Medications

Question 1

What is the best way for the nurse to make sure that the right patient is receiving a prescribed drug when the patient is alert and oriented?

a. ask the patient to state his or her name
b. check the patient’s wrist band
c. look at the patients chart
d. have the patient state his or her name and birth date

Answer 1

d. have the patient state his or her name and birth date

Question 2

when is it acceptable for the nurse to take a verbal order from the prescriber before giving a drug to a patient?
a. during the night shift when the prescriber is not at the hospital
b. in an emergency situation such as a cardiac arrest
c. when a patient is experiencing severe pain
d. at any time it is necessary

Answer 2

b. in an emergency situation such as a cardiac arrest

Question 3

The nurse is giving morning medications to patient who refuses to take an oral dose of docusate (Colace).What is the nurse’s best response?
a. your prescriber ordered that you must take this drug twice a day.
b. docusate will soften your bowel movements so that you do not strain
c. this drug will help prevent constipation while you are on bed rest.
d. can you tell me why you do not want to take the docusate?

Answer 3

d. can you tell me why you do not want to take the docusate?

Question 4

what is the most important role of the nurse in preventing drug errors?
a. always checking the patient’s diagnosis before giving a drug
b. always following the “six rights” of drug administration
c. being the one defense for detecting and preventing drug errors
d. being most likely to detect a drug error that has occurred.

Answer 4

b. always following the “six rights” of drug administration

Question 5

The prescriber orders atenolol (Tenormin) 25 mg to be given orally once a day to control a patients high blood pressure. The nurse takes the patient’s vital signs and finds that the blood pressure is 128/80 and the heart rate is 60 b/m. What does the nurse do first before giving this drug?
a. check the order for prescriber limitations on when the drug should be given
b. notify the prescriber and ask if the drug should be given
c. reassess the blood pressure and heart rate in 30 minutes
d. give the drug exactly as prescribed.

Answer 5

a. check the order for prescriber limitations on when the drug should be given

Question 6

A patient is to receive nitroglycerin ointment, 1 inch STAT, for elevated blood pressure. What must the nurse do before giving this drug?
a. shave the hair off the patient’s chest
b. place the patient on a heart monitor
c. put on a pair of disposable gloves
d. measure the dose directly on the patient’s skin.

Answer 6

c. put on a pair of disposable gloves

Question 7

A sublingual drug is administered by placing the drug in what part of the body?
a. between the cheek and the upper jaw
b. under the tongue
c. in the nose
d. in the eyes

Answer 7

b. under the tongue

Question 8

What administration technique does the nurse use to give a 2 yr old child ear drops?
a. pull the earlobe down and back
b. pull the earlobe up and out
c. keep the earlobe straight
d. hang the patient’s head over the side of the bed.

Answer 8

a. pull the earlobe down and back

Question 9

What must the nurse be sure to tell the patient after a vaginal drug is administered?
a. this drug should be refrigerated
b. you may take this drug at home while sitting on the toilet.
c. be sure to empty your bladder after receiving this drug.
d. remain lying down for 10 to 15 mins after taking this drug.

Answer 9

d. remain lying down for 10 to 15 mins after taking this drug

Question 10

When giving a drug to a patient who is awake but confused, what is the best way for the nurse to identify the patient?
a. check the room and bed number that the patient occupies.
b. ask the patient to state his or her name and birth date.
c. check the name on the patient’s wristband.
d. ask the patient if he or she is Mr. or Ms. (name).

Answer 10

c. check the name on the patient’s wristband.

Question 11

The physician orders all of the following drugs for a patient who had surgery 2 days ago. Which drug order does the nurse administer first?
a. Alphamine (cyanocobalamin) 100 mcg intramuscularly once
b. Benadryl (diphenhydramine) 25 mg orally every 8 hrs.
c. compazine (prochlorperazine) 10 mg orally STAT
d. Dalmane (flurazepam) 30mg orally at night PRN

Answer 11

c. compazine (prochlorperazine) 10 mg orally STAT

Question 12

The nurse is interviewing a patient. Which action by the nurse indicates active listening?
a. asking interview questions while starting an IV
b. correcting the patient’s use of the word “free bleeder” for hemophilia
c. asking the spouse to verify the patient’s responses to family history questions
d. restating what the patient said to ensure the nurse understands what the patient meant.

Answer 12

restating what the patient said to ensure the nurse understands what the patient meant.

