You are reading a physician's order & note date/time of prescriptions, as well as physicians signature. Which of the following prescriptions is complete?
Digoxin (Lanoxin) 1.25mg PO daily.
This order is complete with medication dose, the route, and the frequency of administration.
Which of the following is your highest priority action for ensuring overall safety during medication administration?
Identify patient by two acceptable methods.
One of the six rights of medication administration is to identify that you are giving the medication to the correct patient. It is required that you check the medication administration record against the patient’s identification bracelet, and use a second method of patient identification, such as asking the patient his birth date.
A drugs generic name is also known as the...
same as its nonproprietary name.
A drug’s generic name is its nonproprietary or noncommercial name. Each drug has only one generic name. For example, acetaminophen is the generic name for the drug marketed as Tylenol, while ibuprofen is the generic name for the drugs Advil, Motrin, and others.
An uncommon, unexpected, or individual drug response thought to result from a genetic predisposition is called a...
an idiosyncratic effect.
An idiosyncratic effect is an uncommon, unexpected, or individual drug response thought to result from a genetic predisposition.
Pt. drinks 8oz of water, which is the correct conversion of the patients intake?
240ml.
One fluid oz equals 30 mL; therefore, 8 fluid oz equals 240 mL.
You have a handwritten medication order that is difficult to read. Appropriate action to take to avoid medication administration error?
Call medical provider for clarification of the order.
There is no other way to be sure about what was intended other than confirming it with the person who wrote the order.
Which of the following demonstrate the correct use of one of the six rights of medication administration?
Administering patients medication by route provider has prescribed.
The Six Rights of Medication Administration are the right medication, the right dose, the right patient, the right route, the right time, and the right documentation. Giving the medication by the route prescribed is indeed an application of the Six Rights of Medication Administration.
Which of the following represents the correct administration of the prescribed medication?
Amoxicillin 1g PO prescribed ; 2 500-mg tablets.
To determine the correct dosage, start with the amount prescribed: 1 g (gram). To determine how many tablets to give, divide the dose ordered by the dose on hand and multiply the result by the amount on hand. So, 1 g (dose ordered, and also equivalent to 1,000 mg) divided by 500 mg (dose on hand) = 2, then 2 X 1 (amount on hand) = 2 tablets. So this is the correct amount to give.
Which of the following patients is exhibiting drug tolerance?
A patient requires an increased dose of a medication to achieve continued therapeutic benefit.
As tolerance develops to a medication, a patient requires higher and higher doses of that medication to achieve the desired effect.
Which of the following is the most appropriate documentation of a clients response to pain medication?
The patient reports pain decreased to 3/10, 30 minutes after medication administration.
Using a standardized instrument is the most appropriate method of documenting a response to pain medication.
You are giving a patient several PO medications. Patient tells you that she can only take one pill at a time. It;s appropriate to...
remain at the bedside until you are sure the patient has taken all of the medications.
It is your responsibility to remain with the patient and observe that she has swallowed each medication. It is unacceptable to leave medications unattended for any period of time.
With which route of drug administration are there no barriers to absorption?
Intravenous
The definition of absorption is the movement of a drug from its site of administration into the blood. With intravenous administration, the drug is injected directly into a vein. Thus any possible barriers to absorption are bypassed, and the drug is completely and instantaneously absorbed.
A nurse is administering aspirin 82mg PO daily. The med is scheduled for 0800 hours. Which of the following demonstrates proper use of one of the six rights of med administration.
The nurse documents that the aspirin was given at 0825
All routinely ordered medications should be given within 60 min of the time ordered (30 min before or after the prescribed time).
A patient is to receive 12.5 mg of prednisone by mouth daily. The medication is available in 5mg tabs. How many tabs/dose?
2.5 tabs
Use the following formula to determine how many tablets to administer: Divide the dose ordered by the dose on hand and multiply the result by the quantity on hand. So, 12.5 mg (dose ordered) divided by 5 mg (dose on hand) = 2.5, then 2.5 x 1 tablet (quantity on hand) = 2.5 tablets.
A nurse is preparing to instill antibiotic ear drops into a toddlers ear. Which of the following techniques should the nurse use when administering ear drops to this patient?
Pull the patient's auricle down and back to open the canal when administering ear drops.
The auricle should be pulled down and back for young children, up and out for adults.
For which of the inhalation meds delivery methods is it important for the nurse to assess the pt's ability to inhale deeply before administering the medication.
Dry powder inhaler
This method has no propellant and requires a deep inhalation to trigger the release of medication.
Which of the following should a nurse assess before administering meds through a ng tube
Amount of residual volume left in stomach
Checking residual volume prevents putting medications into an already full stomach.
A nurse is teaching the daughter of an adult patient how to instill eye drops in the patients right eye. Which of the following statements indicates that the daughter has understood the directions?
"I will pull down her lower eyelid and drop the medication inside"
This method will allow the medication to be distributed evenly across the eye with less discomfort.
A pt is to receive his daily isoniazid ( INH ) dosage for TB. He states he is feeling nauseated with this medication and refuses to take it. The nurse knows that the correct way to indicate the refusal is to:
Document the reason for refusal along with the date and time in the patients medical record.
