YOU HAVE A LIST OF ALL OF THE MEDICATIONS, INCLUDING OTC, YOU ARE CURRENTLY TAKING

The order reads: "Give levothyroxine (Synthroid) 50 mcg PO every morning. Which answer correctly depicts the dose in milligrams? A.50,000 mg B.0.05 mg C.0.050 mg D.0.05 mg

ANSWER IS B 0.05MG (There is 1000mg in 1 MCG so you have 50mcg/? x 1mcg/1000mcg = multiple straight across. you get 1000/50 = 0.05mg)

The nurse is administering medications. Examples of high-alert medications include: (Select all that apply). 1 - Chemotherapeutic agents 2 - Antibiotics 3 - Opiates 4 - Antithrombotics 5 - Potassium chloride for injection.

ANSWER: 1, 4, 5 CHEMO DRUGS, ANTI-THROMBOTICS, K+ FOR INJ.

The nurse keeps in mind that which measures are used to reduce the risk of medication errors? (Select all that apply). 1 - When questioning a drug order, keep in mind tHat the prescriber is correct. 2 - Avoid abbreviations and acronyms. 3 - Use 2 patient identifiers before giving medications. 4 - Always double-check the many drugs with sound-alike and look-alike names because of the high risk of error. 5 - If a drug route has not been specified, use the oral route.

ANSWER: 2, 3, 4 (Even prescribers make errors, & you can not just make up a drug route if there isn't one stated)

The nurse is reviewing medication orders. Which digoxin dose is written correctly? A.digoxin 0.25 mcg B.digozin 0.250 mcg C.digoxin .250 mcg D.digoxin .25 mcg

ANSWER: A DIGOXIN 0.25MCG

During the medication administration process, it is important that the nurse remembers which guideline? A.If a patient expresses a concern about a drug, stop, listen, and investigate the concerns. B.Ask what the patient knows about the drug before giving it. C.When giving a new drug, be sure to read about it after giving it. D.When in doubt about a drug, ask a colleague about it before giving the drug.

ANSWER: A. IF A PATIENT EXPRESSES A CONCERN ABOUT A DRUG, STOP, LISTEN, AND INVESTIGATE THE CONCERNS.

The patient develops Stevens-Johnson syndrome after administration of Dilantin. The nurse would recognize this is a(n): A.expected outcome. B.adverse reaction. C.sign of a medication error. D.allergic response.

ANSWER: B ADVERSE REACTION

The nurse is giving medications to a newly admitted patient who is receiving nothing by mouth (NPO status) and finds an order written as follows: Digoxin 250 mcg stat." Which action is appropriate? A.Give the medication immediately (stat) by mouth because the patient has no intravenous (IV) access at this time. B.Clarify the order with the prescriber before giving the drug. C.Start an IV line, then give the medication IV so that it will work faster, because the patient's status is NPO at this time. D.Ask the charge nurse what route the prescriber meant to use.

ANSWER: B. CLARIFY THE ORDER BEFORE GIVING. (always check your rights. If something is missing then you have to clarify)

If a student nurse realizes that he or she has made a drug error, the instructor should remind the student of which concept? A.The student bears no legal responsibility when giving medications. B.Once the student has committed a medication error, his or her responsibility is to the patient and to being honest and accountable. C.The major legal responsibility for drug errors lies with the faculty members. D. The major legal responsibility lies with the health care institution at which the student is placed for the clinical experience.

ANSWER: B. ONCE THE STUDENT HAS COMMITTED A MEDICATION ERROR, HIS OR HER RESPONSIBILITY IS TO THE PATIENT AND TO BEING HONEST AND ACCOUNTABLE.

A drug administration error occurred; after investigation, it was determined the error was category D. Which statement accurately describes the error? An error occurred, but the medication did not reach the patient An error occurred that reached the patient but did not cause patient harm An error occurred that resulted in the need for increased patient monitoring but no patient harm An error occurred and caused temporary patient harm

An error occurred that resulted in the need for increased patient monitoring but no patient harm

The nurse instructs a nursing student to administer 40 mg of furosemide to a patient. The nurse learns that the student nurse has administered an 80-mg tablet of furosemide. Which immediate response by the nurse is appropriate? "I need to complete an incident report on the error you made." "As the patient had a very minor side effect, I will not report it." "I consider this to be your first mistake, and I excuse you this time." "It is the nurse's responsibility to be cautious while caring for the patient."