Question 13

The nurse is preparing to teach a patient about a newly prescribed drug therapy. What time is best for improving teaching effectiveness?
a. during lunch so that the patient is not too hungry to learn
b. after the patient wakes up from a nap and no visitors are present.
c. right after the health care provider has told the patient that the health problem cannot be cured.
d. when the patient’s spouse and 3 adult children are present so that the family can reinforce the teaching.

Answer 13

b. after the patient wakes up from a nap and no visitors are present.

Question 14

Which statement by the nurse is more likely to motivate a patient to adhere to a drug therapy regimen for hypertension?
a. your doctor prescribed this drug and your doctor knows what is best for your health.
b. if you do not take this drug you are at greater risk to die of stroke or heart attack within the next 10 yrs.
c. as an artist, your eyes are important, and taking this drug daily helps prevent eye damage from high blood pressure.
d. if you are not taking this drug because you are to poor to afford it, I can call a social worker so you can get financial aid.

Answer 14

as an artist, your eyes are important, and taking this drug daily helps prevent eye damage from high blood pressure

Question 15

The order reads: Lanoxin 0.125 mg PO now. The medication is available in 0.25 mg tablets. Which of the following represent the number of tablets the nurse will give.
a. 2 tab
b. 1/2 tab
c. 1 1/2 tab
d. 1/4 tab

Answer 15

b. 1/2 tab

Question 16

Which of the following represents the proper way for a nurse to administer an oral capsule?
a. tell the patient to swallow it whole
b. pierce it with a needle and squeeze into the mouth
c. crush and dilute it in warm water.
d. tell the patient to chew it completely

Answer 16

a. tell the patient to swallow it whole

Question 17

The nurse instructs a clinic patient on using an inhaler for his asthma attacks. Which of the following is correct about the use of an inhaler?
a. the medication must go into the back of the nose
b. the medication must go directly into the throat
c. the medication must get to the ears
d. the medication must go into the lungs.

Answer 17

d. the medication must go into the lungs.

Question 18

When giving a medicine through a nasogastric (NG) tube, the nurse will first do which of the following?
a. flush the tube with 30 mL of water
b. Check placement of the tube
c. take the vital signs
d. ask the patient if the tube is painful

Answer 18

b. Check placement of the tube

Question 19

Which of the following is done after giving medication through a nasogastric tube that is connected to suction?
a. the tube is reconnected to the suction
b. the tube is clamped for 10 min then reconnected to suction
c. the tube is clamped for 30min then reconnected to suction
d. the suction is left off for 4 hrs then reconnected to suction

Answer 19

c. the tube is clamped for 30min then reconnected to suction

Question 20

In which of the following ways can a nurse prevent injury from a needlestick?
a. recap the needle before disposal
b. remove the needle from the syringe
c. immediately discard the needle and syringe in a puncture-proof container
d. stick it into the patient’s mattress until it can be disposed of.

Answer 20

c. immediately discard the needle and syringe in a puncture-proof container

Question 21

which of the following is the correct needle for an intramuscular (Im) injection?
a. 18 G, 1-in
b. 20 G, 1/2 in
c. 25 G, 2-in
d. 21 G, 1 1/2 in

Answer 21

d. 21 G, 1 1/2 in

Question 22

Which of the following principles of medication administration will be taught to a patient who will be administering his own subcutaneous (SC) injections?
a. Use a 22 G, 5/8 in needle
b. Rotate sites among the upper arm, abdomen, and anterior thigh
c. Avoid injecting within 3 in of a previous injection site
d. insert the needle at a 30 degree angle to the skin

Answer 22

b. Rotate sites among the upper arm, abdomen, and anterior thigh

Question 23

If an IV has become infiltrated, the nurse will observe which of the following assessment findings?
a. Pallor, pain
b. Erythema, warmth
c. Erythema, swelling
d. Warmth, swelling

Answer 23

c. Erythema, swelling

Question 24

When applying a topical nitroglycerin ointment, the nurse will do which of the following?
a. massage it thoroughly into the skin.
b. squeeze it onto the applicator paper and place it on the skin
c. apply it to the medial aspect of the thigh
d. shave the skin prior to application

Answer 24

b. squeeze it onto the applicator paper and place it on the skin

Question 25

An elderly patient is scheduled to take six medications each morning. The nurse administering these medications knows to do which of the following? a. allow extra time to administer all of the medications b. allow the patient to take only the medications she can swallow. c. crush all of the medications before giving them d. leave the medication at the bedside so the patient can take them slowly.

