Chapter 31

Question 1

The nurse is having difficulty reading a physician’s order for a medication. He or she knows that the physician is very busy and does not like to be called. What is the most appropriate next step for the nurse to take?

1 Call a pharmacist to interpret the order

2 Call the physician to have the order clarified

3 Consult the unit manager to help interpret the order

4 Ask the unit secretary to interpret the physician’s handwriting

Answer 1

2. Call the physician to have the order clarified

Question 2

The patient has an order for 2 tablespoons of Milk of Magnesia. How much medication does the nurse give him or her?

1 2mL

2 5mL

3 16mL

4 30mL

Answer 2

15 ml per 1 tablespoon

4. 30ml

Question 3

A nurse is administering eardrops to an 8-year-old patient with an ear infection. How does the nurse pull the patient’s ear when administering the medication?

1 Outward

2 Back

3 Upward and back

4 Upward and outward

Answer 3

3. upward and back

Question 4

A patient is to receive cephalexin (Keflex) 500mg PO. The pharmacy has sent 250-mg tablets. How many tablets does the nurse administer?

1 tablet

2 1 tablet

3 tablets

4 2 tablets

Answer 4

4. 2 tablets

Question 5

A nurse is administering medications to a 4-year-old patient. After he or she explains which medications are being given, the mother states, “I don’t remember my child having that medication before.” What is the nurse’s next action?

1 Give the medications

2 Identify the patient using two patient identifiers

3 Withhold the medications and verify the medication orders

4 Provide medication education to the mother to help her better understand her child’s medications.

Answer 5

3. without the medications and verify the medication orders

Question 6

A patient is transitioning from the hospital to the home environment. A home care referral is obtained. What is a priority in relation to safe medication administration for the discharge nurse?

1 Set up the follow-up appointments with the physician for the patient.

2 Ensure that someone will provide housekeeping for the patient at home.

3 Ensure that the home care agency is aware of medication and health teaching needs.

4 Make sure that the patient’s family knows how to safely bathe him or her and provide mouth care.

Answer 6

3. Ensure that the home care agency is aware of medication and health teaching needs

Question 7

A nursing student takes a patient’s antibiotic to his room. The patient asks the nursing student what it is and why he should take it. Which information does the nursing student include when replying to the patient?

1 Only the patient’s physician can give this information.

2 The student provides the name of the medication and a description of its desired effect.

3 Information about medications is confidential and cannot be shared.

4 He has to speak with his assigned nurse about this

Answer 7

2. The student provides the name of the medication and a description of its desired effect

Question 8

The nurse is administering a sustained-release capsule to a new patient. The patient insists that he cannot swallow pills. What is the nurse’s next best course of action?

1 Ask the prescriber to change the order

2 Crush the pill with a mortar and pestle

3 Hide the capsule in a piece of solid food

4 Open the capsule and sprinkle it over pudding

Answer 8

1. ask the prescriber to change the order

Question 9

The nurse takes a medication to a patient, and the patient tells him or her to take it away because she is not going to take it. What is the nurse’s next action?

1 Ask the patient’s reason for refusal

2 Explain that she must take the medication

3 Take the medication away and chart the patient’s refusal

4 Tell the patient that her physician knows what is best for her

Answer 9

1. ask the patient’s reason for refusal

Question 10

The nurse receives an order to start giving a loop diuretic to a patient to help lower his or her blood pressure. The nurse determines the appropriate route for administering the diuretic according to:

1 Hospital policy.

2 The prescriber’s orders.

3 The type of medication ordered.

4 The patient’s size and muscle mass.

Answer 10

2. the prescriber’s orders

Question 11

A patient is receiving an intravenous (IV) push medication. If the drug infiltrates into the outer tissues, the nurse:

1 Continues to let the IV run.

2 Applies a warm compress to the infiltrated site.

3 Stops the administration of the medication and follows agency policy.

4 Should not worry about this because vesicant filtration is not a problem.

Answer 11

3. stops the administration of the medication and follows agency policy

Question 12

If a patient who is receiving intravenous (IV) fluids develops tenderness, warmth, erythema, and pain at the site, the nurse suspects:

