Midterm Exam view questions From book Flashcards
The nurse is developing a human needs statement for a patient who has a new diagnosis of heart failure. Identification of human
needs statements occur with which of these activities?
a. Collection of patient data
b. Administering interventions
c. Deciding on patient outcomes
d. Documenting the patient’s behavior
a. Collection of patient data
The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after
the scheduled dose was due. What type of problem does this represent?
a. “Right time”
b. “Right dose”
c. “Right route”
d. “Right medication”
“Right time”
The nurse has been monitoring the patient’s progress on a new drug regimen since the first dose and documenting the patient’s
therapeutic response to the medication. Which phase of the nursing process do these actions illustrate?
a. Human needs statement
b. Planning
c. Implementation
d. Evaluation
d. Evaluation
The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an
outcome criterion for this patient?
a. The patient will follow instructions.
b. The patient will not experience complications.
c. The patient will adhere to the new insulin treatment regimen.
d. The patient will demonstrate correct blood glucose testing technique.
d. The patient will demonstrate correct blood glucose testing technique.
Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with
hypertension?
a. Providing education on keeping a journal of blood pressure readings
b. Setting goals and outcome criteria with the patient’s input
c. Recording a drug history regarding over-the-counter medications used at home
d. Formulating human needs statements regarding insufficient knowledge related to
the new treatment regimen
a. Providing education on keeping a journal of blood pressure readings
The medication order reads, “Give ondansetron (Zofran) 4 mg, 30 minutes before beginning chemotherapy to prevent nausea.” The
nurse notes that the route is missing from the order. What is the nurse’s best action?
a. Give the medication intravenously because the patient might vomit.
b. Give the medication orally because the tablets are available in 4-mg doses.
c. Contact the prescriber to clarify the route of the medication ordered.
d. Hold the medication until the prescriber returns to make rounds.
c. Contact the prescriber to clarify the route of the medication ordered.
When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug?
a. The patient’s ability to swallow
b. The patient’s height
c. The patient’s last meal
d. The patient’s allergies
c. The patient’s last meal
The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data?
a. Blood pressure 158/96 mm Hg
b. Weight 255 pounds
c. The patient reports that he uses the herbal product ginkgo.
d. The patient’s complete blood count results.
c. The patient reports that he uses the herbal product ginkgo.
When giving medications, the nurse will follow the rights of medication administration. The rights include the right documentation,
the right reason, the right response, and the patient’s right to refuse. Which of these are additional rights? (Select all that apply.)
a. Right drug
b. Right route
c. Right dose
d. Right diagnosis
e. Right time
f. Right patient
a. Right drug
b. Right route
c. Right dose
e. Right time
f. Right patient
Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as the last phase. (Select all that apply.)
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Human needs statement
a. Planning
b. Evaluation
c. Assessment
d. Implementation
e. Human needs statement
The patient is receiving two different drugs. At current dosages and dosage forms, both drugs have the same concentration of the
active ingredient. Which term is used to identify this principle?
a. Bioequivalent
b. Synergistic
c. Prodrugs
d. Steady state
a. Bioequivalent
When given an intravenous medication, the patient says to the nurse, “I usually take pills. Why does this medication have to be
given in the arm?” What is the nurse’s best answer?
a. “The medication will cause fewer adverse effects when given intravenously.”
b. “The intravenous medication will have delayed absorption into the body’s
tissues.”
c. “The action of the medication will begin sooner when given intravenously.”
d. “There is a lower chance of allergic reactions when drugs are given
intravenously.”
c. “The action of the medication will begin sooner when given intravenously.”
The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?
a. Parenteral drugs bypass the first-pass effect.
b. Absorption of parenteral drugs is affected by reduced blood flow to the stomach.
c. Absorption of parenteral drugs is faster when the stomach is empty.
d. Parenteral drugs exert their effects while circulating in the bloodstream.
a. Parenteral drugs bypass the first-pass effect.
When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient’s blood
pressure is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse
drug reaction?
a. Adverse effect
b. Allergic reaction
c. Idiosyncratic reaction
d. Pharmacologic reaction
d. Pharmacologic reaction
The nurse is reviewing pharmacology terms for a group of newly graduated nurses. Which sentence defines a drug’s half-life?
a. The time it takes for the drug to cause half of its therapeutic response
b. The time it takes for one half of the original amount of a drug to reach the target
cells
c. The time it takes for one half of the original amount of a drug to be removed from
the body
d. The time it takes for one half of the original amount of a drug to be absorbed into
the circulation
c. The time it takes for one half of the original amount of a drug to be removed from
the body
When administering drugs, the nurse remembers that the duration of action of a drug is defined as which of these?
a. The time it takes for a drug to elicit a therapeutic response
b. The amount of time needed to remove a drug from circulation
c. The time it takes for a drug to achieve its maximum therapeutic response
d. The time period at which a drug’s concentration is sufficient to cause a
therapeutic response
d. The time period at which a drug’s concentration is sufficient to cause a
therapeutic response
When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction.
Which of these processes describes selective enzyme interaction?
a. The drug alters cell membrane permeability.
b. The drug’s effectiveness within the cell walls of the target tissue is enhanced.
c. The drug is attracted to a receptor on the cell wall, preventing an enzyme from
binding to that receptor.
d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme’s
action with the normal target cell.
d. The drug binds to an enzyme molecule and inhibits or enhances the enzyme’s
action with the normal target cell.