Answer 25

a. allow extra time to administer all of the medications

Question 26

Metered-dose inhalers are used to deliver specific amounts of medication. The nurse gives the patient which of the following instructions? a. never shake the inhaler medication before use. b. exhale while squeezing the canister to deliver the medication. c. sit upright, exhale, then activate the inhaler as the next inhalation begins. d. hold the head back while inhaling the medication.

Answer 26

c. sit upright, exhale, then activate the inhaler as the next inhalation begins.

Question 27

Before the nurse administers a liquid medication to an 83 yr old male patient, the nurse should: a. assess the swallowing reflex by offering a sip of water b. ask the patient if he would prefer to give the medication to himself. c. mix thoroughly in applesauce or pudding d. assess the ability to understand information relative to the drug

Answer 27

a. assess the swallowing reflex by offering a sip of water

Question 28

The nurse receives an order to give vitamin D 10 mcg bid. The nurse recognizes that the abbreviation mcg refers to a measurement in: a. milligrams b. milliequivalents c. milliliters d. micrograms

Answer 28

d. micrograms

Question 29

The licensed nurse who is responsible for doing the narcotic count for the shift should count the drugs. a. alone for accuracy. b. with any licensed person c. with another nurse working on the shift d. with a nurse coming on duty for the next shift.

Answer 29

d. with a nurse coming on duty for the next shift.

Question 30

Before the nurse administers a dose of digoxin (Lanoxin) to a patient, the nurse should assess: a. blood pressure b. respiratory rate c. apical heart rate d. level of consciousness

Answer 30

c. apical heart rate

Question 31

A patient complains about the taste of the the sublingual nitroglycerin and admits that the swallows it rather then holding it under his tongue. The nurse explains that sublingual medications. a. should not be swallowed because it alters the absorption potential. b. can be inserted rectally without loss of absorption potential c. can be held against the roof of the mouth with the tongue to reduce taste. d. can be taken between the cheek and tongue to diminish taste.

Answer 31

a. should not be swallowed because it alters the absorption potential.

Question 32

To reduce the systemic absorption of eye drops, the nurse should: a. use finger pressure to close the eyelid tightly b. apply slight finger pressure over the lacrimal duct c. request the patient tilt the head slightly to the side of the unaffected eye d. instruct the patient to widen the eyes in order to increase access to the lacrimal duct.

Answer 32

b. apply slight finger pressure over the lacrimal duct

Question 33

For an adult patient who has an order to receive an otic medication, the nurse should plan to administer it by pulling the pinna: a. down and forward b. up and forward c. down and back d. up and back.

Answer 33

d. up and back.

Question 34

when administering medications to a patient with a feeding tube, the nurse should dissolve each crushed medication in at least ___ mL of water. a. 30 to 60 b. 20 to 30 c. 15 to 20 d. 5 to 15

Answer 34

b. 20 to 30

Question 35

A patient on the long-term care unit receives the wrong medication. The charge nurse should instruct which staff member to complete the incident report? a. the nurse who administered the wrong drug b. the nursing supervisor for the day c. the nurse who discovered the error d. no one, because the charge nurse should do it.

Answer 35

c. the nurse who discovered the error

Question 36

The nurse checking the MAR finds that an order for an antibiotic is no 8 days old. The nurse should: a. check the medications, performing three medication checks b. give the ordered medication c. contact the physician for a new order. d. give the medication, then notify the physician

Answer 36

c. contact the physician for a new order.

Question 37

Examples of medications that are given by enteral routes include which of the following: SELECT ALL THAT APPLY a. total parenteral nutrition (TPN) solutions b. oral tablets c. oral capsules d. rectal suppositories e. liquid medications.

Answer 37

a. total parenteral nutrition (TPN) solutions - actually through IV

Question 38

A client is nauseated, has been vomiting for several hours, and needs to receive an antiemetic (anti-nausea) medication. Which of the following is accurate? A. An enteric-coated medication should be given. B. Any medication will not be absorbed as easily because of the nausea problem. C. A parenteral route is the route of choice. D. A rectal suppository must be administered.