1 Sepsis.

2 Phlebitis.

3 Infiltration.

4 Fluid overload.

Answer 12

2. phlebitis

Question 13

After seeing a patient, the physician gives a nursing student a verbal order for a new medication. The nursing student first needs to:

1 Follow ISMP guidelines for safe medication abbreviations.

2 Explain to the physician that the order needs to be given to a registered nurse.

3 Write down the order on the patient’s order sheet and read it back to the physician.

4 Ensure that the six rights of medication administration are followed when giving the medication.

Answer 13

2. explain to the physician that the order needs to be given to registered nurse

Question 14

A nurse accidently gives a patient a medication at the wrong time. The nurse’s first priority is to:

1 Complete an occurrence report.

2 Notify the health care provider.

3 Inform the charge nurse of the error.

4 Assess the patient for adverse effects.

Answer 14

4. assess the patient for adverse effects

Question 15

A patient is taking albuterol through a pressurized metered-dose inhaler (pMDI) that contains a total of 200 puffs. The patient takes 2 puffs every 4 hours. How many days will the pMDI last?

___________ days

Answer 15

16

Question 16

The nurse is having difficulty reading a physician’s order for a medication. He or she knows that the physician is very busy and does not like to be called. What is the most appropriate next step for the nurse to take?

A. Call a pharmacist to interpret the order

B. Call the physician to have the order clarified

C. Consult the unit manager to help interpret the order

D. Ask the unit secretary to interpret the physician’s handwriting

Answer 16

B. Call the physician to have the order clarified.

You must have the right documentation and clarify all orders with the prescriber before administering medications.

Question 17

The patient has an order for 2 tablespoons of Milk of Magnesia. How much medication does the nurse give him or her?

A. 2 mL

B. 5 mL

C. 16 mL

D. 30 mL

Answer 17

d. 30 ml

1 tablespoon = 15 mL; 2 tablespoons = 30 mL.

Question 18

A nurse is administering eardrops to an 8-year-old patient with an ear infection. How does the nurse pull the patient’s ear when administering the medication?
A. Outward

B. Back

C. Upward and back

D. Upward and outward

Answer 18

D. Upward and outward

Ear Drops are administered with the ear positioned upward and outward for patients greater than 3 years of age.

Question 19

A patient is to receive cephalexin (Keflex) 500 mg PO. The pharmacy has sent 250-mg tablets. How many tablets does the nurse administer?
A. ½ tablet

B. 1 tablet

C. 1 ½ tablets

D. 2 tablets

Answer 19

D. 2 tablets
Using dimensional analysis:
Tablets = 1 tablet/250 mg x 500 mg = 500/250 = 2 tablets.

Question 20

A nurse is administering medications to a 4-year-old patient. After he or she explains which medications are being given, the mother states, “I don’t remember my child having that medication before.” What is the nurse’s next action?

A. Give the medications

B. Identify the patient using two patient identifiers

C. Withhold the medications and verify the medication orders

D. Provide medication education to the mother to help her better understand her child’s medications

Answer 20

C. Withhold the medications and verify the medication orders

Do not ignore patient or caregiver concerns; always verify orders whenever a medication is questioned before administering it.

Question 21

A patient is transitioning from the hospital to the home environment. A home care referral is obtained. What is a priority in relation to safe medication administration for the discharge nurse?
A. Set up the follow-up appointments with the physician for the patient.

B. Ensure that someone will provide housekeeping for the patient at home.

C. Ensure that the home care agency is aware of medication and health teaching needs.

D. Make sure that the patient’s family knows how to safely bathe him or her and provide mouth care.

Answer 21

C. Ensure that the home care agency is aware of medication and health teaching needs.

A nursing responsibility is to collaborate with community resources when patients have home care needs or difficulty understanding their medications.

Question 22

A nursing student takes a patient’s antibiotic to his room. The patient asks the nursing student what it is and why he should take it. Which information does the nursing student include when replying to the patient?
A. Only the patient’s physician can give this information.