When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient’s
albumin levels are normal, the nurse would expect which result, as compared to a medication, that is not highly protein bound?
a. Renal excretion will be faster.
b. The drug will be metabolized quickly.
c. The duration of action of the medication will be shorter.
d. The duration of action of the medication will be longer.
d. The duration of action of the medication will be longer.
The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the
patient to place the tablet?
a. Under the tongue
b. On top of the tongue
c. At the back of the throat
d. In the space between the cheek and the gum
a. Under the tongue
The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is
aware that patients with kidney failure would most likely have problems with which pharmacokinetic phase?
a. Absorption
b. Distribution
c. Metabolism
d. Excretion
d. Excretion
A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of
his life. Which term best describes this type of therapy?
a. Palliative therapy
b. Maintenance therapy
c. Empiric therapy
d. Supplemental therapy
a. Palliative therapy
The patient is stating that he has a headache and asks the nurse which over-the-counter medication form would work the fastest to
help reduce the pain. Which medication form will the nurse suggest?
a. A capsule
b. A tablet
c. An enteric-coated tablet
d. A powder
d. A powder
The nurse will be injecting a drug into the superficial skin layers immediately underneath the epidermal layer of skin. Which route
does this describe?
a. Intradermal
b. Subcutaneous
c. Intramuscular
d. Transdermal
a. Intradermal
Which drugs would be affected by the first-pass effect when administered? (Select all that apply.)
a. Morphine given by IV push injection
b. Sublingual nitroglycerin tablets
c. Diphenhydramine (Benadryl) elixirs
d. Levothyroxine (Synthroid) tablets
e. Transdermal nicotine patches
f. Esomeprazole (Nexium) capsules
g. Penicillin given by IV piggyback infusion
c. Diphenhydramine (Benadryl) elixirs
d. Levothyroxine (Synthroid) tablets
f. Esomeprazole (Nexium) capsules
- A drug dose that delivers 800 mg has a half-life of 5 hours. Identify how much drug will remain in the body after one half-life.
400mg
Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?
a. Decreased fetal surface area
b. Increased placental surface area
c. Enhanced blood flow to the fetus
d. Increased amount of protein-bound drug in maternal circulation
c. Enhanced blood flow to the fetus
The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She
is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her
situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration pregnancy safety category?
a. Category X
b. Category B
c. Category C
d. Category D
d. Category D
When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage
calculation is used most commonly in pediatric calculations?
a. West nomogram
b. Clark rule
c. Height-to-weight ratio
d. Milligram per kilogram of body weight formula
d. Milligram per kilogram of body weight formula
The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which
statement most accurately illustrates polypharmacy?
a. The patient is experiencing multiple illnesses.
b. The patient uses one medication for an illness several times per day.
c. The patient uses over-the-counter drugs for an illness.
d. The patient uses multiple medications simultaneously.
d. The patient uses multiple medications simultaneously.
The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is
taking which type of drug?
a. Laxatives
b. Anticoagulants
c. Sedatives
d. Antidepressants
c. Sedatives
For accurate medication administration to pediatric patients, the nurse must take into account which criteria?
a. Organ maturity
b. Renal output
c. Body temperature
d. Height
a. Organ maturity
The nurse recognizes that an elderly patient may experience a reduction in the stomach’s ability to produce hydrochloric acid. This
change may result in which effect?
a. Delayed gastric emptying
b. Increased gastric acidity
c. Decreased intestinal absorption of medications
d. Altered absorption of some drugs
d. Altered absorption of some drugs
The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity?
a. The lungs are immature.
b. The kidneys are small.
c. The liver is not fully developed.
d. Excretion of the drug occurs quickly.
c. The liver is not fully developed.
An 83-year-old woman has been given a thiazide diuretic to treat heart failure. She and her daughter should be told to watch for
which problems?
a. Constipation and anorexia
b. Fatigue, leg cramps, and dehydration
c. Daytime sedation and lethargy
d. Edema, nausea, and blurred vision
b. Fatigue, leg cramps, and dehydration
An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The
nurse expects which type of dosing to occur with this drug therapy?
a. Drug therapy will be based on the patient’s weight.
b. Drug therapy will be based on the patient’s age.
c. The patient will receive the maximum dose that is expected to reduce the blood
pressure.
d. The patient will receive the lowest possible dose at first, and then the dose will be
increased as needed.
d. The patient will receive the lowest possible dose at first, and then the dose will be
increased as needed.
The nurse is trying to give a liquid medication to a 2 1
2 -year-old child and notes that the medication has a strong taste. Which
technique is the best way for the nurse to give the medication to this child?
a. Give the medication with a spoonful of ice cream.
b. Add the medication to the child’s bottle.
c. Tell the child you have candy for him.
d. Add the medication to a cup of milk.
a. Give the medication with a spoonful of ice cream.
The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age appropriate for this child?
a. Give the injection without any advanced preparation.
b. Give the injection, and then explain the reason for the procedure afterward.
c. Offer a brief, concrete explanation of the procedure at the patient’s level and with
the parent or caregiver present.
d. Prepare the child in advance with details about the procedure without the parent
or caregiver present.
c. Offer a brief, concrete explanation of the procedure at the patient’s level and with
the parent or caregiver present.