I need to complete an incident report on the error you made

Which statement most clearly defines an error in drug administration? Preventable event that leads to inappropriate drug use or patient harm Sentinel event that leads to patient harm or death Preventable event that leads to patient harm or death Sentinel event that leads to inappropriate drug use

Preventable event that leads to inappropriate drug use or patient harm

A drug administration error occurred resulting in myocardial infarction; after investigation, it was determined the error was category H. Which statement accurately describes the error? A.An error occurred that resulted in a near-death event B.An error occurred that resulted in permanent patient harm C.An error occurred that resulted in initial or prolonged hospitalization and caused temporary patient harm D.An error occurred that resulted in the need for treatment or intervention and caused temporary patient harm

a.

Which term describes an unexpected immunologic reaction in a patient due to the use of a particular medication? Medication error Allergic reaction Idiosyncratic reaction Predictable reaction

allergic reaction

At which time would the nurse perform medication reconciliation for a patient? After the patient is discharged While the patient is in surgery While the patient is undergoing a radiologic test Before the patient is transferred to the intensive care unit

before the pt is transferred to ICU

According to the American Medical Association (AMA), which action by a health care provider is categorized as disruptive behavior? Repeating instructions to the staff Repeatedly cross-checking a prescription Paying extra attention to a patient Being critical about the patient's personal life

being critical about the Pt's personal life

Which method helps to standardize medication prescription? Frequent monitoring Bar coding of medication Computerized order entry Standardization of guidelines

computerized order entry

Which orders are written inappropriately according to the Joint Commission's official "Do Not Use" list? Select all that apply. Digoxin .25 mg PO daily Levofloxacin 500 mg PO daily x 10 days Mirtazapine 15.0 mg PO every day at bedtime Heparin 10,000 units subcut twice a day Lisinopril 10 mg PO daily

digoxin .25 mg daily The order "Digoxin .25 mg PO daily" is inappropriate because the dosage does not have a leading zero. mirtazapine 15.0 mg po every day at bedtime The order "Mirtazapine 15.0 mg PO every day at bedtime" is inappropriate because the dosage contains a trailing zero.

A nurse listens to the patient's lungs before administering albuterol for asthma control. The nurse notes wheezing on expiration. After drug administration, the nurse checks the electronic health record (EHR) to see what the patient's lungs sounded like last shift before the administration of the drug. Nothing is noted. Which process of drug delivery does this involve? Monitoring Prescribing Administering Documenting

documenting

System-level failures leading to drug administration errors include which factors? Select all that apply. Heavy workload Distractions Fatigue Miscalculation Unclear order

heavy workload distractions fatigue

Insulin is in which category of medications? Low alert High alert Highly toxic Low toxicity

high alert

Drug administration errors can result from which factors in the process of drug administration? Select all that apply. Social factors Human factors Individual factors System-level factors Environmental factors

human individual system level factors

The nurse draws up insulin into a syringe and calls across the nurses' station for a coworker to double-check. The second nurse, who is charting, looks up from across the room and says, "It's okay"; the first nurse notes the initials for the second nurse in the electronic health record (EHR). In this situation, which factor may contribute to an error in drug administration? Human factors Individual factors System-level factors Environmental factors

human factors

Which statement describes how drug errors are addressed in a system that operates according to principles associated with Just Culture? Individuals are encouraged to report drug errors so that the system may be repaired. Individuals are discouraged from reporting drug errors so that the facility will not be cited. Individuals are encouraged to report only the major drug errors that result in patient harm. Individuals are encouraged to report drug errors of their coworkers to hold coworkers accountable

indiv. are encourged to report drug errors so that the system be repaired

Which action would the nurse take during patient medication reconciliation? Begin by asking the patient closed-ended questions. Use medical jargon while interacting with the patient. Encourage the patient to remember a few medications. Instruct the patient to keep a list of medications in a wallet or purse.

instruct the pt to keep a list of medications in a wallet or purse

After 10 hours on the job, a novice nurse struggles to program the intravenous (IV) pump; to avoid hanging the IV drug late, the nurse decides to let the drug run in by gravity, after calculating the drip rate then adjusting the roller clamp on the tubing. Which individual factors set the situation up for a drug error? Select all that apply. Long workdays Difficulty using equipment Poorly designed equipment Lack of uniform procedures Clinical experience of the nurse

long work days diff. using equipment clinical experience

The nurse asks a patient to provide a list of all medications that the patient is currently taking, including herbal and over-the-counter drugs. Which term describes the nurse's action? Error reporting Notifying the patient Quality improvement Medication reconciliation