B. The student provides the name of the medication and a description of its desired effect.

C. Information about medications is confidential and cannot be shared.

D. He has to speak with his assigned nurse about this.

Answer 22

B. The student provides the name of the medication and a description of its desired effect.

Patients need to know information about their medications so they can take them correctly and safely.

Question 23

The nurse is administering a sustained-release capsule to a new patient. The patient insists that he cannot swallow pills. What is the nurse’s next best course of action?

A. Ask the prescriber to change the order

B. Crush the pill with a mortar and pestle

C. Hide the capsule in a piece of solid food

D. Open the capsule and sprinkle it over pudding

Answer 23

A. Ask the prescriber to change the order

Enteric-coated or sustained-release capsules should not be crushed; the nurse needs to contact the prescriber to change the medication to a form that is liquid or can be crushed.

Question 24

The nurse takes a medication to a patient, and the patient tells him or her to take it away because she is not going to take it. What is the nurse’s next action?

A. Ask the patient’s reason for refusal

B. Explain that she must take the medication

C. Take the medication away and chart the patient’s refusal

D. Tell the patient that her physician knows what is best for her

Answer 24

A. Ask the patient’s reason for refusal

When patients refuse a medication, first ask why they are refusing it.

Question 25

The nurse receives an order to start giving a loop diuretic to a patient to help lower his or her blood pressure. The nurse determines the appropriate route for administering the diuretic according to: A. Hospital policy. B. The prescriber's orders. C. The type of medication ordered. D. The patient's size and muscle mass.

Answer 25

B. The prescriber's orders The order from the prescriber needs to indicate the route of administration.

Question 26

A patient is receiving an intravenous (IV) push medication. If the drug infiltrates into the outer tissues, the nurse: A. Continues to let the IV run. B. Applies a warm compress to the infiltrated site. C. Stops the administration of the medication and follows agency policy. D. Should not worry about this because vesicant filtration is not a problem.

Answer 26

C. Stops the administration of the medication and follows agency policy. When an IV medication infiltrates, stop giving the medication and follow agency policy.

Question 27

If a patient who is receiving intravenous (IV) fluids develops tenderness, warmth, erythema, and pain at the site, the nurse suspects: A. Sepsis. B. Phlebitis. C. Infiltration. D. Fluid overload.

Answer 27

B. Phlebitis Redness, warmth, and tenderness at the IV site are signs of phlebitis.

Question 28

After seeing a patient, the physician gives a nursing student a verbal order for a new medication. The nursing student first needs to: A. Follow ISMP guidelines for safe medication abbreviations. B. Explain to the physician that the order needs to be given to a registered nurse. C. Write down the order on the patient's order sheet and read it back to the physician. D. Ensure that the six rights of medication administration are followed when giving the medication.

Answer 28

B. Explain to the physician that the order needs to be given to a registered nurse. Students can not take orders.

Question 29

A nurse accidentally gives a patient a medication at the wrong time. The nurse's first priority is to: A. Complete an occurrence report. B. Notify the health care provider. C. Inform the charge nurse of the error. D. Assess the patient for adverse effects.

Answer 29

D. Assess the patient for adverse effects. Patient safety and assessing the patient are priorities when a medication error occurs.

Question 30

Briefly summarize the Federal Government role in the regulation of medications

Answer 30

The federal government protects the health of the people by ensuring that medications are safe and effective. Currently, the food and drug administration ensures that all medications

Question 31

Briefly summarize the State Governments role in the regulation of medications

Answer 31

The state governments conform to federal legislation but also have additional controls such as alcohol and tobacco

Question 32

Briefly summarize the Health Care Institutions role in the regulation of medications.

Answer 32

Health care institutions have individual policies to meet federal and state regulations

Question 33

Briefly summarize the nurse practice act role in the regulation of medications.

