RN Pharmacology Assessment-A

What is 125 mcg in milligrams (mg)? 0.125 mg 1.25 mg 12.5 mg 125 mg

0.125mg

The physician ordered atropine sulfate 0.6 mg IM before surgery. The medication is supplied in 0.8 mg/mL. How many mL of the medication would you administer? 0.25 mL 0.5 mL 0.75 mL 1 mL

0.75ml

The physician orders 0.5 mg/kg of a medication. The medication is supplied in a 10 mg/mL solution. The person you are caring for weighs 40 kg. How many mL of the drug would you administer? 2 mL 5 mL 10 mL 12 mL

10ml

The provider orders 1 liter of NS to be infused over 6 hours. At what rate would you set the IV pump?

166.67

A 250 mg dose of an oral medication has been ordered. The medication is supplied only in 100 mg tablets. How many tablets would you administer? 0.5 1.5 2.5 3.5

2.5

Furosemide (Lasix®) is ordered 50 mg IV push. On hand is 20 mg/mL. How many mL would you administer? 1.5 2 2.5 3

2.5

You receive an order to start Heparin drip at 18 units/kg/hr for a person weighing 75 kg. The Heparin comes in a 500 mL bag with 25,000 units. What is the starting rate of the infusion? 2.7 mL/hr 13.5 mL/hr 27 mL/hr 270 mL/hr Step 1: Calculate the starting units per hour. 18 units X 75 kg = 1350 units/hour Step 2: Calculate the starting rate of the Infusion (solve for X). Heparin Infusion Rate: 25,000 units = 1350 units/hour 500ml X (ml/hour) 25,000 units (X ml/hr) = 675,000 X ml/hr = 675,000 25,000 X = 27 ml/hour

27ml/hr

A person is to receive 5 mg/kg of medication. They weigh 80 kg. What amount would you administer? 0.4 mg 40 mg 400 mg 4000 mg

400mg

You receive an order to administer 1 tsp of an elixir. What amount of elixir will you prepare? 2 mL 5 mL 6 mL 10 mL

5ml

A person with no known risk factors to TB would need further diagnostic testing to rule out TB if the Mantoux test showed an induration of what size? 1.5-2.5 mm 5-10 mm 10-12 mm > 15 mm

>15mm

A person on a morphine (Duramorph®) PCA pump without a basal infusion rate is afraid of potential overdosing. What would you say to educate them? A small dose is delivered only when you push the trigger button and only if it has been long enough since your last dose. If you're worried about overdosing, you can press the trigger button very lightly to receive a smaller dose. You can stop the pump if you want to. Just restart it if you need to use it. Do not worry, you will not overdose. The PCA pump is set to turn off if you have any breathing problems.

A small dose is delivered only when you push the trigger button and only if it has been long enough since your last dose.

A person is being treated for mild to moderate pain following an orthopedic procedure. Which order would you question? Eplerenone (Inspra®) 25 mg tab PO daily for pain Acetaminophen (Ofirmev®) 650 mg IV every 6 hours for pain Oxycodone (Roxycodone®) 5 mg tab PO every 4 hours as needed for pain Celecoxib (Celebrex®) 200 mg cap daily for pain

Acetaminophen (Ofirmev®) 650 mg IV every 6 hours for pain

Shortly after administering an IV medication, the person you are caring for starts to complain of itching and feeling flushed. On assessment, you notice hives have begun to form on their chest. What is your BEST intervention? Start normal saline at 125mL/hr and notify provider. Administer PRN IV diphenhydramine (Benadryl®) and notify provider. Place oxygen and administer a corticosteroid cream. Call a code and notify provider.

Administer PRN IV diphenhydramine (Benadryl®) and notify provider.

A person has a new order for digoxin (Lanoxin®). What would be accessed immediately before administration? Patellar reflex Rate and depth of breathing Cranial nerve function Apical heart rate

Apical heart rate

A person with hypothyroidism has a serum calcium level of 13 mg/dL. What medication would you expect to administer? Alendronate (Fosomax®) Chlorthalidone (Thalitone®) Calcitonin (Miacalcin®) Calcipotriol (Dovonex®)

Calcitonin (Miacalcin®)

An order has been placed for a sublingual medication. The person you are caring for currently has a nasogastric tube in place. What is your MOST appropriate action? Ask the pharmacy for a liquid form of the medication. Call the physician and ask if the medication can be ordered by another route. Crush the medication and administer it through the nasogastric tube. Administer the medication as ordered.

Call the physician and ask if the medication can be ordered by another route.