Which statements are true regarding pediatric patients and pharmacokinetics? (Select all that apply.)
a. The levels of microsomal enzymes are decreased.
b. Perfusion to the kidneys may be decreased and may result in reduced renal
function.
c. First-pass elimination is increased because of higher portal circulation.
d. First-pass elimination is reduced because of the immaturity of the liver.
e. Total body water content is much less than in adults.
f. Gastric emptying is slowed because of slow or irregular peristalsis.
g. Gastric emptying is more rapid because of increased peristaltic activity.
a. The levels of microsomal enzymes are decreased.
b. Perfusion to the kidneys may be decreased and may result in reduced renal
function.
d. First-pass elimination is reduced because of the immaturity of the liver.
f. Gastric emptying is slowed because of slow or irregular peristalsis.
Which statements are true regarding the elderly and pharmacokinetics? (Select all that apply.)
a. The levels of microsomal enzymes are decreased.
b. Fat content is increased because of decreased lean body mass.
c. Fat content is decreased because of increased lean body mass.
d. The number of intact nephrons is increased.
e. The number of intact nephrons is decreased.
f. Gastric pH is less acidic.
g. Gastric pH is more acidic.
a. The levels of microsomal enzymes are decreased.
b. Fat content is increased because of decreased lean body mass.
e. The number of intact nephrons is decreased.
f. Gastric pH is less acidic.
A 7-year-old child will be receiving amoxicillin (Amoxil) 50 mg/kg/day in two divided doses. The child weighs 55 pounds. The
medication, once reconstituted, is available as an oral suspension of 125 mg/5 mL. Identify how many milliliters will the child
receive per dose. _______
25 mL per dose
Convert pounds to kilograms: 55 pounds = 25 kg.
25 kg × 50 mg/kg/day = 1250 mg/day
To get the amount per dose, divide 1250 by 2, which equals 625 mg/dose.
To calculate the milliliters:
125 mg:5 mL :: 625 mg:x mL
(125 × x) = (5 × 625); 125x = 3125; x = 25 mL/dose
The nurse is reviewing medication errors. Which situation is an example of a medication error?
a. A patient refuses her morning medications.
b. A patient receives a double dose of a medication because the nurse did not cut the
pill in half.
c. A patient develops hives after having started an IV antibiotic 24 hours earlier.
d. A patient complains of severe pain still present 60 minutes after a pain medication
was given.
b. A patient receives a double dose of a medication because the nurse did not cut the
pill in half.
The nurse is reviewing a list of verbal medication orders. Which is the proper notation of the dose of the drug ordered?
a. Levothyroxine.75 mg
b. Levothyroxine.750 mg
c. Levothyroxine 0.75 mg
d. Levothyroxine 0.750 mg
c. Levothyroxine 0.75 mg
When given a scheduled morning medication, the patient states, “I haven’t seen that pill before. Are you sure it’s correct?” The
nurse checks the medication administration record and verifies that it is listed. Which is the nurse’s best response?
a. “It’s listed here on the medication sheet, so you should take it.”
b. “Go ahead and take it, and then I’ll check with your doctor about it.”
c. “It wouldn’t be listed here if it were not ordered for you!”
d. “Let me check on the order first before you take it.”
d. “Let me check on the order first before you take it.”
During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the
nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber’s handwriting. Which is
the best action for the nurse to take at this time?
a. Ask a colleague what the order says.
b. Contact the prescriber to clarify the order.
c. Wait until the prescriber makes rounds again to clarify the order.
d. Ask the patient what medications he takes at home.
b. Contact the prescriber to clarify the order.
When taking a telephone order for a medication, which action by the nurse is most appropriate?
a. Verify the order with the charge nurse.
b. Call back the prescriber to review the order.
c. Repeat the order to the prescriber before hanging up the telephone.
d. Ask the pharmacist to double-check the order.
c. Repeat the order to the prescriber before hanging up the telephone.
During morning medication administration, the nurse discovered an error on the electronic MAR before the medication was given.
Which action by the nurse is appropriate for this “near-miss?”
a. Correct the MAR error but say nothing because nothing happened.
b. Notify the pharmacy about the error they almost caused.
c. Report the near-miss using the facility’s recommended protocol, and correct the
error on the MAR.
d. Report the near-miss to the next shift before the next dose is due.
c. Report the near-miss using the facility’s recommended protocol, and correct the
error on the MAR
When reviewing pediatric medication administration, the nurse recognizes that which type of medication error is most common
with children?
a. Oral medication administration errors
b. Wrong route errors
c. Incorrect dosage form errors
d. Dosing errors
d. Dosing errors
The nurse can prevent medication errors by following which principles? (Select all that apply.)
a. Assess for allergies after giving medications.
b. Use two patient identifiers before giving medications.
c. Always following the rights of medication administration.
d. Minimize the use of verbal and telephone orders.
e. Use trade names instead of generic names to avoid confusion.
b. Use two patient identifiers before giving medications.
c. Always following the rights of medication administration.
d. Minimize the use of verbal and telephone orders.
Levothyroxine is available in 75-mcg tablet form. Convert this dose to milligram strength. (do not round) _______
0.075 mg
One mg equals 1000 mcg. To convert 75 mcg to mg, divide 75 by 1000 to equal 0.075 mg, or move the decimal point to the left
three spaces. Do not forget to include the leading zero in front of the decimal point.
Digoxin is available in 0.125-mg tablet form. Convert this dose to microgram strength. (do not round) _______
ANS:
125 mcg
One mg equals 1000 mcg. To convert 0.125 mg to mcg, multiply by 1000 to equal 125 mcg, or move the decimal point to the right
three spaces.