Answer 33

The nurse practice act defines the scope of a nurse's professional functions and responsibilities

Question 34

Define Chemical Name

Answer 34

a chemical name provides an exact description of the mediation's composition and molecular structure

Question 35

Define Generic name

Answer 35

A generic name is created by the manufacturer who first develops the medication; this becomes the offical name

Question 36

Define Trade name

Answer 36

The trade name is one that the manufacturer ha trademarked to identify the particular version they manufacture.

Question 37

A medication classification indicates______.

Answer 37

the effect of the medication on a body system, the symptoms the medication relieves, or the mediation's desired effect

Question 38

The form of the medication determines its:__

Answer 38

its route of administration

Question 39

Pharmacokinetics is

Answer 39

the study of how medications enter the body, reach their site of action, metabolize, and exit the body

Question 40

Define Absorption

Answer 40

refers to the passage of medication molecules into the blood from the site of administration

Question 41

Identify the 5 factors that influence drug absorption

Answer 41

1. Route of administration 2. Ability of the medication to dissolve 3. Blood flow to the site of administration 4. Body surface area 5. Lipid solubility

Question 42

Identify the 5 factors that affect the rate and extent of medication distribution

Answer 42

``` A. Circulation B. Membrane permeability C. Protein binding D. Metabolism E. Excretion ```

Question 43

Explain the role of metabolism

Answer 43

After a medication reaches its site of action, it becomes metabolized into a less active or inactive form that is easier to excrete

Question 44

Identify the primary organ for drug excretion

Answer 44

The kidneys are the primary organ excretion,

Question 45

Explain what happens if the primary organ for drug excretion declines

Answer 45

When renal function declines, a patient is at risk for medication toxicity

Question 46

Define Therapeutic effects

Answer 46

therapeutic effects are the expected or predictable physiological response to a medication

Question 47

Is therapeutic effects a predicted or unintended effect of drugs

Answer 47

Predictable response

Question 48

Define side effects

Answer 48

Are predictable and often unavoidable secondary effects a medication predictably will cause

Question 49

Is side effects a predicted or unintended effect of drugs

Answer 49

Predictable and sometimes unavoidable

Question 50

Define Adverse Effects

Answer 50

Are unintended, undesirable and often unpredictable severe responses to medication

Question 51

Is adverse effects a predicted or unintended effect of drugs

Answer 51

Unintended, undesirable and often unpredictable

Question 52

Define Toxic Effects

Answer 52

Develop after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion

Question 53

Is toxic effects a predicted or unintended effect of drugs?

Answer 53

unintended

Question 54

Define Idiosyncratic reactions

Answer 54

are unpredictable effects in which a patient overreacts or under reacts to a medication or has a reaction that is different from normal

Question 55

Is Idiosyncratic reactions a predicted or unintended effect of drugs?

Answer 55

unpredictable

Question 56

Define allergic reactions

Answer 56

are unpredictable responses to a medication

Question 57

Are allergic reactions a predicted or unintended effect of drugs

Answer 57

unpredictable

Question 58

Define Anaphylactic reactions

Answer 58

are allergic reactions that are life threatening and characterized by sudden constriction of bronchial muscles, edema of the pharynx and larynx and severe wheezing and shortness of breath

Question 59

Are anaphylactic reactions a predicted or unintended effect of drugs

Answer 59

unintended

Question 60

Define Medication interaction

Answer 60

occurs when one medication modifies the action of another medication; it may alter the way another medication is absorbed, metabolized, or eliminated from the body

Question 61

Are medication interaction a predicted or unintended effect of drugs

Answer 61

unintended

Question 62

Define Synergistic effect

Answer 62

is when the combine effect of the two medications is greater than the effect of the medications when given separately

Question 63

Are synergistic effect a predicted or unintended effect of drugs

Answer 63

both

Question 64

Define Minimum effective concentration (MEC)

Answer 64

is the plasma level of a medication below which the medication's effect will not occur

Question 65

