Pharm

Question 1

1. The nurse is preparing to administer a medication that the agency designates as “high alert.” What action should the nurse take?
2. Ask another registered nurse to verify the medication.
3. Call the pharmacist to check the efficacy of the medication.
4. Decline to administer the medication unless there is a physician present.
5. Request that the nursing supervisor administer the medication.

Answer 1

1. Ask another registered nurse to verify the medication

Question 2

2. Why is the nurse writing out the name of the drug morphine sulfate instead of using the abbreviation MS?
3. The hospital has placed MS on its list of do-not-use abbreviations.
4. The Joint Commission requires that the abbreviation MS not be used.
5. Using the abbreviation MS puts the client at risk of medication error.
6. Computerized charting systems will not accept the abbreviation MS.

Answer 2

3. Using the abbreviation MS puts the client at risk of medication error.

Question 3

3. The hospitalized client has an order for Tylenol 325 mg 2 tablets every 4 hours prn temperature over 101°F. The client complains of a headache. Can the nurse legally administer Tylenol to treat the headache?
4. Yes, as Tylenol is used both for fever and headache.
5. No, not unless the client also has a temperature over 101°F.
6. Yes, but the nurse should document the reason why the medication was administered as a temperature elevation.
7. Yes, because the medication is available over the counter, an order is not required.

Answer 3

2. No, not unless the client also has a temperature over 101°F.

Question 4

4. The nurse identifies that the ordered dose for a medication is twice the amount generally administered. What action should the nurse take?
5. Administer the medication as it was ordered.
6. Check to see if previous shift nurses gave the medication.
7. Collaborate with the prescriber about the order.
8. Administer only the standard dose of the medication.

Answer 4

3. Collaborate with the prescriber about the order.

Question 5

5. The client has required 2 sublingual nitroglycerine tablets that are gr 1/150 per tablet. How many mg of nitroglycerine did the client receive?
   Standard Text: Record your answer.

Answer 5

: 0.8 mg or 800 mcg
Rationale: The client received gr 2/150 of NTG. There are 60 mg in 1 grain. To convert, multiply 2/150 x 60 = 120/150 = 0.8 mg or 800 mcg.

Question 6

6. The nurse is preparing to administer a medication to a 6-year-old client. What is the nurse’s priority action?
7. Administer the exact dosage as ordered.
8. Give the dosage supplied by the pharmacy.
9. Verify that the dosage is within the safe range for this child.
10. Administer no more than one-half of the safe adult dosage.

Answer 6

3. Verify that the dosage is within the safe range for this child.

Question 7

7. During the process of administering medications, the nurse checks the name band for the client’s name. What should be this nurse’s next action?
8. Administer the medication as ordered.
9. Initial the MAR that the medication will be given.
10. Double check the client’s identification using a second method.
11. Educate the client regarding the medication to be given.

Answer 7

3. Double check the client’s identification using a second method.

Question 8

8. The nurse is planning to administer a bitter-tasting oral medication to a 4-year-old client. What strategy should this nurse plan?
9. Give the medication in orange juice or milk to mask the taste.
10. Tell the child that the medication tastes good.
11. Ask the parents how they give medications at home.
12. Get another nurse to assist by holding the client down.

Answer 8

3. Ask the parents how they give medications at home.

Question 9

The nurse is caring for a team of four clients who are seriously ill. One of the clients has just received a new cardiac medication. How should the nurse instruct the unlicensed assistive personnel (UAP) who is also caring for this client?

1. Have the UAP assess for any unexpected effects from the medication.
2. Tell the UAP to teach the client’s family what to expect from the medication.
3. Have the UAP look the medication up in a drug reference book to read about drug actions and possible side effects.
4. Give the UAP specific instructions regarding what drug actions or side effects to report to the nurse.

Answer 9

4. Give the UAP specific instructions regarding what drug actions or side effects to report to the nurse.

Question 10

The nurse is to administer four oral medications to the client via a nasogastric tube. One of the medications is a tablet that has been crushed, one is a capsule that has been opened and the powder removed, and two are supplied in liquid form. How should the nurse administer these medications?

