Quiz Questions Only: Med Administration Flashcards Preview

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Flashcards in Quiz Questions Only: Med Administration Deck (33)
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1

An order for a medication is as follows:

Brittany Spears MR#93783947
9/22/2021
0615

Acetaminophen 650 mg PO PRN for pain------------------------------------------------

-----------------------------------------------------

Dr. Suess-------------------------------------

What information is missing?
- patient name
- date and time of order
- name of drug
- frequency

Frequency

Rationale: This is written PRN, but there is no specification for how frequently this can be given PRN. As this is written it could be given every 5 minutes, which is not logical for this medication.

2

Which of the following statements is correct?

- A stat order means that the medication should be given immediately.
- An order can be written for a patient by any healthcare provider with an advanced degree.
- A read back verbal order is done for any order that is given by a mid-level provider such as a nurse practitioner or a physician assistant.
- A medication order cannot be fulfilled unless the provider states the reason for the medication.

A stat order means that the medication should be given immediately.

3

A student is preparing to give a medication. Which of the following information should be obtained from the drug book prior to administering the medication? Select all that apply.

- mechanism of action
- common adverse effects
- the chemical name of the medication
- compatibility with other medications for IV administration
- how to administer the medication in relation to food.

- mechanism of action
- common adverse effects
- compatibility with other medications for IV administration
- how to administer the medication in relation to food.

4

The nurse is preparing to administer a blood pressure medication. Which of the following information is essential to know prior to administration to ensure safety?

potassium level
pulse rate
blood pressure
digoxin level

Blood pressure

5

What type of medication might be locked and require a count prior to withdrawing the medication from the medication dispensing system?

- acetaminophen (Tylenol)
- self-administered drugs
- high alert medications like insulin
- controlled substances

Controlled substances

6

The nurse is withdrawing IV morphine sulfate and is not giving the full dose available in the vial. What is the best action of the nurse?
- Keep the excess medication in the patient’s individual drawer for the next dosing.
- Have another nurse witness the wasting of the medication and document this process.
- Return the remaining medication to the pyxis machine.
- At the end of the shift, verify and ungiven doses with the charge nurse.

Have another nurse witness the wasting of the medication and document this process.

Rationale: This may seem wasteful, but it is what has to be done related to controlled substances. A vial of morphine can look like water, so once it is opened and accessed, any leftover amount needs to be wasted.

7

The nurse is preparing to give the patient medication at the bedside. The nurse has already checked the “5 rights” when preparing the medication. What step needs

- The nurse needs to check the “5 rights” again at the bedside prior to administering the medication.
- Scan the armband and then administer the medications.
- Ask the patient to state their name and date of birth
- Compare the medications in the packages to your report sheet listing of the medications for accuracy.

The nurse needs to check the “5 rights” again at the bedside prior to administering the medication.

8

A patient is telling the nurse that she can’t swallow the pill because it is too big. What option does the nurse have without calling the provider for a different route? SATA

- Crush the medication and mix it with applesauce.
- Call the pharmacy to change the medication to a rectal preparation.
- Open a capsule and mix it with pudding for administration.
- Call the pharmacy to send up a liquid version of the medication.
- Administer the medication via the IV route.

- Crush the medication and mix it with applesauce.
- Open a capsule and mix it with pudding for administration.
- Call the pharmacy to send up a liquid version of the medication.

9

The nurse has withdrawn insulin from an insulin vial that is used by many patients on the floor. What action is essential for the nurse to take to ensure safety?

- Always draw up insulin in orange colored syringes.
- Label the medication.
- Carry the insulin vial to the patient’s bedside to verify the order with the patient.
- Ask the patient to state what medication he/she takes at home to verify the type of insulin is correct.

Label the medication.

Why these don't work:
- Always draw up insulin in orange colored syringes. Although insulin syringes are often orange in color, tomorrow, another syringe may be made in orange as well.
- Carry the insulin vial to the patient’s bedside to verify the order with the patient. If a vial is used by every patient, we wouldn’t want to bring that into a patient’s room every time for infection control purposes.
- Ask the patient to state what medication he/she takes at home to verify the type of insulin is correct. The patient may be placed on a different type of insulin while in the hospital, so this may not be helpful.

10

The nurse has made a medication error by giving the patient a double dose of blood pressure medication. Which action should the nurse take first?

- Check the patient’s blood pressure now and continue to monitor at intervals.
- Leave the patient’s room and notify the charge nurse.
- Document the error in the chart and pass this along to the next shift.
- Hold the patient’s next dose of blood pressure medication.

Check the patient’s blood pressure now and continue to monitor at intervals. This is priority. Always check the patient first.

Other rationale:
- Leave the patient’s room and notify the charge nurse. The charge nurse should be notified, but you want to check the patient first.
- Document the error in the chart and pass this along to the next shift. This may need to happen, but we don’t document in the chart that an error occurred. Instead we document the facts. For example, we may document. Administered 300 mg of drug X.
- Hold the patient’s next dose of blood pressure medication. This might need to happen but would be directed by the provider.

11

The nurse is preparing a medication for a patient and it is taking 4 vials to have enough medication for a dose. What action should the nurse take?

- Call the pharmacy to verify.
- Administer the medication as ordered.
- Administer the medication very slowly due to the large dosing.
- Administer the medication in divided doses.

Call the pharmacy to verify. Any time it takes more than 3 of any one drug, is a red flag.

12

Which of the following actions require intervention by the nursing instructor?

- Crushing a medication and mixing with applesauce.
- Applying a topical medication without gloves.
- Administer eye drops by pulling downward and placing in the conjunctival pouch.
- Instructing the patient to sit up and lean forward to administer nasal spray.