Answer 38

C. A parenteral route is the route of choice.

Question 39

The client receiving an intravenous infusion of morphine sulfate begins to experience respiratory depression and decreased urine output. This effect is described as: A. Therapeutic B. Toxic C. Idiosyncratic D. Allergic

Answer 39

B. Toxic

Question 40

The client is to receive a sedative via the buccal route. Which of the following is true? A. The medication is placed under the tongue. B. This route is probably more expensive than the intramuscular route. C. The nurse should offer the client a glass of orange juice after taking the sedative. D. This method of administration would be avoided in the event of facial injuries.

Answer 40

D. This method of administration would be avoided in the event of facial injuries.

Question 41

To determine the proper drug dosages for children, calculations are made on the basis of the child's: A. Weight B. Height C. Age D. Body surface area

Answer 41

D. Body surface area

Question 42

The nurse uses a mortar and pedestal to crush a medication before giving it to one of her clients. Which of the five rights is the nurse ensuring? A. The right route B. The right client C. The right time D. The right drug

Answer 42

A. The right route

Question 43

A 76-year-old client lives alone and takes medications without supervision. Which of the following is the most appropriate question for his home health nurse to ask in regard to his medication regimen? A. "How much do you weigh?" B. "What medications are you currently taking?" C. "We'll have to take away your sedatives if you keep taking them during the day. " D. "Have you been taking other substances than those ordered by the physician?"

Answer 43

D. "Have you been taking other substances than those ordered by the physician?"

Question 44

In preparing two different medications from two vials, the nurse must: A. Inject fluid from one vial into the other B. Uncap the syringe and wipe the needle with an alcohol preparation before inserting into either vial C. Discard the medication from vial number two if medication from vial number one is pushed into it D. Insert air into the first vial, but not the second vial

Answer 44

C. Discard the medication from vial number two if medication from vial number one is pushed into it

Question 45

The nurse is preparing 10 units of regular insulin and 5 units of NPH insulin. Which of the following statements is the most accurate? A. The NPH insulin is the shortest acting form of insulin. B. Air is injected first into the regular insulin, then into the NPH. C. The insulin vial should be discarded if there are any bubbles in it. D. This medication order is given via the subcutaneous route.

Answer 45

D. This medication order is given via the subcutaneous route.

Question 46

A 73-year-old client who is very obese requires an intramuscular injection of Demerol 100 mg. Which of the following is least appropriate for the administration of this medication? A. A 5/8-inch needle is used at a 45-degree angle to the skin B. Pinching the skin before administration is necessary C. Aspirating the syringe before injecting the medication is a priority D. Using a 25-gauge needle would be best

Answer 46

C. Aspirating the syringe before injecting the medication is a priority

Question 47

You are a new graduate nurse completing your orientation on a very busy intensive care unit. You cannot read a health care provider's order for one of your patient's medications. You have heard from more experienced nurses that this health care provider does not like to be called, and you know that another of the health care provider's patients is very unstable. What is the most appropriate next step for you to take? A. Call the health care provider to clarify the order B. Talk with your preceptor to help you interpret the order C. Refer to a medication manual before giving the medication D. Use your best judgment and critical thinking and administer the dose you think the health care provider ordered

Answer 47

A. Call the health care provider to clarify the order

Question 48

A toddler is to receive 2.5 mL of an antipyretic by mouth. Which equipment is the most appropriate for medication administration for this child? A. A medication cup B. A teaspoon C. A 5-mL syringe D. An oral-dosing syringe

Answer 48

D. An oral-dosing syringe

Question 49

What statement made by a 2-year-old patient's mother indicates that she understands how to administer her son's eardrops? A. "To straighten his ear canal, I need to pull the outside part of his ear down and back." B. "I need to straighten his ear canal before administering the medication by pulling his ear upward and outward." C. "I need to put my son in a chair and make sure that he's sitting up with his head tilted back before I give him the eardrops." D. "After I'm done giving him his eardrops, I need to make sure that my son remains sitting straight up for at least 10 minutes."