1. Flush the tube, mix the crushed tablet and the capsule powder into the two liquids for administration, and follow by flushing the tube.
2. Mix the crushed tablet and capsule powder in warm water and administer. Flush the tube and administer the mixed liquids.
3. Flush the tube with the mixed liquids first, then administer the crushed tablet and capsule powder mixed in cold water.
4. Mix the crushed tablet and capsule powder individually in warm water. Administer each medication separately, flushing the tube before and after each administration.

Answer 10

4. Mix the crushed tablet and capsule powder individually in warm water. Administer each medication separately, flushing the tube before and after each administration.

Question 11

At which point of preparing medication from an ampule does the nurse anticipate using a filter needle?

1. Filter needles are not used for this preparation.
2. When drawing the medication from the ampule.
3. When administering the medication to the client.
4. Both for drawing up the medication and for administering the medication.

Answer 11

2. When drawing the medication from the ampule.

Question 12

The client is to receive an intramuscular injection of a medication that is supplied in a 2-mL cartridge and a second medication that is supplied in a vial. The total amount to be administered of these medications exceeds the volume of the cartridge by 0.5 mL. How should the nurse proceed?

1. Administer the cartridge medication in one injection and the vial medication in a separate injection.
2. Call the pharmacy for advice on administering these medications.
3. Draw both of the medications up into a syringe for administration.
4. Add as much of the vial medication to the cartridge as possible prior to injection, giving the balance in a separate injection.

Answer 12

3. Draw both of the medications up into a syringe for administration.

Question 13

During administration of an intradermal injection, the nurse notices that the outline of the needle bevel is visible under the client’s skin. How should the nurse proceed?

1. Recognize that this is an expected finding in a properly administered intradermal injection.
2. Withdraw the needle, prepare a new injection, and start again.
3. Insert the needle further into the skin at a deeper angle.
4. Turn the needle so that the bevel is down and inject the medication slowly, looking for development of a bleb.

Answer 13

1. Recognize that this is an expected finding in a properly administered intradermal injection.

Question 14

The nurse has just injected insulin subcutaneously into the client’s abdomen. What action should the nurse take at this point?

1. Massage the site to encourage absorption.
2. Leave the needle embedded in the client’s skin for 5 seconds after administration.
3. Remove the needle rapidly by pulling it quickly from the skin.
4. Cover the injection site with a pressure dressing for at least 15 minutes or until the bleb disappears.

Answer 14

2. Leave the needle embedded in the client’s skin for 5 seconds after administration.

Question 15

The nurse who is to administer 2.5 mL of intramuscular pain medication to an adult client notes that the previous injection was administered in the right ventrogluteal site. In which site should the nurse plan to administer this injection?

1. The same site
2. The deltoid
3. The left ventrogluteal
4. The rectus femoris

Answer 15

3. The left ventrogluteal

Question 16

While administering an intramuscular injection, the nurse notes blood return in the syringe barrel after aspirating. What action should the nurse take?

1. Pull the needle out 1/4 inch and inject the medication.
2. Inject the medication as planned.
3. Notify the physician immediately.
4. Discard the medication and start over.

Answer 16

4. Discard the medication and start over.

Question 17

The nurse is adding medication to an existing intravenous setup. Which nursing action is indicated?

1. Close the infusion clamp.
2. Ensure that the IV bag is full prior to adding medication.
3. Do not remove the IV bag from the pole.
4. Briskly shake the IV bag after injecting the medication.

Answer 17

1. Close the infusion clamp.

Question 18

Upon aspirating a saline lock prior to administering intravenous medication, the nurse notes that there is no blood return. What nursing action should be taken?

1. Discontinue this infiltrated lock and restart another site for medication administration.
2. Slowly infuse 1 mL of saline into the lock, assessing for infiltration.
3. Reinsert the needle into the lock and aspirate using more pressure.
4. Pull the intravenous catheter out 1/8 inch and attempt aspiration.

