Prep U- Chapter: 29- Medications

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.

The nurse is caring for an older adult client who sees several different health care providers and specialists. Which question will the nurse ask?

"Do you get all of your medications filled at the same pharmacy?"

The charge nurse has just completed an inservice with a group of nursing students. One nurse student asks, "Why do I have to know how to give medications in different ways. I thought the unlicensed assistive personnel (UAP) performs those skills?" What is best response by the charge nurse?

"Entry-level nurses will perform basic skills appropriate to the scope of practice and that includes administering medications through various routes."

The nurse is teaching a client with arthritis about taking medications at home. Which client statement indicates that nursing teaching has been effective? a) "Brand name drugs are cheaper than generic drugs." b) "I trust my daughter to give my medications when I need them." c) "Setting up a monthly medication management system will be helpful." d) "I will ask my pharmacist about an easy-to-open lid."

"I will ask my pharmacist about an easy-to-open lid

Nurse A is having difficulty logging into the automated medication-dispensing system, and asks Nurse B to log in momentarily so that Nurse A is not delayed in administering client medications. What is Nurse B's appropriate response? a) "I will log in so that you can proceed with medication delivery." b) "I will get the hospital's information system's phone number for you." c) "I am giving you my password so you can log in." d) "I can log in and give the medications for you."

"I will get the hospital's information system's phone number for you."

The nurse just completed a refresher course on parenteral drug administration. Which statement by the nurse indicates that teaching was effective? a) "Reconstitution is the process of adding liquid, known as diluent, to a powdered substance." b) "Reconstitution is a sealed glass cylinder of parenteral medication with an attached needle." c) "Reconstitution is a sealed glass drug container that must be broken to withdraw the medication." d) "Reconstitution is a glass or plastic container of parental medication with a self-sealing rubber stopper."

"Reconstitution is the process of adding liquid, known as diluent, to a powdered substance."

A client is taking numerous eye drops to prepare for cataract surgery. Which teaching about ophthalmic application will the nurse provide?

"Wait 5 minutes between instillation of different types of eye drops

Which resource(s) does the nurse utilize to identify the right client when administering medications? Select all that apply.

- Identification bracelet - Verbal statement from the client verifying name and date of birth - Electronic medication record with personal identifiers

A nurse is administering a subcutaneous injection to a client. What is the common maximum volume of a subcutaneous injection?

1 mL

A pediatric client has a fever for which the provider has prescribed ibuprofen 200 mg orally every 6 hours. The instructions on the bottle indicate there is 100 mg/5ml. How many milliliters should the nurse give? Record your answer using a whole number.

10 ml

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 to 15 degrees

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? a) 16-year-old client diagnosed with left radial fracture b) 35-year-old client diagnosed with migraines c) 45-year-old client diagnosed with lung cancer d) 73-year-old client diagnosed with liver disease

73-year-old client diagnosed with liver disease

The client is prescribed a medication that needs to be taken on an empty stomach. The nurse inadvertently administers this medication with food. What are the ramifications of this error? a) The medication will be more effective. b) The medication schedule will have to be changed. c) The client may experience abdominal pain. d) Absorption of the medication will be impaired.

Absorption of the medication will be impaired.

A nurse educator is teaching a student nurse how to choose the correct needle for an injection. Which guidelines for needle selection might they discuss?

As the gauge number becomes larger, the size of the needle becomes smaller

A young woman has an IV infusing for magnesium sulfate to treat preterm labor. The woman develops a fever. What is the first assessment the nurse should make?

Assess the IV site for redness.

The nurse observes a prescription written for a client for a medication that does not correlate with the client's diagnosis or comorbid factors. What is the best action for the nurse to take? a) Call the provider to obtain a rationale for the use of the medication for the client b) Ask the client if he or she should be taking this medication c) Call pharmacy to inquire about the medications used for the diagnosis d) Take off the prescription, because the provider knows best what the client needs

Call the provider to obtain a rationale for the use of the medication for the client

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.