Answer 49

B. "I need to straighten his ear canal before administering the medication by pulling his ear upward and outward."

Question 50

A nurse admits a 72-year-old patient with a medical history of hypertension, heart failure, renal failure, and depression to a general medical patient care unit. The nurse reviews the patient's medication orders and notes that the patient has three healthcare providers who have ordered a total of 13 medications. What is the most appropriate action for the nurse to take next? A. Give the medications after identifying the patient using two patient identifiers B. Provide medication education to the patient to help with adherence to the medical plan C. Review the list of medications with the health care providers to ensure that the patient needs all 13 medications D. Set up a medication schedule for the patient that is least disruptive to the expected treatment schedule in the hospital

Answer 50

C. Review the list of medications with the health care providers to ensure that the patient needs all 13 medications

Question 51

The nurse is administering an intravenous (IV) push medication to a patient who has a compatible IV fluid running through intravenous tubing. Place the following steps in the appropriate order. 1. Release tubing and inject medication within amount of time recommended by agency policy, pharmacist, or medication reference manual. Use watch to time administration. 2. Select injection port of intravenous (IV) tubing closest to patient. Whenever possible, injection port should accept a needleless syringe. Use IV filter if required by medication reference or agency policy. 3. After injecting medication, release tubing, withdraw syringe, and recheck fluid infusion rate. 4. Connect syringe to port of intravenous (IV) line. Insert needleless tip or small-gauge needle of syringe containing prepared drug through center of injection port. 5. Clean injection port with antiseptic swab. Allow to dry. 6. Occlude intravenous (IV) line by pinching tubing just above injection port. Pull back gently on syringe plunger to aspirate blood return. A. 2, 5, 4, 1, 3, 6 B. 2, 5, 6, 4, 1, 3 C. 5, 4, 2, 6, 1, 3 D. 2, 5, 4, 6, 1, 3

Answer 51

D. 2, 5, 4, 6, 1, 3

Question 52

A nursing student is administering ampicillin PO. The expiration date on the medication wrapper was yesterday. What is the appropriate action for the nursing student to take next? A. Ask the nursing professor for advice B. Return the medication to pharmacy and get another tablet C. Call the health care provider after discussing this situation with the charge nurse D. Administer the medication since medications are good for 30 days after their expiration date

Answer 52

B. Return the medication to pharmacy and get another tablet

Question 53

A nursing student is administering medications to a patient through a gastric tube (G-tube). Which of the following actions taken by the nursing student requires the nursing instructor to intervene? A. The nursing student places all the patient's medications in different medicine cups. B. The nursing student evaluates each medication and holds the tube feeding before administering a medication that needs to be administered on an empty stomach. C. The nursing student flushes the tube with 30 mL of water between each medication. D. The nursing student crushes a nifedipine extended-release tablet and mixes it with water before administering it.

Answer 53

D. The nursing student crushes a nifedipine extended-release tablet and mixes it with water before administering it.

Question 54

A pediatric nurse takes a medication to a 12-year-old female patient. The patient tells the nurse 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. Consult with the patient's parents for advice C. Take the medication away and chart the patient's refusal D. Tell the patient that her health care provider knows what is best for her

Answer 54

A. Ask the patient's reason for refusal

Question 55

After seeing a patient, the health care provider starts to give 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 health care provider 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 health care provider. D. Ensure that the six rights of medication administration are followed when giving the medication.

Answer 55

B. Explain to the health care provider that the order needs to be given to a registered nurse.

Question 56

A nurse accidently gives a patient the medications that were ordered for the patient's roommate. What is the nurse's first priority? 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 56

D. Assess the patient for adverse effects.

Question 57

After receiving an intramuscular (IM) injection in the deltoid, a patient states, "My arm really hurts. It's burning and tingling where I got my injection. What should the nurse do next? (Select all that apply.) A. Assess the injection site B. Administer an oral medication for pain C. Notify the patient's health care provider of assessment findings D. Document assessment findings and related interventions in the patient's medical record E. This is a normal finding so nothing needs to be done F. Apply ice to the site for relief of burning pain

Answer 57

A. Assess the injection site C. Notify the patient's health care provider of assessment findings D. Document assessment findings and related interventions in the patient's medical record

Question 58

You are working in a health clinic on a college campus. You need to administer medroxyprogesterone acetate intramuscularly (IM) to a female patient for birth control. You look up this medication in a reference manual and determine that it is viscous and injections can be painful. On the basis of this information, you plan which of the following when administering this medication? (Select all that apply.) A. Inject the medication over 3 minutes to reduce pain associated with the injection B. Administer the medication in the ventral gluteal site C. Use the z-track method when administering the medication D. Use the deltoid site for medication administration E. Ask the patient questions about her major and which classes she is taking during the injection to provide distraction

Answer 58

B. Administer the medication in the ventral gluteal site C. Use the z-track method when administering the medication E. Ask the patient questions about her major and which classes she is taking during the injection to provide distraction

Question 59

The nurse is teaching a patient about how to take a sublingual nitroglycerin tablet. Which statement by the patient best demonstrates understanding of the teaching? a. "I will hold the tablet next to my skin." b. "I will put the tablet inside my cheek." c. "I will put the tablet under my tongue." d. "I will place the tablet in the lower lid of my eye."