A person is noted to have a penicillin allergy. What medication would you question if ordered by a physician? Levofloxacin Ceftriaxone Ciprofloxacin (Cipro®) Azithromycin (Zithromax®)

Ciprofloxacin (Cipro®)

Which of the following is considered an antiplatelet medication? Dabigatran (Pradaxa®) Enoxaparin (Lovenox®) Apixaban (Eliquis®) Clopidogrel (Plavix®)

Clopidogrel (Plavix®)

You are caring for a person with a capillary blood glucose of 33 mg/dL and they are unable to tolerate oral intake. Which of the following would you administer? Pramlintide (SymlinPen®) SQ Regular insulin (Humulin R®) IV drip Acarbose (Precose®) PO Dextrose 50% IV push

Dextrose 50% IV push

What medication is incompatible for administration with Lactated Ringer's solution? Fluconazole (Diflucan®) Vancomycin (Vancocin®) Acetaminophen (Ofirmev®) Diazepam (Valium®)

Diazepam (Valium®)

A person has a new-onset dysrhythmia. What medication might be prescribed for this condition? Tiotropium (Spiriva®) Duloxetine (Cymbalta®) Tramadol (Ultram®) Diltiazem (Cardizem®)

Diltiazem (Cardizem®)

The person you are caring for has refused a dose of IV medication. What is your MOST appropriate action? Suggest that they should go home if they will not adhere to their plan of care. Document their refusal and notify the prescribing provider. Switch to using the brand name of the drug so that they will not recognize it next time. Inform the person that they have already signed a consent at admission and continue medication administration.

Document their refusal and notify the prescribing provider.

You receive report from the off-going nurse that the person being cared for just received their fourth dose of IV Vancomycin (Vancocin®) that was administered over 30 minutes. Upon assessment of them, you notice their face and neck are red and they are itching all over. What would you suspect? Hot flashes due to the onset of menopause A sharp increase in erythrocyte production A hemolytic reaction from the IV medication Red man syndrome due to a rapid infusion rate

Red man syndrome due to a rapid infusion rate

The person you are caring for is reviewing written instructions from their physician and see that they have four new medicines prescribed. They are primarily concerned with their migraine headaches and want to know which of the medicines will help with that. What medication might be used to treat their migraine headaches? Rizatriptan (Maxalt®) Finasteride (Proscar®) Nitroglycerin (Nitrobid®) Tinzaparin (Innohep®), i.e. enoxaparin

Rizatriptan (Maxalt®)

A physician's written order for the person you are caring for is as follows: Insulin glargine (Lantus®), 10 U, subQ, Q.D. What changes would you suggest for safety and to avoid the use of "do not use" abbreviations? Spell out units and daily. Spell out subcutaneous and every other day. Include a decimal point and trailing zero in the dosage for clarity. Include the indication for the drug

Spell out subcutaneous and every other day.

What medication is considered a potassium-sparing diuretic?

Spirinolactone

A person has been prescribed nitrofurantoin (Furadantin®) for a urinary tract infection. What education would you provide to them? You might want to take this medicine with antacids so your stomach does not get overly irritated. Wash your mouth out after taking this medicine to avoid staining of the teeth. You should restrict your fluid intake while taking this medicine. It is okay to crush or chew this medicine.

Wash your mouth out after taking this medicine to avoid staining of the teeth.

Which statement is CORRECT for determining you have the correct person before administering a drug? It is unnecessary to ask them for their personal details when administering medications if your facility has barcode scanners for medication administration. You should ask them to say their name and date of birth, then compare those to their arm band and the medication record. Person's name and date of birth only need to be confirmed at the first encounter of the shift. No further confirmation is necessary until the next shift if another healthcare professional has confirmed the persons identity within a shift.

You should ask them to say their name and date of birth, then compare those to their arm band and the medication record.

What is appropriate education to provide to a person who has received a new prescription for a proton-pump inhibitor? You should take this medicine with fruit juice and your regular morning medicines. Take this medicine at night and on a full stomach. You should not take this medicine at the same time as other medicines. Take this medicine after meals to reduce nausea.

You should not take this medicine at the same time as other medicines.

A person has been diagnosed with diabetes and prescribed an oral antihyperglycemic agent. What statement made by your them indicates that they adequately understand the symptoms of hypoglycemia?

If I have sweating, shakes, nervousness, increased heart rate, or headache, my sugar might be low because of my new medicine.

What is the PRIMARY cause of red man syndrome (RMS) during the administration of vancomycin (Vancocin®)? Increased room temperature Increased histamine production Elevated core temperature Increased erythrocyte count

Increased histamine production

A person was recently prescribed a corticosteroid inhaler. What would you include when educating them on the medication? Never shake your inhaler canister because it can cause a malfunction. When you receive the inhaler from the pharmacy, remove the cylinder and discard the plastic holder. It is important that you wash out your mask after every dose to help prevent a fungal infection of your mouth. Once you depress the cylinder, take in the fastest deep breath that you can and immediately blow it out.