The nurse is caring for a client who has had a cerebrovascular accident. Prior to administering oral medications, what is the nurse's appropriate action?

Consult with a speech therapist for dysphagia.

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? a) Assume that the provider meant to order buspirone. b) Ask another nurse to verify the order. c) Contact the health care provider for order clarification. d) Administer the drug as ordered.

Contact the health care provider for order clarification

A nurse is administering a hepatitis B immunization injection to an adult client. Which site would the nurse choose for this injection?

Deltoid muscle site

Which situation accurately describes a recommended guideline when administering oral medications to clients?

If a child refuses to take medication, crush the medication, if allowable, and add to a small amount of food.

The nurse is preparing to administer an allergy test via an intradermal injection. Which injection site would be most appropriate in this situation?

Inner surface of the forearm

A nurse is explaining to a client the correct method of using a metered-dose inhaler when self-administering a prescribed dose of medication. What is a feature of a metered-dose inhaler? a) It is a canister that contains pressurized medication. b) It suspends finely powdered medication. c) It has propellers that get activated during inhalation. d) It is a battery-operated device that spins.

It is a canister that contains pressurized medication.

If the dosage is inappropriate for a client, who is responsible? a) Physician b) Nurse c) Medical technician d) Pharmacist

Nurse

The chemotherapy client has been admitted for thrombocytopenia. Which blood product will the nurse anticipate administering? a) Whole blood b) Platelets c) Packed cells d) White blood cells e) Fresh frozen plasma

Platelets

The nurse is assessing a client who was seen 7 days ago with strep throat. The client states, "I felt better after 2 days of the antibiotic the provider prescribed, so I quit taking it." What would the nurse do to address this situation? a) Instruct the client to take both the current antibiotic along with a new prescribed antibiotic to avoid antibiotic resistance b) Instruct the client to return to taking the current prescribed medication until it is all gone c) Provide education on taking all antibiotics for effective treatment d) Offer to speak to the provider for different treatment options

Provide education on taking all antibiotics for effective treatment

Which technique should the nurse employ when instilling otic medication in an adult ear?

Pull the client's ear up and back.

The nurse has received a telephone order for a client from a health care provider. How will the nurse indicate in the documentation that the order was received via telephone? a) Record "T.O." at the end of the order. b) Tell the provider to sign the order as soon as possible. c) Have another nurse cosign the order input. d) No extra documentation is necessary.

Record "T.O." at the end of the order.

A nurse brings a client the prescribed dose of medication and finds that the client is not in the unit. What should the nurse do in this case?

Return the medication to the medication cart or medication room.

A nurse is preparing to administer a scheduled dose of enteric-coated ASA to a client who has a history of angina. When preparing the medication, the nurse is careful to check the five rights of medication administration. The five rights include which of the following?

Right time

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.

The nurse has confirmed the client's identity and provided a client with oral medications to take. What is the next appropriate nursing intervention? a) Assess for therapeutic effect of medications. b) Leave the room. c) Document medication administration. d) Stay with the client while medications are taken.

Stay with the client while medications are taken

A client who has been receiving a secondary infusion of a new antibiotic for several minutes reports itching and a sensation of throat tightness. What is the priority nursing intervention? a) Stop the infusion of the antibiotic. b) Assess skin for rash. c) Open the airway. d) Activate the Rapid Response Team.

Stop the infusion of the antibiotic

A health care provider who just arrived on the unit gives a verbal order to the nurse regarding a nonemergent client situation. What is the nurse's appropriate response? a) Have another nurse witness and record the order into the medication administration record (MAR). b) Tactfully request the provider to input the order into the computerized provider order system. c) Input the order into the computerized provider order system. d) Refuse to implement the order and notify the nurse manager.

Tactfully request the provider to input the order into the computerized provider order

What is the term used for the concentration of drug in the blood serum that produces the desired effect without causing toxicity?