Answer 59

"I will put the tablet under my tongue."

Question 60

The nurse is caring for a critically ill patient. What are the contraindications for administering medications by the oral route for this patient? (Select all that apply.) a. Vomiting b. Unconsciousness c. Fractured leg d. Penicillin allergy e. Family visitor f. Diarrhea

Answer 60

a. Vomiting b. Unconsciousness

Question 61

The nurse is about to administer a new medication to a patient. Which action best demonstrates awareness of safe, proficient nursing practice? a. Identify the patient by comparing her name and birth date to the medication administration record (MAR). b. Determine whether the medication and dose are appropriate for the patient. c. Make sure the medication is in the medication cart. d. Check the accuracy of the dose with another nurse.

Answer 61

a. Identify the patient by comparing her name and birth date to the medication administration record (MAR).

Question 62

A patient has been using herbal medication as part of her daily routine. Which actions should the nurse take? (Select all that apply.) a. Document the herbs as part of the medication history. b. Recommend a reputable company from which to buy herbs. c. Allow the patient to self-administer the herbs with her morning medications. d. Inform the health care provider of the findings. e. Identify possible adverse effects of the herbal medications.

Answer 62

a. Document the herbs as part of the medication history. d. Inform the health care provider of the findings. e. Identify possible adverse effects of the herbal medications.

Question 63

The health care provider prescribes a medication that is administered transdermally. The nurse understands what feature of the transdermal route? a. It is inhaled into the respiratory tract. b. It is dissolved inside the cheek. c. It is absorbed through the skin. d. It is inserted into the vaginal cavity.

Answer 63

c. It is absorbed through the skin.

Question 64

The nurse is caring for a patient who is unable to hold a cup or spoon. How should the nurse administer oral medications to the patient? a. Crush the pills and mix them in pudding before administering. b. Ask the pharmacist to change all of the medications to a liquid form. c. Use a small paper cup to put the pills into the patient's mouth. d. Place the pills on the table and have the patient take the pills by hand.

Answer 64

c. Use a small paper cup to put the pills into the patient's mouth.

Question 65

What should the nurse do first when preparing to administer medications to a patient? a. Check the medication expiration date. b. Check the medication administration record (MAR). c. Call the pharmacy for administration instructions. d. Check the patient's name band.

Answer 65

b. Check the medication administration record (MAR).

Question 66

The nurse is selecting a site to administer a medication by the intramuscular route. The nurse chooses to avoid which site due to the high risk for injury? a. Vastus lateralis b. Ventrogluteal c. Dorsogluteal d. Deltoid

Answer 66

c. Dorsogluteal

Question 67

The nurse understands that medication absorption is affected by the administration route. Which route for medications has the fastest absorption rate? a. Cream applied to the skin b. Enteric-coated capsules c. Subcutaneous injection d. Intravenous injection

Answer 67

d. Intravenous injection

Question 68

The nurse reviews a physician's order and finds that the medication amount is greater than the standard dose. What should the nurse do? a. Give the standard dose rather than the one that is ordered. b. Inform the nursing supervisor. c. Call the physician to discuss the order. d. Give the drug as ordered by the physician.

Answer 68

c. Call the physician to discuss the order.

Question 69

A 2 year old child is ordered to have eardrops daily. Which action will the nurse take? A. Pull the auricle down and back B. Pull the auricle up and outward C. Sit the child up for 2-3 min after instilling drops D. Sit the child up to insert the cotton ball into the innermost ear canal

Answer 69

A. Pull the auricle down and back

Question 70

A patient has an order to receive 12.5 mg of hydrochlorothiazide. The nurse has on hand a 25 mg tablet. How many tablet(s) will the nurse administer? A. 1/2 tablet B. 1 tablet C. 1 1/2 tablets D. 2 tablets

Answer 70

A. 1/2 tablet

Question 71

The patient is to receive Dilantin at 0900. When will the ideal time for the nurse to schedule a trough level? A. 0800 B. 0830 C. 0900 D. 0930