Applying a topical medication without gloves. Gloves are needed as the nurse will absorb the medication.

13

The nurse is preparing to give a patient a rectal suppository. What is needed for this procedure?

- a bedpan
- water based lubricant like KY jelly
- bathroom in close proximity
- applicator

Water based lubricant like KY jelly. Although many rectal medications are to stimulate the bowels, that is not always the case. We can prepare many medications in a rectal suppository form that can be used for nausea/vomiting, pain medications, seizure medications.

14

What is the best method for medication administration through an enteral tube?

- Use cold water for dissolving medications.
- Always stop the tube feeding.
- Flush the tube with water before, between and after medication administration to ensure patency.
- Keep the head of bed at 15 degree during medication administration.

Flush the tube with water before, between and after medication administration to ensure patency.

15

Of the following parts of the syringe, which part has to remain sterile?

- plunger
- barrel
- tip
- barrel flange

The tip. This has to stay sterile as this is where the needle is attached.

16

Which of the following situations should be cause for concern for a nurse?

- Use of non-safety needles in an outpatient clinic
- Not aspirating for SQ injections
- Use of scoop technique for recapping clean needles
- Use of sharps containers in patient rooms without recapping the needle

Use of non-safety needles in an outpatient clinic. OSHA violation. Safety needles should be used.

17

How does the nurse know that the safety needle mechanism has been activated?

- The nurse should try to open the safety sheath
- The nurse heard a clicking noise when it closed
- Remove the needle from the syringe for disposal
- Attempt to bend the needle to see if it opens

The nurse heard a clicking noise when it closed

18

When withdrawing medication from an ampule, what special equipment may be needed?

- filter needle
- fill needle
- safety needle
- alcohol pad or gauze

Filter needle

19

What action will help facilitate the removal of the medication from a vial?

- Inverting the vial prior to withdrawing the medication
- Shaking or rolling the vial first
- Warming the vial between the hands
- Instillation of air into the vial before removal

Instillation of air into the vial before removal

20

When preparing two medications into one syringe, if the nurse withdraws too much of the second medication, what action should be taken?

- Instill the extra medication back into the vial.
- Squirt the extra medication into the trash until the dosage is correct.
- Dispose of the syringe and start over again
- Check the mediation with another nurse for accuracy

Dispose of the syringe and start over again

21

The nurse is giving an IM injection into the deltoid of the muscle. Which choice describes the correct landmark?

- Identify the belly of the muscle of the deltoid
- Locate the acromion process and measure down three fingers
- Locate the acromion process, go down three fingers for the top of the triangle and the axilla for the apex of the triangle
- Locate the greater trochanter and then measure three fingers down

Locate the acromion process, go down three fingers for the top of the triangle and the axilla for the apex of the triangle

22

Which of the following is the safest location for an IM injection?

- Right forearm
- Left abdominal wall
- Left upper arm
- Right lateral hip

Right lateral hip. This the option that most closely resembles the vastus lateralis location

23

The nurse is administering a SQ injection of heparin. Which action requires additional education?

- The nurse massages the site.
- The nurse does not aspirate before injecting the medication.
- The nurse administers the medication into the right abdominal wall 2 inches away from the umbilicus.
- The nurse goes through the skin quickly for insertion and for removal of the needle.

The nurse massages the site. Heparin should not be massaged.

24

Which needle choice is most appropriate for administration of a ppd?
- 25 g 1 inch needle
- 20 g 5/8 inch needle
- 27g ¼ inch needle
- 18 g 5/8 needle

27g ¼ inch needle. This is the best choice due to the small size and diameter.

25

Which syringe is used for the administration of regular insulin 40 units?

- tuberculin syringe
- 3 cc syringe
- insulin syringe
- carpuject

Insulin syringe. Insulin syringes are only used for insulin administration as the measurement is in units

26

The nurse is withdrawing medication from a vial and sets down the needle/syringe without a cap on the needle. What action is required?

- The needle and syringe should be disposed, and the nurse needs to start again.
- The needle needs to be changed and then it can be used.
- As long as the needle did not touch the surface, it can be used.
- If the nurse had eyes on the needle/syringe at all times, this technique is appropriate.

The needle and syringe should be disposed, and the nurse needs to start again. The sterility can’t be verified as it is too risky that it was contaminated.

27

When might the Z-track method be used? Select all that apply.

- The medication is irritating.
- The drug book directs the nurse to use the Z-track technique.
- The nurse wants to decrease pain with injection.
- There is a large volume being administered via IM injection.
- The patient is obese.

- The medication is irritating.
- The drug book directs the nurse to use the Z-track technique.
- The nurse wants to decrease pain with injection.

28

In which situation should the nurse wait to activate the safety mechanism on a needle after giving an injection?

- The patient is bleeding.
- The patient is moving around a lot in the bed.
- The patient has an infectious disease.
- There is no reason to not immediately activate the safety mechanism.

There is no reason to not immediately activate the safety mechanism.

29

In which situation should the nursing instructor intervene or further instruct a nursing student giving an injection?

- The nursing student aspirates for blood when giving an IM injection.
- The nursing student goes slowly through the skin to inject the needle.
- The nursing student injects the medication over a 5 second time frame.
- The nursing student activates the safety mechanism as soon as the needle is removed from the skin.

The nursing student goes slowly through the skin to inject the needle.

30

WHICH NEEDLE:

Heparin SQ injection

- 1/2 inch 27 gauge needle
- 1 inch 25 gauge needle
- 1 1/4 inch 25 gauge needle
- 1 inch 18 gauge needle

1/2 inch 27 gauge needle. 1/2 inch to 5/8 inch is used for SQ injections.