Therapeutic range

The client states "I think my IV dressing needs to be changed." In which instance should the nurse change the dressing? a) When the dressing is loose, bloody or wet. b) When the dressing is curling up at the edges. c) When the client requests it. d) Never; changing the dressing can dislodge the catheter.

When the dressing is loose, bloody or wet.

While injecting a needle into a client for an intramuscular injection, the nurse hits the client's bone. What would be the appropriate initial response of the nurse to this situation?

Withdraw the needle, apply a new needle to syringe, and administer the injection in an alternate site.

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

To which client would the nurse be most likely to administer a p.r.n. medication?

a client who is reporting pain near the surgical site

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

The nurse is preparing to administer a bolus of an intravenous medication. How should the medication be administered?

all at once

At what point should the nurse perform the first of the three checks of medication administration? a) at the beginning of a shift b) after retrieving the drug from the drawer of a drug cart c) as the nurse reaches for the drug package or container d) when reviewing the client's medication administration record (MAR)

as the nurse reaches for the drug package or container

A client with chronic obstructive pulmonary disease has been prescribed a bronchodilator to be administered by small-volume nebulizer. The nurse should ensure that the client:

breathes through his or her mouth until all the medication has been inhaled.

A client with chronic obstructive pulmonary disease has been prescribed a bronchodilator to be administered by small-volume nebulizer. The nurse should ensure that the client: a) breathes through his or her mouth until all the medication has been inhaled. b) rinses his or her mouth with water before the medication is administered. c) coughs intermittently while the medication is being administered. d) takes rapid, shallow breaths until the medication is complete.

breathes through his or her mouth until all the medication has been inhaled.

Which assessment should be conducted by the nurse before the nurse administers tuberculin intradermal injection? a) checking for documented allergies to food or drugs b) cleaning the area with an alcohol swab c) preparing the syringe with the medication d) gathering all the equipment needed

checking for documented allergies to food or drugs

What does the nurse expect to be included in the directions for reconstitution on a drug label? Select all that apply. type of diluent not to use size of the client directions for storing the drug amount of diluent to be added dosage per volume after reconstitution

directions for storing the drug amount of diluent to be added dosage per volume after reconstitution

The nurse is providing teaching to an older adult with arthritis and an implanted catheter. What living arrangement does the nurse anticipate in the discharge plan of care? a) continued inpatient admission b) assisted living arrangement c) long-term care facility admission d) home nursing visits

home nursing visits

The nurse assesses that a client uses accessory muscles, breathes shallowly, and has a pulse oximetry reading of 94%. Which nursing diagnosis will the nurse assign?

ineffective breathing patterns

When administering heparin subcutaneously, the nurse should: a) aspirate after the injection. b) aspirate before the injection. c) vigorously massage the site. d) never aspirate.

never aspirate.

A nurse is taking care of a client who requests acetaminophen to help with a headache. The nurse checks to see if there is an order for acetaminophen and notices that the client is able to have 650 mg every 4 hours for pain. What type of order is this considered?

p.r.n. order

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? a) covering application paper with plastic with transparent semipermeable dressing b) using wooden applicator to spread paste over the paper c) squeezing prescribed amount of paste from tube onto application paper d) removing prior application and any remaining residue from skin

removing prior application and any remaining residue from skin

A client has been prescribed nasal medication. What care should the nurse take to avoid potential complications due to the administration of this medication?

review the client's medication, allergy, and medical history

The nurse is caring for a client who has problems coordinating his breathing with the inhaler use. Therefore, the client is unable to receive the full dose. Which would help maximize drug absorption in this client?

spacer

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

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? a) to determine the extent to which the client responded to the drugs b) to prevent interfering with test results c) to implement measures to reduce the transmission of microorganisms d) to administer timely emergency treatment

to determine the extent to which the client responded to the drugs

The primary reason for the Controlled Substances Act is:

to prevent drug use and dependence.