Answer 71

B. 0830

Question 72

The nurse is preparing to administer an injection into the deltoid muscle of an adult patient. Which needle size and length will the nurse choose? A. 18 gauge x 1 1/12" B. 23 gauge x 1/2" C. 25 gauge x 1" D. 27 gauge x 5/8"

Answer 72

C. 25 gauge x 1"

Question 73

The nurse is planning to administer a tuberculin test with a 27 gauge, inch needle. At which angle will the nurse insert the needle? A. 15 degree B. 30 degree C. 45 degree D. 90 degree

Answer 73

A. 15 degree

Question 74

The supervising nurse is watching nurses prepare medications. Which action by one of the nurses will the supervising nurse stop immediately? A. Rolls insulin vial between hands B. Administers a dose of correction insulin C. Draws up glargine (Lantus) is a syringe by itself D. Prepares NPH insulin to be given intravenously

Answer 74

D. Prepares NPH insulin to be given intravenously

Question 75

A nurse is performing the three accuracy checks before administering an oral liquid medication to a patient. When will the nurse perform the second accuracy check? A. At the patient's bedside B. Before going into the patient's room C. When checking the medication order D. When selecting medication from the unit-dose drawer

Answer 75

B. Before going into the patient's room

Question 76

A nurse receives an order to administer 8 units regular insulin and 20 units NPH insulin before breakfast. Using a U-100 syringe, the nurse would prepare this dose in which of the following ways? a. drawing up 8 units NPH, then 20 units regular in the same syringe. b. drawing up 9 units regular in one syringe, and 20 units NPH in a separate syringe. c. drawing up 8units regular, then 20 units NPH in the same syringe d. giving the 20 units NPH insulin 15 min before food, and the 8 units of regular when the food arrives.

Answer 76

c. drawing up 8units regular, then 20 units NPH in the same syringe

Question 77

If Phenergan is available in 100 mg/2 mL ampules, which of the following represents the amount is needed in mL to give a dose of 12.5 mg IM? a. 0.20 b. 0.25 c. 0.50 d. 0.75

Answer 77

b. 0.25

Question 78

A nurse is preparing to administer eye drops to a client. Which one of the following actions should the nurse take? Select all that apply. A. Have the client lie on her side. B. Ask the client to look up at the ceiling. C. Tell the client to blink when the drops enter her eye. D. Drop the medication into the center of the client's conjunctival sac. E. Instruct the client to close her eye gently after instillation.

Answer 78

B. Ask the client to look up at the ceiling. D. Drop the medication into the center of the client's conjunctival sac. E. Instruct the client to close her eye gently after instillation.

Question 79

A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. I will clean the site with an alcohol swab before I apply the patch. B. I will rotate the application sites weekly. C. I will apply the patch to an area of skin with no hair. D. I will place the new patch on the site of the old patch.

Answer 79

C. I will apply the patch to an area of skin with no hair.

Question 80

A nurse who is administering medications to patients in an acute care setting studies the pharmacokinetics of the drugs being administered. Which statements accurately describe these mechanisms of action? Select all that apply.

Answer 80

Distribution occurs after a drug has been absorbed into the bloodstream and is made available to body fluids and tissues. During first-pass effect, drugs move from the intestinal lumen to the liver by way of the portal vein instead of going into the system's circulation. Excretion is the process of removing a drug, or its metabolites (products of metabolism), from the body.

Question 81

which of the following medication administration routes is most commonly prescribed? A. Transdermal B. Topical C. Suppository D. Oral

Answer 81

D. Oral

Question 82

The nurse is preparing to administer a rectal suppository to an adult client. How many inches should you plan to insert the suppository? A. 2 - 2.5 B. 3 - 4 C. 1/2 - 1 D. 6 - 7

Answer 82

B. 3 - 4

Question 83

Which of the following are included in the "rights of medication administration?" Select all that apply. a. right medication b. right route c. right diagnosis d. right dosage e. right time f. right room

Answer 83

A. B. D. E.

Question 84

What does it mean if a medication is to be given "PRN?" A. Per resident's note B. As patient needs it C. before bedtime D. before the first meal of the day

Answer 84

B. As patient needs it

Question 85

You see a patient's order written as: "Tylenol 200mg BID." What does BID mean? A. by the mouth B. by rectal suppository C. twice a day D. three times a day