Define Peak concentration

Answer 65

is the highest serum level concentration

Question 66

Define trough concentration

Answer 66

is the lowest serum level concentration

Question 67

Define Biological half-life

Answer 67

is the time it takes for excretion processes to lower the serum medication concentration by half

Question 68

Identify the three types of oral routes

Answer 68

1. oral 2. buccal 3. sublingual

Question 69

List the four major sites for parenteral injections

Answer 69

1. Intradermal 2. Subcutaneous 3. Intramuscular 4. Intravenous

Question 70

Define Epidural

Answer 70

are administered in the epidural space via a catheter, usually used for postoperative analgesia

Question 71

Define Intrathecal

Answer 71

is via a catheter that is in the subarachnoid space or one of the ventricles of the brain

Question 72

Define Intraosseous

Answer 72

is an infusion of medication that is administered directly into the bone marrow; it is commonly used in infants and toddlers

Question 73

Define Intraperitoneal

Answer 73

such as chemotherapeutic agents, insulin and antibiotics are administered into the peritoneal cavity

Question 74

Define Intrapleural

Answer 74

commonly chemotherapeutics, are administered directly into the pleural space

Question 75

Define Intraaterial

Answer 75

are administered directly into the arteries

Question 76

Define Intracardiac

Answer 76

Are injected directly into he cardiac tissue

Question 77

Define Intraarticular

Answer 77

are injected into a joint

Question 78

Identify 5 methods for applying medications to mucous membranes

Answer 78

1. directly applying a liquid or ointment 2. Inserting a medication into a body cavity 3. Instilling fluid into a body cavity 4. Irrigating a body cavity 5. Spraying

Question 79

Identify the benefit of the inhalation route

Answer 79

inhaled medications are readily absorbed and work rapidly because of the rich vascular alveolar capillary network present in the pulmonary tissue.

Question 80

Identify the 3 types of measurements used in medication therapy

Answer 80

1. Metric 2. Apothecary 3. Household

Question 81

a solution is

Answer 81

a given mass of solid substance dissolved in an known volume of fluid or a given volume of liquid dissolved in a known volume of another fluid

Question 82

Write out the formula used to determine the correct dose when preparing solid or liquid forms of medications

Answer 82

dose ordered/dose on hand x amount on hand = amount to administer

Question 83

Define a verbal order

Answer 83

if a medication order is given by the physician to the nurse

Question 84

Define a standing order

Answer 84

is also known as a routine order is carried out until the prescriber cancels it by another order or until a prescribed number of days elapse

Question 85

Define a prn order

Answer 85

is a medication that is given only when a patient requires it

Question 86

Define a single (one-time) order

Answer 86

is given only once at a specified time

Question 87

Define STAT order

Answer 87

describes a single dose of a medication to be given immediately and only once

Question 88

Define now order

Answer 88

is used when a patient needs a medication quickly but not right away; the nurse has up to 90 minutes to administer

Question 89

List the two medication distribution systems

Answer 89

1. Unit Dose | 2. Automated medication dispensing systems (AMDS)

Question 90

Identify the 5 common medication errors that can cause patient harm

Answer 90

1. Inaccurate prescribing 2. Administration of the wrong medicine 3. Giving the medication using the wrong route or time interval 4. Administering extra doses 5. Failing to administer a medication

Question 91

Identify the 4 process for medication reconciliation

Answer 91

1. Verify 2. Clarify 3. Reconcile 4. Transmit

Question 92

Lis the six rights of medication administration

Answer 92

1. The right medication 2. The right dose 3. The right patient 4. The right route 5. The right time 6. The right documentation

Question 93

Briefly summarize the 8 the patient care partnership related to medication administration

Answer 93

1. Be informed of the medication's name, purpose, action, and potential undesired effects. 2. refuse a medication regardless of the consequences. 3. Have qualified nurses or physicians assess a medication history 4. Be properly advised of the experimental nature of medication therapy and give written consent. 5. Receive labeled medications safely without discomfort 6. Receive appropriate supportive therapy. 7. Not receive unnecessary medications. 8. Be informed if medications are a part of a research study.