It is important that you wash out your mask after every dose to help prevent a fungal infection of your mouth.

What medication is a leukotriene receptor antagonist? Montelukast (Singulair®) Diphenhydramine (Benadryl®) Citirizine (Zyrtec®) famotidine (Pepcid®)

Montelukast (Singulair®)

You are educating a person about their prescription for cyclosporine (Gengraf®) and a new diet with a potassium intake restriction. What food would you tell them to avoid?

Mushrooms

You are caring for a person who is on a Morphine (Duramorph®) PCA. While conducting your rounds, you notice that they are slumped over and unresponsive with delayed and slowed respirations. You suspect narcotic overdose. What reversal medication would you administer? Neostigmine (Bloxiverz®) Naloxone (Narcan®) Sugammadex (Bridion®) Flumazenil (Romazicon®)

Naloxone (Narcan®)

Which of the following would you question if prescribed for a person taking sildenafil (Viagra®)? Nitroglycerin (Nitrostat®) Levothyroxine (Synthroid®) Vitamin K Atorvastatin (Lipitor®)

Nitroglycerin (Nitrostat®)

Normal Saline (NS) is the solution of choice over D5W when preparing to administer a blood transfusion because:

Normal Saline is an isotonic solution and prevents cell hemolysis

A person has an epidural infusing hydromorphone (Dilaudid®) with bupivacaine (Marcaine®) infusing at 6mL/hr continuously. Their blood pressure at the beginning of your shift was 92/58 with a heart rate of 68. You notice their prior blood pressures have been around 130/70. What would you do FIRST? Ask the care technician to recheck vital signs in 30 minutes. Ask the person to rate their pain from 1-10 and educate them on pain medication. Notify provider and recommend a bolus of 1 L normal saline. Check infusion rate to confirm 6 mL/hr and then notify anesthesia provider.

Notify provider and recommend a bolus of 1 L normal saline.

You are caring for a person with a central line who is receiving TPN. What is your MOST important action to prevent CLABSI? Change the central line dressing every shift. Change the IV tubing every 8 hours. Perform correct sterile technique for dressing change at the CVC site. Monitor blood sugar and report the results to the physician.

Perform correct sterile technique for dressing change at the CVC site.

Which medication would you question if ordered by the provider to treat a person that is complaining of nausea and vomiting? Trimethobenzamide (Tigan®) Promethazine (Phenergan®) Famotidine (Pepcid®) Prochlorperazine (Compazine®)

Prochlorperazine (Compazine®)

Which of the following is the antidote for Heparin? Atropine sulfate Magnesium sulfate Protamine sulfate Calcium gluconate

Protamine sulfate

What class of medication would you expect to be ordered for a person with acid reflux? Beta blocker Proton pump inhibitor ACE inhibitor Corticosteroid

Proton pump inhibitor

A person you are caring for has a known gastrointestinal bleed. What drug is contraindicated? Enoxaparin (Lovenox®) Pantoprazole (Protonix®) Ondansetron (Zofran®) Famotidine (Pepcid®)

Enoxaparin

There is an order to give digoxin now. You note that the person you are caring for has a heart rate of 52. What would you do NEXT? Administer half the ordered dose of digoxin. Give digoxin as ordered. Check orthostatic blood pressure. Hold digoxin and call the provider.

Hold digoxin and call the provider.

A person you are caring for tells you that they frequently take acetaminophen (Tylenol®) at home. Which statement made by them is correct? I am very careful because I know this medicine can make me bleed easily. I should not take any more than 12 of my 500 mg in a single day so I do not hurt my liver. It is okay to take this with alcohol. I should pay close attention to OTC drug labels so I don't take too much of.

I should pay close attention to OTC drug labels so I don't take too much of.

Which statement made by a person regarding hydrochlorothiazide (HCTZ) is correct?

I should take extra care when standing up or changing positions

You are educating a person about their new prescription for levothyroxine (Synthroid®). Which statement made by them requires correction?

I should take this on a full stomach so I don't get nauseous.

Which statement, if made by the person you are caring for, reflects the need for further education regarding a new prescription of warfarin (Coumadin®)? I will be certain to avoid alcohol consumption. If I get headaches, aspirin is my best option for pain. I have already called my family to pick up a Medic-Alert bracelet in case of emergency. I will take my pills every day at the same time as prescribed by my primary doctor

If I get headaches, aspirin is my best option for pain.