Answer 18

2. Slowly infuse 1 mL of saline into the lock, assessing for infiltration

Question 19

While preparing to administer an eye ointment, the nurse inadvertently squeezes the tube, discarding the first bead of medication. What action should the nurse take at this point?

1. Administer the eye ointment as ordered, as the first bead of ointment should be discarded anyway.
2. Notify the pharmacy and request a new, unopened tube of ointment.
3. Have a second licensed nurse witness the waste and sign the chart.
4. Continue to squeeze the tube until a clear line of ointment has been discarded from the tip.

Answer 19

1. Administer the eye ointment as ordered, as the first bead of ointment should be discarded anyway.

Question 20

The nurse is preparing to administer eardrops to a 6-year-old client. What nursing action is correct?

1. Pull the earlobe down and back to straighten the ear canal.
2. Insert the tip of the applicator into the ear canal.
3. Put the eardrops in the refrigerator for 10 minutes prior to administration.
4. Press gently on the tragus of the ear a few times after administration.

Answer 20

4. Press gently on the tragus of the ear a few times after administration.

Question 21

While preparing to administer a transdermal estrogen patch, the nurse finds the previously applied patch in the client’s bed linens. How can the nurse avoid this situation with the patch now being applied?

1. Shave the area where the patch is being applied.
2. Place a heating pad over the area where the patch is applied for 10 minutes after application.
3. Run a finger around the adhesive edges of the new patch before placing it on the client’s skin.
4. Press firmly over the patch with the palm of the hand for about 10 seconds after applying it to the skin.

Answer 21

4. Press firmly over the patch with the palm of the hand for about 10 seconds after applying it to the skin.

Question 22

The nurse is preparing a small amount of medication for oral administration. Which nursing action is essential?

1. Draw up the medication in a syringe with a large-gauge needle.
2. Measure the medication at the top of the meniscus.
3. Label the syringe with the medication name, amount, and route.
4. Dilute the medication with water before measuring.

Answer 22

3. Label the syringe with the medication name, amount, and route.

Question 23

23. A client diagnosed with diabetes asks the nurse about reusing insulin syringes. Assessment reveals that the client has poor personal hygiene and difficulty with fine motor skills. The nurse also knows the client has financial difficulties. What instruction should the nurse give this client?
24. “The American Diabetes Association advises that syringes are for single use only.”
25. “In order to save money, I advise you to reuse syringes up to three times or until the needle feels dull.”
26. “Only people who practice good personal hygiene can reuse syringes.”
27. “All clients are different, but I advise you to use a new syringe for each injection.”

Answer 23

4. “All clients are different, but I advise you to use a new syringe for each injection.”

Question 24

The client who regularly uses a metered-dose inhaler four times a day tells the nurse that it is difficult to tell when the canister is empty. What instruction should the nurse give this client?

1. Place the canister in a bowl of water. If the canister floats, it is not empty.
2. When you get a new canister, divide the number of puffs that is listed on the label by four. That will tell you how many days the canister will last.
3. You can tell that the canister is empty when you can no longer smell the medication when you activate the plunger.
4. When you feel like you are no longer getting maximum effect from the medication, your canister is empty.

Answer 24

2. When you get a new canister, divide the number of puffs that is listed on the label by four. That will tell you how many days the canister will last.

Question 25

The nurse is providing discharge teaching for a client who is being dismissed with prescriptions for a bronchodilator inhaler and a corticosteroid inhaler. What information should the nurse provide regarding the dosage schedule for these two medications? 1. Always use the corticosteroid inhaler first. 2. Use the bronchodilator first. 3. It makes no difference which inhaler is used first. 4. Use the inhalers on alternate days, not on the same day.

Answer 25

2. Use the bronchodilator first.

Question 26

The nurse is planning to administer medications to a new client. What is the nurse's greatest priority in administering these medications? 1. Be certain the medications are given within 15 minutes of the time they are scheduled. 2. Before giving the medications, know what the intended effects are for this client. 3. Assess the client's knowledge of the action of the medications. 4. Document the administration accurately so the reimbursement is correct.