Question 94

Identify the 9 areas the nurse needs to assess to determine the need for and potential response to mediation therapy

Answer 94

1. history 2. history of allergies 3. medication data 4. diet history 5. Patient's perceptual coordination problems 6. patient's current condition 7. patient's attitude about medication use 8. patients knowledge and understanding of medication therapy 9. Patient's learning needs

Question 95

Identify 7 of the potential nursing dx used during the administration of medications

Answer 95

1. Anxiety 2. Ineffective health maintenance 3. readiness for enhanced immunization status 4. deficient knowledge 5. Noncompliance 6. Effective therapeutic regimen management 7. Impaired swallowing

Question 96

Identify the outcomes for a patient with newly dx type 2 diabetes

Answer 96

1. will verbalize understanding of desired effects and adverse effects of medications 2. will state signs, symptoms, and treatment of hypoglycemia. 3. will monitor blood sugar to determine if medication is appropriate to take 4. Will establish a daily routine that will coordinate timing of medication with meal times

Question 97

Identify 4 factors that can influence the patients compliance with the medication regimen

Answer 97

1. health beliefs 2. personal motivations 3. Socioeconomic factors 4. habits

Question 98

Identify the 7 components of medication orders

Answer 98

1. Patients full name 2. Date and time that the order is written 3. Medication name 4. Dose 5. Route of administration 6. time and frequency of administration 7. Signature of provider

Question 99

5 things needed for the recording of medication

Answer 99

1. The name of the medication 2. Dose 3. Route 4. Exact time of administration 5. Site

Question 100

Explain the reason why polypharmacy happens to a patient

Answer 100

When patients need to take several medications to treat their illnesses, take two or more medications from the same chemical class, use two or more medications supplements or herbal products with medications, polypharmacy happens

Question 101

Identify two goals for safe and effective medication administration

Answer 101

1. a patient responds to therapy | 2. Patient has the ability to assume responsibility for self-care.

Question 102

identify 10 precautions to take when administering any oral preparation to prevent aspiration

Answer 102

1. determine the patient's ability to swallow and cough and check for gag reflex. 2. prepare oral medications in the form that is easiest to swallow. 3. allow the patient to self-administer medications if possible. 4. If the patient has unilateral weakness, place the medication in the stronger side of the mouth. 5. administer pills one at a time, ensuring that each medication is properly swallowed before the next one is introduced. 6. thicken regular liquids or offer fruit nectars if the patient cannot tolerate thin liquids 7. Avoid straws because they decrease the control the patient has over volume intake, which increases the risk of aspiration. 8. have the patient hold the cup and drink it if possible. 9. Time medications to coincide with meal times or when the patient is well rested and awake if possible. 10. administer medications using another route if risk of aspiration is severe.

Question 103

Identify the 5 guidelines to ensure safe administration of transdermal or topical medications

Answer 103

1. Document where the medication was placed in the MAR. 2 Assess if patient has an existing patch before application 3. Medication history and reconciling medications 4. Apply a noticeable label to the patch 5. Document removal of medication on the MAR

Question 104

the most common form of nasal instillation is?

Answer 104

Decongestant spray or drops

Question 105

List 4 principles for administering eye instillations

Answer 105

1. Avoid instilling any eye medication directly onto the cornea. 2. Avoid touching the eyelids or other eye. 3. Use medication only for the patients affected eye 4. never allow a patient to use another patient's eye medications

Question 106

Failure to instill ear drops at room temperature causes (3)

Answer 106

1. Vertigo 2. Dizziness 3. Nausea

Question 107

Vaginal medications are available as (4)

Answer 107

1. Suppositories 2. Foam 3. Jellies 4. Creams

Question 108

Rectal suppositories are used for

Answer 108

Exerting local effects (promoting defecation) or systemic effects (reducing nausea)

Question 109

explain what pressurized metered-dose inhalers (pMDIs) are

Answer 109

Delivers a measured dose of medication with each push of a canister often used with a spacer

Question 110