medication reconciliation

A nurse administers metoprolol 100 mg to a patient with hypertension but does not check the patient's apical pulse before administration. The patient develops bradycardia, becomes dizzy with standing, and falls, resulting in a fractured lumbar vertebra. Which process of drug delivery does this involve? Monitoring Prescribing Administering Documenting

monitoring

Which principle will the nurse follow to prevent medication errors while administering medication to patients? The Four Rights The rule of five The rule of six The Nine Rights

nine rights

Which action by the nurse will help a patient who is having difficulty understanding medication instructions because of a language barrier? Obtain a translator to assist with teaching. Instruct the patient to read the black box warnings. Advise the patient to call the health care provider for more information. Demonstrate how to administer the medication and provide written information.

obtain a translator

For which reason are specific medications classified as "high-alert" medications? Medications always cause certain adverse effects. Only RNs are allowed to administer these medications. Potential for patient harm is higher with these medications. States require these medications to be on the high-alert list.

potential for harm is higher with these medications

which step of the medication process can a medication error occur? Select all that apply. Select all that apply Prescribing Verification Procurement Transcribing Administration

prescribing procurement transcribing administration

Which strategies are helpful in preventing medication errors in nursing practice? Select all that apply. Select all that apply Provide patients with proper education. Verify medication orders before administering them. Develop professional relationships with pharmacists. Avoid using computerized prescriber order entry and bar coding. Instruct the patient not to question the primary health care provider.

provide pts with proper education verify medication orders before administering them develop professional relationships with pharmacists

The nurse inadvertently administers a high dose of morphine to a patient who has had a myocardial infarction, and the patient develops respiratory arrest. Once the patient is resuscitated, which action would the nurse take next? Report the error to the nurse manager. Leave the patient alone for some time. Inform the patient's family about the error. Document the error in the patient's medical record.

report error to nurse manager

Which rights are part of the six rights for nurses to ensure safe drug administration? Select all that apply. Right to a complete and clear order Right to have access to information Right to have smart infusion pumps Right to adhere to the five rights of drug administration Right to administer drugs safely and to identify problems in the system

right to complete and clear order right to have access to information right to administer drugs safely

The nurse caring for a patient receiving cisplatin notes extravasation of the intravenous (IV) fluid when the patient reported IV site pain. Even though the antidote (sodium thiosulfate) to cisplatin was administered, the patient experienced extensive tissue necrosis around the insertion site and required multiple skin grafts. Which feelings might the nurse experience after the drug administration error? Select all that apply. Self-doubt Blamelessness Suicidal ideation Self-assurance Posttraumatic stress disorder (PTSD)

self doubt suicidal PTSD

A nursing student reviews the prescription for a patient who has depression and who was prescribed a selective serotonin reuptake inhibitor (SSRI) and cyclobenzaprine. The nursing student knows that cyclobenzaprine is contraindicated with SSRIs. Which is the mostappropriate action taken next by the student nurse? The student nurse consults the faculty. The student nurse refers to a drug handbook. The student nurse discusses the matter with a peer. The student nurse discusses the matter with the staff nurse.

student refers to a drug handbook

Which groups of pediatric patients are at a higher risk of medication errors? Select all that apply. Select all that apply Children who are 5 years old or older Those admitted in an intensive care unit Children receiving chemotherapeutic agents Those whose weight is accurately determined Children in the emergency department on the weekend

those admitted to ICU children receiving chemo children in ER on w/e

Computerized health care provider order entry in place of handwritten orders is an example of which strategy for preventing errors in drug administration? Dispensing Prescribing Transcribing Administration

transcribing

Which organization announced new regulations requiring bar codes for all prescription and over-the-counter medications? Drug Enforcement Agency (DEA) Federal Bureau of Investigation (FBI) US Food and Drug Administration (FDA) Department of Health and Human Services (DHHS)

us food and drug admin

Which steps are used in medication reconciliation? Select all that apply. Select all that apply Verification Clarification Identification Classification Reconciliation

verification clarification reconciliation

The nurse is caring for an older adult. The patient tells the nurse, "I cannot take this medication because this tablet is a different color from the tablets at home." Which action is most appropriate? Verify the patient's prescription. Suggest that the patient take the medication. Inform the patient that a new medication is prescribed. Notify the health care provider to change the medication.

verify the prescription

The electronic health record indicates that a patient's continuous infusion of heparin intravenously was to be stopped at 1000. At 1900, the nurse notices that the heparin is still running. Which type of error in drug administration is this? Wrong drug Wrong dose Wrong time Wrong route

wrong dose