Deck 9: Safety and Quality

Question 1

The nurse is caring for a patient who has asthma. The provider has ordered an albuterol metered-dose inhaler (MDI), 2 puffs q4 to 6h PRN wheezing. The patient's last dose was 4 hours ago. What is the nurse's next action?

A) Administer 2 puffs of albuterol with the MDI.
B) Auscultate the patient's lung sounds.
C) Give the albuterol if the patient reports wheezing.
D) Give the medication and evaluate its effectiveness.

Answer 1

Auscultate the patient's lung sounds.

Question 2

The nurse is preparing to administer a chewable tablet to a preschool-age child. The child's parent reports always crushing the tablet and mixing it with pudding when giving it at home. What is the nurse's next action?

A) Ask the pharmacist if the drug may be crushed.
B) Crush the tablet and mix it with pudding.
C) Insist that the tablet must be chewed as ordered.
D) Request a liquid form of the medication from the pharmacy.

Answer 2

Ask the pharmacist if the drug may be crushed.

Question 3

In order to ensure that a medication is given to the right patient, the nurse must perform which action?

A) Ask the patient to spell their last name.
B) Match the patient with a photo ID.
C) Swipe a bar code on the patient's ID bracelet.
D) Verify the patient using two identifiers.

Answer 3

Verify the patient using two identifiers.

Question 4

When the nurse practices the "Six Rights" of medication administration, what does it ensure?

A) Adequate information is provided to the patient
B) Cost-effective use of medications
C) Informed consent for drug administration is obtained
D) Safe administration of medications

Question 5

The nurse is caring for a patient who will begin taking a thiazide diuretic to treat hypertension. The patient says, "I know this will lower my blood pressure, but how does it work?" How will the nurse respond?

A) "It can cause orthostatic hypotension, so be careful."
B) "It reduces the volume of fluid in your blood stream to lower blood pressure."
C) "The actions are complicated, but it's an effective drug."
D) "Your provider should explain this medication to you."

Question 6

The nurse is preparing to administer a medication from a unit-dose system. The nurse verifies that the medication, dose, and time are correct and that the expiration date was the day prior. Which action is correct?

A) Administer the medication and observe for adequate drug effects.
B) Notify the pharmacist and the provider of a medication error.
C) Return the medication to the pharmacy to be replaced.
D) Verify the right patient and administer the medication.

Question 7

The community health nurse is preparing to administer a medication to a patient in the patient's home. The order reads "amoxicillin as directed BID PO." The nurse will perform which action?

A) Administer the medication as ordered on the prescription label.
B) Ask the patient to take the medication as ordered.
C) Contact the provider to confirm the correct dose of the medication.
D) Review the drug information to verify the correct dose.

Question 8

The nurse is caring for a patient who will have surgery that morning. The patient usually takes an antihypertensive medication every morning. The patient has been nothing per os (NPO) since midnight. What action will the nurse perform?

A) Ask the patient to swallow the pill without water.
B) Give the medication with a small sip of water.
C) Consult the surgeon about giving the medication.
D) Hold the medication until after the patient's surgery.

Question 9

A patient who is diagnosed with atrial fibrillation is to begin taking warfarin (Coumadin). The patient refuses to take the medication because "it is rat poison." After the nurse provides teaching, the patient still refuses. What action will the nurse take?

A) Hold the dose and document the patient's refusal.
B) Hold the dose, notify the provider of the situation, and document these actions.
C) Put the medication in the patient's food.
D) Tell the patient that the drug is necessary for treatment.

Question 10

The nurse is caring for a 20-kg child who is ordered to receive amoxicillin 400 mg per os (PO) TID for 10 days. The nurse reviews the drug information and notes that the correct dose of amoxicillin is 40 to 50 mg/kg/day in two to three divided doses. Which action by the nurse is correct?

A) Adjust the drug dose based on drug manufacturer dosing information.
B) Administer the medication as ordered.
C) Ask the pharmacist to double check that the dose is correct.
D) Contact the provider and ask whether the drug should be given twice daily (BID) instead of TID.

Question 11

The nurse assumes care of a patient who had surgery that morning. The provider has ordered hydrocodone (Lortab) every 4 hours for mild to moderate pain and morphine sulfate for moderate to severe pain. The nurse reviews the patient's record and notes the patient has received two doses of hydrocodone 4 hours apart for a pain level of 7 to 8 on a scale of 1 to 10 and has reported a decrease in pain to a level of 6 to 7 after 30 minutes. It has been 4 hours since the last dose, and the patient reports a pain level of 7. What will the nurse do?

A) Administer the hydrocodone.
B) Administer morphine.
C) Ask the patient which drug to give.
D) Notify the provider of the patient's current pain level.

Question 12

The school nurse happens to observe a child pulling a pill out of a backpack and preparing to take it. What action will the nurse take?

A) Ask the child to describe the medication, dose, and reason for taking it.
B) Ask the child to keep all pills in the nurse's office.
C) Call the child's provider for a telephone order to give the medication.
D) Contact the child's parent to request a properly labeled prescription.

Question 13

A health care provider calls a nursing unit to leave a telephone order for an as needed (PRN) antipyretic medication for a child. The provider tells the nurse to "give PO acetaminophen for a fever greater than 101° F per protocol." What will the nurse do next?

A) Ask the provider to verify how many mg per kg per dose and how frequently to give the medication.
B) Look up the protocol in the unit manual and write the drug order for the provider to sign.
C) Provide the child's weight to the hospital pharmacist to write the order based on the protocol.
D) Transcribe the verbal order to the order sheet as "give PO acetaminophen for a fever greater than 101° F per protocol."

Question 14

The pediatric nurse reviews a hand-written medication order, which reads, "09/16/2016, acetaminophen 160 mg (5 mL) PO q4h for fever." What will the nurse do next?

A) Administer the drug when indicated.
B) Ask the provider to confirm if the dose is correct for the patient's age.
C) Clarify the nursing assessments necessary for giving a dose.
D) Contact the provider to request patient allergy information.

Question 15

The nurse is teaching a patient about a new medication that will be administered using an MDI. To evaluate the patient's understanding about how to use the device, what will the nurse do?

A) Ask the patient to give a return demonstration using the inhaler.
B) Give the patient written instructions to review as needed.
C) Offer the patient an Internet web address with information about the product.
D) Provide information about drug effects and adverse reactions.

Question 16

Which is a violation of a nurse's right when administering medications?

A) A hospital policy for off-label drug uses
B) A medication preparation area at the unit secretary's desk
C) A multiple-dose drug vial requiring the nurse to calculate and measure the dose
D) A new drug ordered that the nurse must look up in a drug manual