The nurse is reviewing the teaching plan for a clinic patient who was seen for a sinus infection. Which of these outcomes reflect the
affective domain of learning?
a. The patient will take the prescribed antibiotic for the full 14 days of the
prescription.
b. The patient will demonstrate correct nasal spray self-administration.
c. The patient will list signs and symptoms that need to be reported immediately if
they occur.
d. The patient will list measures to take to reduce allergy triggers at home.
a. The patient will take the prescribed antibiotic for the full 14 days of the
prescription.
The nurse is developing a care plan for a patient who will be self-administering a metered-dose inhaler. Which statement reflects a
measurable outcome?
a. The patient will know about self-administration of a metered-dose inhaler.
b. The patient will understand the principles of self-administration of a metered-dose
inhaler.
c. The patient will demonstrate the proper technique of self-administering a
metered-dose inhaler.
d. The patient will comprehend the proper technique of self-administering a
metered-dose inhaler.
c. The patient will demonstrate the proper technique of self-administering a
metered-dose inhaler.
During a nursing assessment, which question by the nurse allows for greater clarification and additional discussion with the
patient?
a. “Are you allergic to penicillin?”
b. “What medications do you take?”
c. “Have you had a reaction to this drug?”
d. “Are you taking this medication with meals?”
b. “What medications do you take?”
The nurse is setting up a teaching session with an 85-year-old patient who will be going home on anticoagulant therapy. Which
educational strategy would reflect consideration of the age-related changes that may exist with this patient?
a. Show a video about anticoagulation therapy.
b. Present all the information in one session just before discharge.
c. Give the patient pamphlets about the medications to read at home.
d. Develop large-print handouts that reflect the verbal information presented.
d. Develop large-print handouts that reflect the verbal information presented.
When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best way to set up the teaching/learning
session?
a. Provide written pamphlets for instruction.
b. Show a video, and allow the patient to practice as needed on his own.
c. Verbally explain the procedure, and provide written handouts for reinforcement.
d. After demonstrating the procedure, allow the patient to do several return
demonstrations.
d. After demonstrating the procedure, allow the patient to do several return
demonstrations.
A patient with a new prescription for a diuretic has just reviewed with the nurse how to include more potassium in her diet. This
reflects learning in which domain?
a. Cognitive
b. Affective
c. Physical
d. Psychomotor
a. Cognitive
During an admission assessment, the nurse discovers that the patient does not speak English. Which is considered the ideal resource
for translation?
a. A family member of the patient
b. A close family friend of the patient
c. A translator who does not know the patient
d. Prewritten note cards with both English and the patient’s language
c. A translator who does not know the patient
A 60-year-old patient is on several new medications and expresses worry that she will forget to take her pills. Which action by the
nurse would be most helpful in this situation?
a. Teaching effective coping strategies
b. Asking the patient’s prescriber to reduce the number of drugs prescribed
c. Assuring the patient that she will not forget once she is accustomed to the routine
d. Assisting the patient with obtaining and learning to use a calendar or pill
container
d. Assisting the patient with obtaining and learning to use a calendar or pill
container
Which are appropriate considerations when the nurse is assessing the learning needs of a patient? (Select all that apply.)
a. Cultural background
b. Family history
c. Level of education
d. Readiness to learn
e. Health beliefs
a. Cultural background
c. Level of education
d. Readiness to learn
e. Health beliefs
The nurse is teaching an older patient about the use of an incentive spirometer after surgery. Which of these age-related changes are
appropriate for the nurse to consider when teaching older patients? (Select all that apply.)
a. Decreased sense of touch
b. Increased conduction of sound
c. Decreased cognitive function
d. Decreased short-term memory
e. Increased ability to concentrate
a. Decreased sense of touch
c. Decreased cognitive function
d. Decreased short-term memory
A patient is to receive prednisone 7.5 mg PO daily. The tablets are available in a 2.5-mg strength. Identify how many tablets will
the patient receive. _______
ANS:
3 tablets
1 tablet:2.5 mg :: x tablet:7.5 mg.
(1 × 7.5) = (2.5 × x); 7.5 = 2.5x; x = 3; therefore 7.5 mg = 3 tablets.
A 25-year-old woman is visiting the prenatal clinic and shares with the nurse her desire to go “natural” with her pregnancy. She
shows the nurse a list of herbal remedies that she wants to buy so that she can “avoid taking any drugs.” Which statement by the
nurse is correct?
a. “Most herbal remedies are not harmful and are safe for use during pregnancy.”
b. “Please read each label carefully before use to check for cautionary warnings.”
c. “Keep in mind that products from different manufacturers are required to contain
consistent amounts of the herbal products.”
d. “It’s important to remember that herbal remedies do not have proven safety
ratings for pregnant women.”
d. “It’s important to remember that herbal remedies do not have proven safety
ratings for pregnant women.”
The nurse is giving a lecture about current U.S. laws and regulations of herbal products. According to the Dietary Supplement and
Health Education Act of 1994, which statement is true?
a. Medicinal herbs are viewed as dietary supplements.
b. Herbal remedies are held to the same standards as drugs.
c. Producers of herbal products must prove therapeutic efficacy.
d. Herbal remedies are protected by patent laws.
a. Medicinal herbs are viewed as dietary supplements.