Answer 85

C. twice a day

Question 86

What is the first action a nurse should take if she administers the wrong medication? A. Document the mis-administration in the patient's chart B. File an incident report C. Notify the patient's family D. Notify the physician

Answer 86

D. Notify the physician

Question 87

You are to administer a sustained-release/extended-release oral medication to a patient. When is it necessary to crush these types of oral pills? A. Never B. When the patient can't swallow and you need to give it in an IV solution C. When the patient asks for it to be crushed in applesauce D. When the doctor's order says to crush

Answer 87

A. Never

Question 88

A client is to receiving a medication that requires it to be taken the buccal route. How would you educate the client on self-administration of the medication since he is being discharged tomorrow? A. Tell him to lay down and use a dropper to administer drops of the med on his tongue. B. Rub the powder onto the gums of his teeth. C. Place the ointment medication directly on his skin. D. Place tablet into cheek and keep it there until dissolved.

Answer 88

D. Place tablet into cheek and keep it there until dissolved.

Question 89

A nurse who gives subcutaneous and intramuscular injections to patients in a hospital setting attempts to reduce discomfort for the patients receiving the injections. Which technique is recommended?

Answer 89

The nurse uses the Z-track technique for intramuscular injections to prevent leakage of medication into the needle track.

Question 90

A medication order reads: "K-Dur, 20 mEq po BID." When and how does the nurse correctly give this drug?

Answer 90

Twice a day by the oral route

Question 91

A nurse is preparing medications for patients in the ICU. The nurse is aware that there are patient variables that may affect the absorption of these medications. Which statements accurately describe these variables? Select all that apply.

Answer 91

Patients in certain ethnic groups obtain therapeutic responses at lower doses or higher doses than those usually prescribed. Some people experience the same response with a placebo as with the active drug used in studies. A patient who receives a pain medication in a noisy environment may not receive full benefit from the medication's effects. Circadian rhythms and cycles may influence drug action.

Question 92

A health care provider orders a pain medication for a postoperative patient that is a PRN order. When would the nurse administer this medication?

Answer 92

Doses administered as needed for pain relief

Question 93

A nurse is administering a pain medication to a patient. In addition to checking his identification bracelet, the nurse correctly verifies the patient's identity by performing which action?

Answer 93

Asking the patient his name and birthdate

Question 94

The nurse is administering a medication to a patient via an enteral feeding tube. Which are accurate guidelines related to this procedure? Select all that apply.

Answer 94

Use the recommended procedure for checking tube placement in the stomach or intestine. Give each medication separately and flush with water between each drug Adjust the amount of water used if patient's fluid intake is restricted.

Question 95

A medication order reads: "Hydromorphone, 2 mg IV every 3 to 4 hours PRN pain." The prefilled cartridge is available with a label reading "Hydromorphone 2 mg/1 mL." The cartridge contains 1.2 mL of hydromorphone. What should the nurse do?

Answer 95

Dispose of 0.2 mL before administering the drug; verify the waste with another nurse.

Question 96

A patient requires 40 units of NPH insulin and 10 units of regular insulin daily subcutaneously. What is the correct sequence when mixing insulins?

Answer 96

Inject air into the NPH insulin vial, being careful not to allow the solution to touch the needle; next, inject air into the regular insulin vial and withdraw 10 units; then, withdraw 40 units of NPH insulin.

Question 97

Ms. Hall has an order for hydromorphone, 2 mg, intravenously, q 4 hours PRN pain. The nurse notes that according to Ms. Hall's chart, she is allergic to hydromorphone. The order for medication was signed by Dr. Long. What would be the correct procedure for the nurse to follow in this situation?

Answer 97

Call Dr. Long and ask that the medication be changed.

Question 98

A nurse is administering heparin subcutaneously to a patient. What is the correct technique for this procedure?

Answer 98

Do not aspirate before or massage after the injection.

Question 99

A nurse discovers that a medication error occurred. What should be the nurse's first response?

Answer 99

Check the patient's condition to note any possible effect of the error.

Question 100

A nurse is teaching a patient how to use a meter-dosed inhaler to control asthma. What are appropriate guidelines for this procedure? Select all that apply.

Answer 100

Shake the inhaler well and remove the mouthpiece covers from the MDI and spacer. Depress the canister releasing one puff into the spacer and inhale slowly and deeply. Wait 1 to 5 minutes as prescribed before administering the next puff.