Answer 26

2. Before giving the medications, know what the intended effects are for this client.

Question 27

A client who has been prescribed a narcotic for chronic back pain is demonstrating signs of withdrawal. The nurse identifies these symptoms as being 1. physical dependence. 2. psychological dependence. 3. plateau. 4. drug allergy.

Answer 27

1. physical dependence.

Question 28

A client is diagnosed with liver disease. The nurse realizes that which element of pharmacokinetics will be affected in this client? 1. Absorption 2. Distribution 3. Biotransformation 4. Excretion

Answer 28

3. Biotransformation

Question 29

The nurse is administering a medication to a client as prescribed in order to maintain a specific amount of the medication in the client’s bloodstream at all times. The nurse is ensuring that which action is being maintained for this client? 1. Peak plasma level 2. Drug half-life 3. Onset of action 4. Plateau

Answer 29

4. Plateau

Question 30

``` The nurse determines that the effectiveness of a medication is not as great when provided to female clients as it is with male clients. The nurse suspects that this difference in effectiveness is because of which factor? Standard Text: Select all that apply. 1. Occupation 2. Hormones 3. Fat amount 4. Physical activity status 5. Fluid level ```

Answer 30

2. Hormones 3. Fat amount 5. Fluid level

Question 31

``` A client is prescribed an oral medication. When reviewing this medication, the nurse realizes it might not be the route of choice for this client because the client is experiencing Standard Text: Select all that apply. 1. nausea. 2. anxiety. 3. vomiting. 4. pain from cuts and abrasions. 5. irritated gastric mucosa. ```

Answer 31

1. nausea. 3. vomiting. 5. irritated gastric mucosa.