The patient wants to take the herbal product kava to help him rest at night. The nurse would be concerned about potential
interactions if he is taking a medication from which class of drugs?
a. Digitalis
b. Anticoagulants
c. Sedatives
d. Immunosuppressants
c. Sedatives
The patient has been taking an over-the-counter (OTC) acid-reducing drug because he has had “stomach problems” for several
months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement
by the nurse is the best advice for this patient?
a. “The over-the-counter drug has helped you, so you should continue to take it.”
b. “The over-the-counter dosage may not be strong enough. You should be taking
prescription-strength for best effects.”
c. “For best results, you need to watch what you eat in addition to taking this drug.”
d. “Using this drug may relieve your symptoms, but it does not address the cause.
Please make an appointment with your health care provider.”
d. “Using this drug may relieve your symptoms, but it does not address the cause.
Please make an appointment with your health care provider.”
During an assessment, the patient tells the nurse that he eats large amounts of garlic for its cardiovascular benefits. Which drug or
drug class, if taken, would have a potential interaction with the garlic?
a. Acetaminophen (Tylenol)
b. Insulin
c. Antilipemic drugs
d. Sedatives
b. Insulin
A patient calls the clinic to ask about taking cranberry dietary supplement capsules because a friend recommended them. The nurse
will discuss which possible concern when a patient is taking cranberry supplements?
a. It may increase the risk for bleeding if the patient is taking anticoagulants.
b. It may increase the risk of toxicity of some psychotherapeutic drugs.
c. It may reduce elimination of drugs that are excreted by the kidneys.
d. Cranberry may increase the intensity and duration of effects of caffeine.
c. It may reduce elimination of drugs that are excreted by the kidneys.
A patient wants to take the herb gingko to help his memory. The nurse reviews his current medication list and would be concerned
about potential interactions if he is taking a medication from which class of drugs?
a. Digitalis
b. Antiplatelet drugs
c. Sedatives
d. Immunosuppressants
b. Antiplatelet drugs
The nurse is conducting a class for senior citizens about the use of over-the-counter (OTC) drugs. Which statements are true
regarding the use of OTC drugs? (Select all that apply.)
a. Use of OTC drugs may delay treatment of serious ailments.
b. Drug interactions with OTC medications are rare.
c. OTC drugs may relieve symptoms without addressing the cause of the problem.
d. OTC drugs are indicated for long-term treatment of conditions.
e. Patients may misunderstand product labels and use the drugs improperly.
a. Use of OTC drugs may delay treatment of serious ailments.
c. OTC drugs may relieve symptoms without addressing the cause of the problem.
e. Patients may misunderstand product labels and use the drugs improperly.
The nurse is reviewing the criteria for over-the-counter drugs. Which criteria for over-the-counter status in the United States are
accurate? (Select all that apply.)
a. The drug must be easy to use.
b. The drug must have a low therapeutic index.
c. The consumer must be able to monitor the drug’s effectiveness.
d. The drug must have a low potential for abuse.
e. The drug must not have any interactions with other drugs.
a. The drug must be easy to use.
c. The consumer must be able to monitor the drug’s effectiveness.
e. The drug must not have any interactions with other drugs.
A patient with a PEG tube is to receive ferrous sulfate, 65 mg per the tube, daily. The medication is available as an elixir, 220 mg/5
mL. How many milliliters will the patient receive per dose? Record your answer using one decimal place.
ANS:
1.5 mL
220 mg:5 mL :: 65 mg:x mL
(220 × x) = (5 × 65); 220x = 325; x = 1.477 which rounds to 1.5 mL/dose
Before administering any medication, what is the nurse’s priority action regarding patient safety?
a. Verifying orders with another nurse
b. Documenting the medications given
c. Counting medications in the medication cart drawers
d. Checking the patient’s identification using two identifiers
d. Checking the patient’s identification using two identifiers
A patient is to receive a penicillin intramuscular (IM) injection in the ventrogluteal site. The nurse will use which angle for the
needle insertion?
a. 15 degrees
b. 45 degrees
c. 60 degrees
d. 90 degrees
d. 90 degrees
When administering medication by IV bolus (push), the nurse will occlude the IV line by which method?
a. Not pinching the IV tubing at all
b. Pinching the tubing just above the injection port
c. Pinching the tubing just below the injection port
d. Pinching the tubing just above the drip chamber of the infusion set
b. Pinching the tubing just above the injection port
The nurse has an order to administer an intramuscular (IM) immunization to a 2-month-old child. Which site is considered the best
choice for this injection?
a. Deltoid
b. Dorsogluteal
c. Ventrogluteal
d. Vastus lateralis
d. Vastus lateralis
The nurse needs to administer insulin subcutaneously to an obese patient. Which is the proper technique for this injection?
a. Using the Z-track method
b. Inserting the needle at a 5- to 15-degree angle until resistance is felt
c. Pinching the skin at the injection site, and then inserting the needle to below the
tissue fold at a 90-degree angle
d. Spreading the skin tightly over the injection site, inserting the needle, and then
releasing the skin
c. Pinching the skin at the injection site, and then inserting the needle to below the
tissue fold at a 90-degree angle
The nurse will plan to use the Z-track method of intramuscular (IM) injections for which situation?
a. The medication is known to be irritating to tissues.
b. The patient is emaciated and has very little muscle mass.
c. The medication must be absorbed quickly into the tissues.
d. The patient is obese and has a deep fat layer below the muscle mass.
a. The medication is known to be irritating to tissues.