Explain what breath-actuated metered-dose inhalers (BAIs)

Answer 110

releases medication when a patient raises a level and then inhales

Question 111

Explain dry powder inhalers (DPIs)

Answer 111

Hold dry, powdered medication and create an aerosol when the patient inhales through a reservoir that contains the medication

Question 112

Identify the 4 aseptic techniques to use to prevent an infection during an injection

Answer 112

1. Draw medication from ampule quickly; do not allow it to stand open 2. avoid letting the needle touch contaminated surface. 3. Avoid touching the length of the plunger or inner part of the barrel 4. Prepare the skin, use friction and a circular motion while cleaning with an antiseptic swab, and start from the center and move outward

Question 113

Identify the factors that must be considered when selecting a needle for an injection (2)

Answer 113

1. the patient's size and weight | 2. Type of tissue into which the medication is to be injected

Question 114

Describe ampule

Answer 114

contain single doses of medications in a liquid

Question 115

Describe vial

Answer 115

A single dose or multi-dose container with a rubber seal at the top (closed system)

Question 116

List the 3 principles to follow when mixing medications from two vials

Answer 116

1. Do not contaminate one medication with another. 2. Ensure that the final dose is accurate 3. Maintain aseptic technique

Question 117

Insulin is classified by

Answer 117

Rate of action (rapid, short, intermediate and long acting) each has a different onset, peak, and duration of action

Question 118

Identify the principles to follow when mixing two types of insulin in the same syringe (5)

Answer 118

1. Need to maintain their individual routine when preparing and administrating their insulin 2. Do not mix insulin with any other medication or diluents 3. Never mix insulin glargine or insulin detemir with other types of insulin 4. Inject rapid-actin insulin mixed with NPH within other types of insulin 5. Verify insulin dosages with another nurse while preparing them.

Question 119

List the techniques used to minimize patient discomfort that is associated with injections (8)

Answer 119

1. Use a sharp beveled needle in the smallest suitable length and gauge. 2. Position the patient as comfortably as possible to reduce muscle tension 3. select the proper injection site. 4. apply a vapocoolant spray or topical anesthetic to the site if possible. 5. divert the patient's attention from the injection 6. insert the needle quickly and smoothly 7. Hold the syringe while the needle remains in tissue. 8. Inject the medication slowly and steadily

Question 120

Identify the best sites for subcutaneous injections

Answer 120

1. The outer posterior aspect of the upper arm 2. the abdomen (below the costal margins to the iliac crests) 3. The anterior aspects of the thighs

Question 121

What is the maximum amount of water-soluble medication given by the subcutaneous route

Answer 121

0.5 to 1 ml

Question 122

What angles should be used when administering a subcutaneous injection with which needle should they be used (2)

Answer 122

1. 25 gauge, 5/8 inch needle inserted at a 45 degree angle | 2. 1/2 inch needle inserted at a 90 degree angle

Question 123

What is the angle of insertion for an intramuscular (IM) injection

Answer 123

90 degrees

Question 124

Indicate the maximum volume of medication for an IM injection in well-developed adults

Answer 124

2 to 5 ml into a large muscle

Question 125

Indicate the maximum volume of medication for an IM injection in Vastus Lateralis

Answer 125

2 ml

Question 126

Indicate the maximum volume of medication for an IM injection in Deltoid

Answer 126

1 ml

Question 127

Explain the rationale for the Z-track method in IM injections

Answer 127

minimizes local skin irritation by sealing the medication into the tissue

Question 128

Explain the rationale for intradermal injections

Answer 128

skin testing, injected into the dermis where medication is absorbed slowly

Question 129

List the 3 methods a nurse can use to administer medications intravenously

Answer 129

1. as mixtures within large volumes of IV fluids 2. Injection of a bolus or small volume of medication 3. Piggyback infusion

Question 130

Identify the 3 advantages of the intravenous (IV) route of administration

Answer 130

1. fast-acting medications must be delivered quickly 2. it provides constant therapeutic blood levels 3. it can be used when medications are highly alkaline and irritating to the muscle and subcutaneous tissue

Question 131

The 2 disadvantages of IV bolus medications are

Answer 131

