Question 1

After administering an antibiotic to the patient, the patient complains of feeling very ill. The nurse notes that the patient is scratching and has hives. The patient soon starts having difficulty breathing and his blood pressure drops. What is the nurse's assessment of the situation?

Accepted Answer

The patient's symptoms are indicative of anaphylaxis: a severe, life-threatening allergic reaction. the airways close up, the throat swells closed, and the blood pressure drops dangerously low. The patient may go into shock and die. Patients may have very mild allergic reactions to medications and experience a rash or itching.

Question 2

The nurse is caring for a patient who will give himself medication injections at home after discharge. How can the nurse best determine that the patient understands the technique and can administer the injections correctly?

Accepted Answer

The nurse should watch the patient give himself an injection to make sure that he is doing it correctly. This will give the nurse an opportunity to point out and correct any mistakes and offer the patient reassurance about his technique.

Question 3

The nurse prepares to administer the following medication to the patient. Which instruction will the nurse be sure to give before the patient takes the medication?

Accepted Answer

Extended release medications must always be swallowed whole without crushing or dissolving the tablet. MS Contin is always to be administered orally rather than sublingually.

Question 4

The nurse is to administer 15 mg of morphine liquid to the patient. How much morphine liquid will the nurse draw up to administer to the patient? Morphire sulfate oral solution
(CONCENTRATE)
$100 \mathrm { mg } / 5 \mathrm {~mL}$
(20 mg/mL)
CII Px only

Accepted Answer

The concentration of the morphine solution is 20 mg/mL. Therefore, to administer 15 mg of morphine, the nurse would need to draw up 0.75 mL of the solution (15 mg ÷ 20 mg/mL = 0.75 mL).

Question 5

The nurse makes a medication error. Which action will the nurse take first?

Accepted Answer

When a medication error occurs, the nurse's first priority is to make sure that the patient is okay. If the patient shows any signs of adverse reaction to the medication error, the doctor/prescriber should be notified right away. Documentation, filling out the facility incident report, and explaining the error to the patient can take place later after the patient's condition is determined to be stable.

Question 6

The nurse is caring for a patient who was just made NPO. The nurse is to administer carvedilol (Coreg) 25 mg PO to the patient for control of high blood pressure. What is the best action of the nurse?

Accepted Answer

The nurse should contact the patient's physician to clarify the order. Oral medications should never be administered to NPO patients without specific orders to do so from the physician. Coreg may not be administered intravenously.

Question 7

The nurse is caring for a patient who is in agonizing pain. All of the following options are listed on the patient's medication order sheet to relive pain. Which will provide the most rapid pain relief for the patient?

Accepted Answer

IV administration has the most rapid onset of action and will provide the patient with the quickest pain relief.

Question 8

The nurse administers a medication to the patient. Which symptoms indicate that the patient is having an allergic reaction rather than a side effect?

Accepted Answer

Itchy rash and difficulty breathing are indicative of an allergic reaction to a medication. The other symptoms are common side effects of medications.

Question 9

The nurse is caring for a patient who is receiving vancomycin (Vancocin) to treat a severe infection. The next vancomycin dose is due to be administered at 10:00 A.M. What time will the nurse draw the vancomycin serum trough level?

Accepted Answer

Serum trough levels are to be drawn just prior to the administration of the medication in order to determine the lowest blood level of the drug within the patient's system.

Question 10

The nurse carefully reviews the patient's medication list. Which observation about the list indicates the highest risk for serious drug-drug interactions?

Accepted Answer

The risk of drug-drug interactions increases when many drugs are taken by the patient. One of the most important ways to prevent adverse drug interactions is to minimize the number of drugs that the patient is taking.

Question 11

When administering phenytoin (Dilantin) through the patient's IV line, the nurse carefully flushes the IV with normal saline before and afterward to avoid crystal formation of the medication that occurs when it mixes with dextrose in water (DS1U1B15S1U1B0 W) solution. Which type of drug interaction is the nurse being careful to avoid?

Accepted Answer

When medications combine to form crystals or adverse chemical reactions, the result is a drug incompatibility. Compatibility must be assessed prior to medication preparation and administration.

Question 12

Which medication has the highest potential for abuse?

Accepted Answer

According to the Controlled Substances Act, drugs that have the potential for abuse/dependency are classified as schedule I-V. Schedule I drugs have no approved medical applications in the United States. Schedule II drugs have high potential for abuse/dependency and have multiple restrictions for prescriptions. Schedule III, IV, and V have lower risks of dependency/abuse and fewer restrictions for prescriptions

Question 13

The nurse administers a medication to a patient. Shortly afterward, the patient develops an itchy rash all of his body and reports feeling very unwell. What is the priority action of the nurse?

Accepted Answer

The nurse must first determine if the patient is having any difficulty breathing, since the patient may be starting to have an anaphylactic reaction to the medication. Anaphylaxis is life threatening and requires immediate treatment; the nurse must recognize this potential and plan to initiate emergency interventions right away.

Question 14

The nurse is noting an order for a medication to be given TID. Which times will the nurse plan to administer the medication to the patient?

Accepted Answer

TID indicates that the medication is to be administered three times daily. Common times for TID medications are 9 A.M., 1 P.M. and 5 P.M.

Question 15

The nurse begins a shift on a busy medical-surgical unit. The nurse will be caring for multiple patients. Which patient will the nurse assess first?

Accepted Answer

The nurse's first priority is always: ABCs- Airway, Breathing, and Circulation. This includes any patients who are having chest pain and/or difficulty breathing. The nurse needs to see this patient first to determine if the chest pain has been relieved or not. An assessment should be done right away to determine if the patient is now stable or if additional interventions need to be done. The other patients' needs are less critical and can be met after this patient is assessed.

Question 16

The nurse is caring for a patient who is taking many prescription medications for various health problems. Which direction from the nurse will help the patient avoid dangerous drug interactions?

Accepted Answer

The patient's risk for dangerous drug interactions is increased when many medications are taken. Filling all of the prescriptions at the same pharmacy will allow the pharmacist to check for possible interactions.

Question 17

The nurse is to administer 1 mL of prochlorperazine (Compazine) 10 mg IM to an adult patient. Which syringe will the nurse select to administer the medication?

Accepted Answer

The nurse would select a 3 mL syringe with a 23 gauge, 1 1/2 inch needle. This is because intramuscular injections require a longer needle to reach the muscle tissue, and a larger gauge (which indicates a larger diameter) to administer the medication effectively. The 1 1/2 inch needle is appropriate for most adults. The 3 mL syringe is also appropriate as the medication volume is 1 mL.

Question 18

During discharge teaching, the nurse is to give the patient a signed, dated, and timed prescription from the physician for medications to be taken at home. Which prescription drug order needs to be corrected before it is given to the patient?

Accepted Answer

All prescriptions must have the name of the drug to be administered along with dosage, route, and frequency. The methotrexate order does not contain a dosage for the drug, just the number of pills to be taken.

Question 19

The nurse suspects that the patient is experiencing a drug toxicity rather than a side effect. Which question will the nurse ask to help confirm this suspicion?

Accepted Answer

Asking if the patient has been taking extra doses of the medication will allow the nurse to determine if the patient has been taking too much of the drug or more than was prescribed. Toxicity occurs when the patient receives/takes excessive amounts of the drug.

Question 20

Which of the following medication orders is to be administered PRN?

Accepted Answer

The nurse is to give the Ambien if the patient cannot sleep. The nurse uses discretion when deciding when to administer the medication PRN.

Quiz 35: Medication Administration