After administering an intradermal (ID) injection for a skin test, the nurse notices a small bleb at the injection site. Which of these
is the best action for the nurse to take at this time?
a. Apply heat.
b. Massage the area.
c. Do nothing.
d. Report the bleb to the physician.
c. Do nothing.
The nurse is administering an IV push medication through an IV lock. After injecting the medication, which action will be taken
next?
a. Flushing the lock
b. Regulating the IV flow
c. Clamping the tubing for 10 minutes
d. Holding the patient’s arm up to improve blood flow
a. Flushing the lock
When adding medications to a bag of intravenous (IV) fluid, the nurse will use which method to mix the solution?
a. Shaking the bag or bottle vigorously
b. Turning the bag or bottle gently from side to side
c. Inverting the bag or bottle one time after injecting the medication
d. Allowing the IV solution to stand for 10 minutes to enhance even distribution of
medication
b. Turning the bag or bottle gently from side to side
The nurse is measuring 4 mL of a liquid cough elixir for a child. Which method is most appropriate?
a. Using a teaspoon to measure and administer
b. Holding the medication cup at eye level and filling it to the desired level
c. Withdrawing the elixir from the container using a syringe without a needle
attached
d. Withdrawing the elixir from the container using a calibrated oral syringe
d. Withdrawing the elixir from the container using a calibrated oral syringe
While the nurse is assisting a patient in taking his medications, the medication cup falls to the floor, spilling the tablets. What is the
nurse’s best action at this time?
a. Discarding the medications and repeating preparation
b. Asking the patient if he will take the medications
c. Waiting until the next dose time, and then giving the medications
d. Retrieving the medications and administering them to avoid waste
a. Discarding the medications and repeating preparation
When giving a buccal medication to a patient, which action by the nurse is appropriate?
a. Encouraging the patient to swallow, if necessary
b. Administering water after the medication has been given
c. Placing the medication between the upper or lower molar teeth and the cheek
d. Placing the tablet under the patient’s tongue and allowing it to dissolve
completely
c. Placing the medication between the upper or lower molar teeth and the cheek
The nurse is giving liquid medications through a percutaneous endoscopic gastrostomy (PEG) tube. Which technique is correct?
a. Administering the medications using a 3-mL medication syringe
b. Applying firm pressure on the syringe’s piston to infuse the medication
c. Flushing the tubing with 30 mL of saline after the medication has been given
d. Using the barrel of the syringe, allowing the medication to flow via gravity into
the tube
d. Using the barrel of the syringe, allowing the medication to flow via gravity into
the tube
The nurse is about to give a rectal suppository to a patient. Which technique would facilitate the administration and absorption of
the rectal suppository?
a. Having the patient lie on his or her right side, unless contraindicated
b. Having the patient hold his or her breath during insertion of the medication
c. Lubricating the suppository with a small amount of petroleum-based lubricant
before insertion
d. Encouraging the patient to lie on his or her left side for 15 to 20 minutes after
insertion
d. Encouraging the patient to lie on his or her left side for 15 to 20 minutes after
insertion
A patient is receiving eyedrops that contain a beta-blocker medication. The nurse will use what method to reduce systemic effects
after administering the eyedrops?
a. Wiping off excess liquid immediately after instilling the drops
b. Having the patient close the eye tightly after the drops are instilled
c. Having the patient try to keep the eye open for 30 seconds after the drops are
instilled
d. Applying gentle pressure to the patient’s nasolacrimal duct for 30 to 60 seconds
after instilling the drops
d. Applying gentle pressure to the patient’s nasolacrimal duct for 30 to 60 seconds
after instilling the drops
A 2-year-old child is to receive eardrops. The nurse is teaching the parent about giving the eardrops. Which statement reflects the
proper technique for administering eardrops to this child?
a. Administer the drops without pulling on the ear lobe.
b. Straighten the ear canal by pulling the lobe upward and back.
c. Straighten the ear canal by pulling the pinna down and back.
d. Straighten the ear canal by pulling the pinna upward and outward.
c. Straighten the ear canal by pulling the pinna down and back.
A patient with asthma is to begin medication therapy using a metered-dose inhaler. What is an important reminder to include during
teaching sessions with the patient?
a. Repeat subsequent puffs, if ordered, after 5 minutes.
b. Inhale slowly while pressing down to release the medication.
c. Inhale quickly while pressing down to release the medication.
d. Administer the inhaler while holding it 3 to 4 inches away from the mouth.
b. Inhale slowly while pressing down to release the medication.
When giving medications, the nurse will use Standard Precautions, which include what action?
a. Bending the needle to prevent reuse
b. Recapping needles to prevent needle sticks
c. Discarding all syringes and needles in the trash can
d. Discarding all syringes and needles in a puncture-resistant container
d. Discarding all syringes and needles in a puncture-resistant container
A patient says he prefers to chew rather than swallow his pills. One of the pills has the abbreviation SR behind the name of the
medication. The nurse needs to remember which correct instruction regarding how to give this medication?
a. Break the tablet into halves or quarters.
b. Dissolve the tablet in a small amount of water before giving it.
c. Do not crush or break the tablet before administration.
d. Crush the tablet as needed to ease administration.
c. Do not crush or break the tablet before administration.
When administering nasal spray, which instruction by the nurse is appropriate?
a. “You will need to blow your nose before I give this medication.”
b. “You will need to blow your nose after I give this medication.”
c. “When I give this medication, you will need to hold your breath.”
d. “You need to sit up for 5 minutes after you receive the nasal spray.”
a. “You will need to blow your nose before I give this medication.”