Question 32

``` A client is prescribed a medication to be administered through the parenteral route. The nurse would expect that this medication will be provided through which method? Standard Text: Select all that apply. 1. Subcutaneous injection 2. Intramuscular injection 3. The oral route 4. Intradermal injection 5. Intravenous infusion ```

Answer 32

1. Subcutaneous injection 2. Intramuscular injection 4. Intradermal injection 5. Intravenous infusion

Question 33

The nurse is reviewing a new medication order for a client, and determines that the order is incomplete when which element is missing? Standard Text: Select all that apply. 1. Client’s address 2. Dispensing instructions for the pharmacist 3. Name of the medication 4. Dosage 5. Route of administration

Answer 33

3. Name of the medication 4. Dosage 5. Route of administration

Question 34

A client tells the nurse that the pharmacy will not fill a prescription that was written by the physician. Upon closer examination, what should the nurse determine is missing from the prescription? Standard Text: Select all that apply. 1. Rx symbol 2. Client’s diagnosis 3. Client’s Social Security number 4. Dispensing instructions for the pharmacist 5. Number of refills

Answer 34

1. Rx symbol 4. Dispensing instructions for the pharmacist 5. Number of refills

Question 35

A client has a new order for a medication that does not have a termination date. The nurse would place this medication order under which classification on the client’s medication administration record? 1. Standing 2. PRN 3. STAT 4. Single

Answer 35

1. Standing

Question 36

A client’s status is deteriorating, and the physician prescribes a medication to be administered immediately one time. The nurse would contact the pharmacy and identify this medication order as being of which type? 1. Standing 2. PRN 3. STAT 4. Single order

Answer 36

3. STAT

Question 37

While hospitalized, a client was receiving 15 ml of an oral medication three times a day. When providing discharge instructions, the nurse should teach the client to take how much of this medication at home? 1. 2 teaspoons 2. 1 teaspoon 3. 2 tablespoons 4. 1 tablespoon

Answer 37

4. 1 tablespoon

Question 38

While reviewing a medication order, the nurse determines that it is written using the metric system. What did the nurse observe to come to this conclusion about the medication order? Standard Text: Select all that apply. 1. Number of ounces 2. Number of drams of the solution 3. Number of milligrams of the medication 4. Number of grains of the medication 5. Number of milliliters of the solution

Answer 38

3. Number of milligrams of the medication | 5. Number of milliliters of the solution

Question 39

The nurse is providing medications to a client. After identifying the client, the nurse should take which action? 1. Inform the client as to the intended action of the medication. 2. Administer the drug. 3. Document that the drug was provided. 4. Evaluate the effectiveness of the drug.

Answer 39

1. Inform the client as to the intended action of the medication.

Question 40

Before administering a medication to a client, the nurse checks the client’s pulse, blood pressure, and laboratory values. The nurse is performing which “right” of medication administration? 1. Medication 2. Assessment 3. Route 4. Dose

Answer 40

2. Assessment

Question 41

The nurse is preparing medications for a client. What should the nurse do to ensure that the correct medication is provided to the client? Standard Text: Select all that apply. 1. Make sure it is the right client. 2. Make sure it is the right medication. 3. Make sure it is the right dose. 4. Make sure it is the right route. 5. Make sure it is for the right diagnosis.

Answer 41

1. Make sure it is the right client. 2. Make sure it is the right medication. 3. Make sure it is the right dose. 4. Make sure it is the right route.

Question 42

The nurse is concerned that an older client is experiencing an adverse effect from a prescribed medication. What did the nurse assess to make this clinical decision? 1. Altered memory 2. Altered organ responsiveness 3. Decreased manual dexterity 4. Decreased visual acuity

Answer 42

2. Altered organ responsiveness

Question 43

The nurse is concerned that an older client will have difficulty self-administering medications. What did the nurse assess that caused this concern? Standard Text: Select all that apply. 1. Eats several servings of fruits and vegetables each day 2. Altered memory 3. Decreased visual acuity 4. Decreased manual dexterity 5. Limits red meat in the diet

Answer 43

2. Altered memory 3. Decreased visual acuity 4. Decreased manual dexterity

Question 44

The nurse is preparing to administer a subcutaneous injection to a client. When selecting the needle, the nurse should choose one with a 1. small gauge number. 2. long shaft. 3. long bevel. 4. short bevel.

Answer 44

3. long bevel.

Question 45

An adult client is prescribed the hepatitis B vaccination. The nurse will administer this medication through which site? 1. Dorsogluteal 2. Rectus femoris 3. Vastus lateralis 4. Deltoid

Answer 45

4. Deltoid

Question 46

``` The nurse has provided an otic medication to a client. What should the nurse document about this medication’s administration? Standard Text: Select all that apply. 1. Name of the drug 2. The strength 3. The appetite of the client 4. The number of drops 5. The response of the client ```

Answer 46

1. Name of the drug 2. The strength 4. The number of drops 5. The response of the client

Question 47

A client is prescribed a new medication. The pharmacy notifies the nurse that the dosage is outside of route prescribing limits. The nurse is unable to reach the prescribing physician about the order. What should the nurse do? 1. Give the medication to the client as prescribed. 2. Withhold the medication. 3. Give one-half of the medication dose prescribed. 4. Administer the medication through the oral route.

Answer 47

2. Withhold the medication.

Question 48

A client weighing 220 lbs. is prescribed to receive 25 mg/kg of a medication, divided over 4 equal doses. How many mg of the medication should the nurse provide for each dose?

Answer 48

Correct Answer: 625 mg

Question 49

The nurse is instructing a new mother on the method to provide a newly prescribed medication to her 2-month-old infant. What should the nurse include in this teaching? Standard Text: Select all that apply. 1. Mix the medication into the baby’s formula. 2. Use a nipple so the baby can suck the medication. 3. Use a syringe or dropper to provide the medication. 4. Place a small amount of the medication along the side of the baby’s cheek. 5. Prepare twice the amount of medication prescribed because the baby will spit out half of it.

Answer 49

2. Use a nipple so the baby can suck the medication. 3. Use a syringe or dropper to provide the medication. 4. Place a small amount of the medication along the side of the baby’s cheek.