The patient has the right to refuse medication. Refusals must be documented in the patient's record with the date, time, and reason for refusal, if known.
A nurse will be administering several medications to a patient who is receiving enteral feedings through a small bore nasogastric tube. The nurse administers the meds correctly by
Infusing each medication by gravity and flushing with water before and after instillation.
Medications should be instilled via gravity, flushing before and after with water.
A nurse is caring for a patient who has been prescribed fluticasone propinate inhaler with a spacer. The patient asks the nurse why a spacer is needed with the inhaler. Correct response from the nurse:
More medication is delivered to the lungs when you use a spacer
A spacer slows down and breaks up the medication, allowing the patient to better control the flow of medication. This, in turn, decreases the amount of medication deposited in the oropharynx.
A nurse is administering a subQ injection to a patient. Which of the following data should the nurse recognize as the highest priority to prevent potential complications
Identify if the patient has allergies to the medication
The nurse needs to identify if the patient is allergic to the medication prior to administration. This is the highest priority.
A nurse is preparing to give an IM injection into the left ventrogluteal muscle. Which of the following should the nurse do to locate the appropriate site?
With the heel of the hand on the greater trochanter,point the index finger up toward the anterior superior iliac spine, extending the other fingers back and along the iliac crest.
This will locate the ventrogluteal site.
A patient is to receive 30mg of ketorolac ( Toradol ) IM every 6 hr for 48 hr. The med is available in a 60mg/2mL vial. How many mL should the nurse administer for each dose
1 mL
To determine the correct dosage, start with the amount prescribed: 30 mg. To determine how many mL to administer, divide the dosage desired by the dose available and multiply the result by the quantity available. So, 30 mg (dose desired) divided by 60 mg (dose available) = 0.5, then 0.5 x 2 mL (quantity available) = 1 mL.
The proper needle length when giving an intramuscular injection in the ventrogluteal area to an average-sized adult is which of the following?
1 1/2 inch
Use a 11/2-inch needle for most adults when giving an intramuscular injection in the ventrogluteal area.
A nurse is preparing to administer an intradermal injection. Which of the following should the nurse do to ensure proper technique
Use a tb syringe with a 3/8 to 5/8 inch, 25-27 gauge needle
This is the correct size syringe and needle for administering an intradermal injection.
A nurse is preparing to administer an insulin injection to a patient. Which of the following is appropriate
Rotate injection sites to avoid tissue injury.
Rotating injection sites prevents tissue damage from repeated injections at the same site.
Which of the following terms indicates a med is given by injection
Parenteral
Parenteral indicates a medication is given by injection.
A nurse administers the first dose of a pt's prescribed antibiotic via IV piggyback. During the first 10 to 15 min of administration of the medication, the nurse gives priority to which of the following assessments?
Patient for systemic allergic reaction
Yes. Patients may experience a systemic allergic reaction especially with IV antibiotics and should be observed for the first 10 to 15 min.
A nurse is caring for a patient receiving 0.9% sodium chloride at 75 ml/hr through a triple lumen central venous catheter. The pump is alarming that there is an occlusion. Which of the following is the first thing the nurse should do?
Check the line at or above the hub for kinked tubing that is creating a resistance to flow
Yes. This is most likely the problem and should be where the nurse checks first.
A nurse is caring for a pt who is receiving D5W with 20 mEq of KCL at 75 ml/hr. the provider has prescribed 1 g Ceftriaxone (Rocephin) iv. When preparing to administer this medication by iv piggyback, which of the following data is the highest priority for the nurse to collect?
The medication's compatibility with the primary IV solution
The nurse must assess the medication’s compatibility with the primary solution prior to administration. If the medication is not compatible with the primary solution, a precipitate can form in the IV tubing, preventing medication administration.
A patient was admitted to the hospital for same day surgery and has orders for continuous intravenous therapy. Before performing a venipuncture, the nurse should
Inspect the IV solution for fluid color, clarity, and expiration date
All IV solutions must be free of contaminants, particles, and current for usage.
A nurse is caring for a patient with a peripherally inserted central catheter (PICC line). Which of the following is true about this type of intravenous route?
A PICC line is a long catheter inserted through the veins of the antecubital fossa
Yes. PICC lines have lower complication rates because they are inserted in the upper extremity.
A patient is to receive 1 g of Ceftriaxone (Rocephin) in 100 ml over 30 min. the tubing drip rate is 10 gtt/ml. the nurse should adjust the flow rate to what infusion rate?
33 gtt/min
To determine the correct flow rate divide the volume to be infused by the time in minutes and multiply by the drop factor. So, 100 (volume to be infused) divided by 30 (time in min) x 10 (drops per mL) = 33 gtt/min.
A nurse is assessing a pt receiving iv normal saline at 125ml/hr. which of the following should the nurse recognize as a possible complication related to the iv therapy?
Patient reports cough and shortness of breath
Yes. This is a sign of fluid overload. You should slow the IV and notify the provider.
A nurse is about to administer an iv medication directly into the vein. The nurse should understand that a disadvantage of parenterally administered medications is that they
Are irreversible
Yes. Once a medication has been injected, it cannot be retrieved. If the dose is excessive or the patient is allergic, the consequences can be deadly.