The nurse is preparing to give an aqueous intramuscular (IM) injection to an average-sized adult. Which actions are appropriate?
(Select all that apply.)
a. Choose a 26- or 27-gauge, 1/4- to 1/2-inch needle.
b. Choose a 20- to 25-gauge, 1- to 1 1/2-inch needle.
c. Choose the dorsogluteal site, the preferred site for IM injections for adults.
d. Insert the needle at a 45-degree angle.
e. Insert the needle at a 90-degree angle.
f. Before injecting the medication, withdraw the plunger to check for blood return.
b. Choose a 20- to 25-gauge, 1- to 1 1/2-inch needle.
e. Insert the needle at a 90-degree angle.
f. Before injecting the medication, withdraw the plunger to check for blood return.
A patient is to receive hydromorphone (Dilaudid) 1.5 mg IV push now. The medication comes in a prefilled syringe, 2 mg/mL.
Identify how many milliliters the nurse will administer for this dose. _______
ANS:
0.75 mL
2 mg:1 mL :: 1.5 mg:x mL
(2 × x) = (1 × 1.5); 2x = 1.5; x = 0.75; administer 0.75 mL
A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain relievers taken at home are no longer effective. What type of pain is
the patient experiencing?
a. Acute pain
b. Chronic pain
c. Somatic pain
d. Neuropathic pain
b. Chronic pain
A 16-year-old field hockey player fell and twisted her ankle during a game. The nurse will expect to administer which type of
analgesic?
a. Synthetic opioid, such as meperidine (Demerol)
b. Opium alkaloid, such as morphine sulfate
c. Opioid antagonist, such as naloxone HCL (Narcan)
d. Nonopioid analgesics, such as indomethacin (Indocin)
d. Nonopioid analgesics, such as indomethacin (Indocin)
A patient had abdominal surgery this morning. The patient is groggy but complaining of severe pain around the incision. What is
the most important assessment data to consider before the nurse administers a dose of morphine sulfate to the patient?
a. The patient’s pulse rate
b. The patient’s respiratory rate
c. The appearance of the incision
d. The date of the patient’s last bowel movement
b. The patient’s respiratory rate
A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is gradually awakening, he requests
pain medication. Within 10 minutes after receiving a dose of morphine sulfate, he is very lethargic and his respirations are shallow,
with a rate of 7 breaths/minute. The nurse prepares for which priority action at this time?
a. Assessment of the patient’s pain level
b. Immediate intubation and artificial ventilation
c. Administration of naloxone (Narcan)
d. Close observation of signs of opioid tolerance
c. Administration of naloxone (Narcan)
A patient will be discharged with a 1-week supply of an opioid analgesic for pain management after abdominal surgery. The nurse
will include which information in the teaching plan?
a. How to prevent dehydration due to diarrhea
b. The importance of taking the drug only when the pain becomes severe
c. How to prevent constipation
d. The importance of taking the drug on an empty stomach
c. How to prevent constipation
A patient has been treated for lung cancer for 3 years. Over the past few months, the patient has noticed that the opioid analgesic is
not helping as much as it had previously and more medication is needed for the same pain relief. The nurse is aware that this patient
is experiencing which of these?
a. Opioid addiction
b. Opioid tolerance
c. Opioid toxicity
d. Opioid abstinence syndrome
b. Opioid tolerance
A 38-year-old man has come into the urgent care center with severe hip pain after falling from a ladder at work. He says he has
taken several pain pills over the past few hours but cannot remember how many he has taken. He hands the nurse an empty bottle
of acetaminophen (Tylenol). The nurse is aware that the most serious toxic effect of acute acetaminophen overdose is which
condition?
a. Tachycardia
b. Central nervous system depression
c. Hepatic necrosis
d. Nephropathy
c. Hepatic necrosis
A 57-year-old woman being treated for end-stage breast cancer has been using a transdermal opioid analgesic as part of the
management of pain. Lately, she has been experiencing breakthrough pain. The nurse expects this type of pain to be managed by
which of these interventions?
a. Administering NSAIDs
b. Administering an immediate-release opioid
c. Changing the opioid route to the rectal route
d. Making no changes to the current therapy
b. Administering an immediate-release opioid
The nurse is reviewing herbal therapies. Which is a common use of the herb feverfew?
a. Muscle aches
b. Menstrual cramps
c. Joint pain
d. Incision pain after surgery
b. Menstrual cramps
A patient is to receive acetylcysteine (Mucomyst) as part of the treatment for an acetaminophen (Tylenol) overdose. Which action
by the nurse is appropriate when giving this medication?
a. Giving the medication undiluted for full effect
b. Avoiding the use of a straw when giving this medication
c. Disguising the flavor with soda or flavored water
d. Preparing to give this medication via a nebulizer
c. Disguising the flavor with soda or flavored water
A patient is receiving gabapentin (Neurontin), an anticonvulsant, but has no history of seizures. The nurse expects that the patient is
receiving this drug for which condition?
a. Inflammation pain
b. Pain associated with peripheral neuropathy
c. Depression associated with chronic pain
d. Prevention of seizures
b. Pain associated with peripheral neuropathy
The nurse is assessing a patient who has been admitted to the emergency department for a possible opioid overdose. Which
assessment finding is characteristic of an opioid drug overdose?
a. Dilated pupils
b. Restlessness
c. Respiration rate of 6 breaths/min
d. Heart rate of 55 beats/min
c. Respiration rate of 6 breaths/min
The drug nalbuphine (Nubain) is an agonist-antagonist (partial agonist). The nurse understands that which is a characteristic of
partial agonists?
a. They have anti-inflammatory effects.
b. They are given to reverse the effects of opiates.
c. They have a higher potency than agonists.
d. They have a lower dependency potential than agonists.
d. They have a lower dependency potential than agonists.