1. It is the most dangerous method because there is no time to correct errors. 2. A bolus may cause direct irritation to the lining of blood vessels

Question 132

List the 3 advantages of using volume-controlled infusions

Answer 132

1. They reduce the risk of rapid infusion by IV push 2. They allow for administration of medications that are stable for a limited time in solution 3. They allow for control of IV fluid intake.

Question 133

what is a piggyback set

Answer 133

a small (25 to 250 ml) IV bag connected to short tubing line that connects to the upper Y port of a primary infusion line

Question 134

What is a volume-control administration set

Answer 134

a small (50 to 150 ml) container that attaches below the primary infusion line

Question 135

What is a mini-infusion pump

Answer 135

a battery-operated machine that allows medications to be given in very small amounts of fluid (5 to 60ml)

Question 136

List the 5 advantages of using intermittent venous access devices

Answer 136

1. cost saving 2. Convenience 3. Increased mobility 4. Safety 5. Patient Comfort

Question 137

The study of how drugs enter the body, reach their sites of action are metabolized, and exit from the body is called: 1. Pharmacology 2. Pharmacopoeia 3. Pharmacokinetics 4. Biopharmaceutical

Answer 137

3. Pharmacokinetics

Question 138

Which statement correctly characterizes drug absorption? 1. Most drugs must enter the systemic circulation to have a therapeutic effect 2. Oral medications are absorbed more quickly when administered with meals 3. Mucous membranes are relatively impermeable to chemicals, making absorption slow 4. Drugs administered subcutaneously are absorbed more quickly than those injected intramuscularly

Answer 138

1. absorption refers to the passage of medication molecules into the blood fr the site of administration

Question 139

The onset of drug action is the time it takes for a drug to: 1. Produce a response 2. Accelerate the cellular process 3. Reach its highest effective concentration 4. Produce blood serum concentration and maintenance

Answer 139

1. definition of onset to produce a response

Question 140

which of the following is not a parenteral route of administration 1. buccal 2. Intradermal 3. Intramuscular 4. Subcutaneous

Answer 140

1. an oral route Buccal

Question 141

Using the body surface area formula, what does of drug X should a child who weighs 12kg (body surface area =0.54m2) receive if the normal adult dose of drug X is 300 mg. 1. 50mg 2. 90mg 3. 100mg 4. 200 mg

Answer 141

2. childs dose = surface of child/1.7m2 x normal adult dose

Question 142

The nurse is preparing an insulin injection in which both regular and NPH will be mixed. Into which vial should the nurse inject air first. 1. the vial of regular insulin 2. the vial of NPH 3. Either vial, as long as modified insulin in drawn up first 4. Neither vial: it is not necessary to put air into vials before withdrawing medication

Answer 142

2. if mixing rapid- or - short-acting insulin with intermediate - or long-acting insulin, take the insulin syringe and aspirate a volume of air equivalent to the dose of insulin to be withdrawn from the long-acting insulin first.

Question 143

Of the following names which is most often seen by the nurse: 1. Chemical name 2. Generic name 3. Trade name

Answer 143

Generic name | Trade name

Question 144

Drug Classifications can be classified by: 1. Effect on the body system 2 Chemical composition 3. Clinical indication or therapeutic action 4. Trade name

Answer 144

Effect on the body system Chemical composition Clinical indication or therapeutic action

Question 145

Define serum half-life

Answer 145

time for serum medication concentration to be halved

Question 146

What are the 3 checks for reading the label

Answer 146

1. As you reach for the medication 2. before opening or pouring the medication 3. as you replace the med to drawer and before giving to the patient

Question 147

Can topical administration of medications be only skin

Answer 147

No, it can be vaginal, rectal, instillation, irrigation, and skin

Question 148

What is the preferred site for infants

Answer 148

vastus lateralis

Question 149

Which of the following is not part of the syringe and needle: 1. bevel 2. shaft 3. gauge number 4. hub 5. alcohol swap

Answer 149

alcohol swap is not part of the syringe and needle

Question 150

what are the 6 controlled substance regulations

Answer 150

1. name of patient receiving narcotic 2. Amount of narcotic used 3. The hour narcotic was given 4. The name of physician prescribing narcotic 5. Name of the nurse administering narcotic 6. Process if medication is wasted