The nurse is assessing a patient for contraindications to drug therapy with acetaminophen (Tylenol). Which patient should not
receive acetaminophen?
a. A patient with a fever of 101° F (38.3° C)
b. A patient who is complaining of a mild headache
c. A patient with a history of liver disease
d. A patient with a history of peptic ulcer disease
c. A patient with a history of liver disease
A patient arrives at the urgent care center complaining of leg pain after a fall when rock climbing. The radiographs show no broken
bones, but he has a large bruise on his thigh. The patient says he drives a truck and does not want to take anything strong because
he needs to stay awake. Which statement by the nurse is most appropriate?
a. “It would be best for you not to take anything if you are planning to drive your
truck.”
b. “We will discuss with your doctor about taking an opioid because that would
work best for your pain.”
c. “You can take acetaminophen, also known as Tylenol, for pain, but no more than
1000 mg per day.”
d. “You can take acetaminophen, also known as Tylenol, for pain, but no more than
3000 mg/day.”
d. “You can take acetaminophen, also known as Tylenol, for pain, but no more than
3000 mg/day.”
A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient’s medication administration record and
recognizes that which adjuvant medication is most appropriate for this type of pain?
a. Antidepressant
b. Anticonvulsant
c. Corticosteroid
d. Local anesthesia
c. Corticosteroid
The opioid Vicodin (acetaminophen/hydrocodone) is prescribed for a patient who has had surgery. The nurse informs the patient
that which common adverse effects can occur with this medication? (Select all that apply.)
a. Diarrhea
b. Constipation
c. Lightheadedness
d. Nervousness
e. Urinary retention
f. Itching
b. Constipation
c. Lightheadedness
e. Urinary retention
f. Itching
A patient is to receive methadone (Dolophine) 2.5 mg intramuscularly (IM) now. The medication is available in a concentration of
10 mg/mL. Identify how many milliliters of methadone will be drawn up for this dose. ______
ANS:
0.25 mL
10 mg: 1 mL:: 2.5 mg: 1 mL
(10 × x) = (2.5 × 1); 10x = 2.5; x = 0.25 mg
During a fishing trip, a patient pierced his finger with a large fishhook. He is now in the emergency department to have it removed.
The nurse anticipates that which type of anesthesia will be used for this procedure?
a. No anesthesia
b. Topical benzocaine spray on the area
c. Topical prilocaine/lidocaine (EMLA) cream around the site
d. Infiltration of the puncture wound with lidocaine
d. Infiltration of the puncture wound with lidocaine
While monitoring a patient who had surgery under general anesthesia 2 hours ago, the nurse notes a sudden elevation in body
temperature. This finding may be an indication of which problem?
a. Tachyphylaxis
b. Postoperative infection
c. Malignant hypertension
d. Malignant hyperthermia
d. Malignant hyperthermia
When assessing patients in the preoperative area, the nurse knows that which patient is at a higher risk for an altered response to
anesthesia?
a. The 21-year-old patient who has never had surgery before
b. The 35-year-old patient who stopped smoking 8 years ago
c. The 40-year-old patient who is to have a kidney stone removed
d. The 82-year-old patient who is to have gallbladder removal
d. The 82-year-old patient who is to have gallbladder removal
The nurse is caring for a patient who is on a ventilator for respiratory arrest. Which parenteral anesthetic is also used for sedation
during mechanical ventilation in ICU settings?
a. Ketamine
b. Midazolam (Versed)
c. Propofol (Diprivan)
d. Sevoflurane (Ultane)
c. Propofol (Diprivan)
When administering a neuromuscular blocking drug, the nurse needs to remember which principle?
a. It is used instead of general anesthesia during surgery.
b. Only skeletal muscles are paralyzed; respiratory muscles remain functional.
c. It causes sedation and pain relief while allowing for lower doses of anesthetics.
d. Artificial mechanical ventilation is required because of paralyzed respiratory
muscles.
d. Artificial mechanical ventilation is required because of paralyzed respiratory
muscles.
A patient is being prepared for an oral endoscopy, and the nurse anesthetist reminds him that he will be awake during the procedure
but probably will not remember it. What type of anesthetic technique is used in this situation?
a. Local anesthesia
b. Moderate sedation
c. Topical anesthesia
d. Spinal anesthesia
b. Moderate sedation
During the immediate postoperative period, the Post Anesthesia Care Unit nurse is assessing a patient who had hip surgery. The
patient is experiencing tachycardia, tachypnea, and muscle rigidity, and his temperature is 103° F (39.4° C). The nurse will prepare
for what immediate treatment?
a. Naltrexone hydrochloride (Narcan) injection, an opioid reversal drug
b. Dantrolene (Dantrium) injection, a skeletal muscle relaxant
c. An anticholinesterase drug, such as neostigmine
d. Cardiopulmonary resuscitation (CPR) and intubation
b. Dantrolene (Dantrium) injection, a skeletal muscle relaxant