Deck 3: Patient Safety in Medication Administration

Question 1

A nurse from the adult medical unit is pulled to the geriatric unit. The nurse notes many of the common medications provided are in lower doses than typically prescribed. What action by the nurse is the highest priority?

A) Notify the charge nurse that patients may have received inappropriate medication dosages.
B) Call the nursing supervisor to investigate the nurse's concerns.
C) Do not worry about the discrepancy because this is not the nurse's unit.
D) Evaluate the laboratory values of each patient to determine liver and kidney function.

Answer 1

Evaluate the laboratory values of each patient to determine liver and kidney function.

Question 2

A nurse on the pediatric unit is preparing to pass medications for a 10-year-old patient with exacerbation of asthma. Amphetamine (Adderall) and fluticasone (Advair) are scheduled. The nurse must be aware of which of the following?

A) Adderall and Advair should not be given at the same time.
B) Adderall is used to reduce bronchospasms.
C) Advair must be given with food.
D) Adderall and Advair each have look-alike/sound-alike names.

Answer 2

Adderall and Advair each have look-alike/sound-alike names.

Question 3

The nurse is preparing to discharge a patient originally admitted for community-acquired pneumonia who has a discharge prescription for cefditoren (Spectracef). Which of the following instructions would the nurse include in the discharge teaching?

A) "Be sure to take the medication until your cough is gone."
B) "It is important that you take the medication with meals."
C) "Taking the medication at set time intervals will help blood levels stay constant."
D) "Keeping the medication on the countertop will help you remember to take it."

Answer 3

"Taking the medication at set time intervals will help blood levels stay constant."

Question 4

A nurse working at the poison control center receives a call from a young woman babysitting a 4-year-old child who reportedly swallowed some of his parent's medication. Which statement by the nurse is best at this time?

A) "I'm calling emergency personnel for you now."
B) "What do the pills look like?"
C) "Have the child drink a glass of milk."
D) "What is the name of the pills?"

Question 5

The nurse notes that an elderly patient admitted with metastatic cancer has a low serum protein level. Which action by the nurse is best?

A) Take no action because the patient is terminal.
B) Increase the frequency of vital sign monitoring.
C) Determine the most recent complete blood count (CBC) results.
D) Increase awareness and assessment of potential medication side effects.

Question 6

The nurse receives a phone call from an elderly woman who states that her husband has recently started taking atorvastatin (Lipitor) and is complaining of having sore muscles. Which response by the nurse is best?

A) "Does your husband smoke cigarettes?"
B) "What type of exercise is your husband doing?"
C) "This is an expected side effect in patients who take atorvastatin."
D) "Your husband should be seen in the clinic today for some tests."

Question 7

The nurse is preparing to provide medications to a patient in a double room. The patient's roommate has multiple visitors present. Which of the following actions would the nurse take first?

A) Identify the action and side effect of each medication as it is provided.
B) Pull the patient's bedside curtain and talk in subdued tones.
C) Ask the patient to state his name and birthdate to verify identity.
D) Determine what questions the patient has about his medications.

Question 8

A patient being seen in the outpatient clinic has been given a new prescription for tetracycline (Doxycycline) orally each day. The patient reported current medications include a multivitamin with calcium, St. John's wort, and omeprazole (Prilosec). The nurse would provide additional teaching for which patient statement?

A) "I should try to take the medication at roughly the same time each day."
B) "I can take this medication with my other morning meds."
C) "I should take this medication at least an hour before or 2 hours after I eat."
D) "Drinking extra water is important when taking this medication."

Question 9

While working on a geriatric unit, the nurse would be most concerned by which of these findings?

A) An 81-year-old patient is scheduled to take 12 pills at 9Am.
B) A 72-year-old patient given a sleeping pill the night before seems confused.
C) A 69-year-old patient with a deep vein thrombosis has an order for an anticoagulant.
D) A 74-year-old patient with diabetes has a fasting glucose result of 88 g/dL.

Question 10

The nurse is providing medications to a patient with a gastrostomy tube (g-tube). Diclofenac (Cambia) has been ordered per g-tube. Prior to administration, the nurse should take which of the following actions?

A) Ensure that the medication comes as a liquid preparation.
B) Obtain a 3-mL syringe and needle with a safety device.
C) Document the medication administration.
D) Ask the patient to state her name and room number.

Question 11

The nurse is uncertain of the meaning of an abbreviation used by the physician in ordering medications for the patient. Which of the following is the best action to take regarding this abbreviation?

A) Contact the physician and ask for clarification of the abbreviation.
B) Ask the charge nurse to interpret the abbreviation.
C) Check The Joint Commission's "do not use" list of abbreviations.
D) Leave the order for the next nurse to complete.

Question 12

Shortly after providing a new sleeping pill to a patient on the medical unit, the nurse answers the patient's call light. Which of the following findings would indicate to the nurse that the patient is experiencing an anaphylactic reaction to the medication?

A) The patient's respiratory rate is 28 breaths/min and slightly labored.
B) The patient complains of continued wakefulness and agitation.
C) The patient states that she feels nauseated and has a headache.
D) The patient reports feeling hot and her face appears flushed.

Question 13

The nurse is conducting a home visit for a 43-year-old patient. The patient, who has three children under the age of 12, is 3 days post-mastectomy. The nurse would be most concerned by which of the following?

A) The patient has a calendar for appointments and a list with physician contact information by the phone.
B) The patient keeps her medications in a daily pill box that sits on the kitchen windowsill.
C) The patient reports that it is too uncomfortable to wear the temporary prosthesis she had been given.
D) The children are participating in a support group for family members of people with cancer.

Question 14

A nurse working in the GI clinic is performing pre-operative phone calls. The nurse calls a patient who is scheduled for a colonoscopy to inform the patient of the following orders: "Begin a clear liquid diet 24 hours prior to the exam; take magnesium citrate (Citroma) 1 bottle PO 12 hours prior to the exam and another 8 hours prior to the exam; remain NPO for 6 hours prior to the study." The test is scheduled the next day at 1400 hours. Which of the following demonstrates the most appropriate patient teaching the nurse can give to the patient?

A) "Only have liquids to drink at this point until the test. Use the enema preparation at 2 a.m. and then again at 6 a.m. You cannot have anything to eat or drink after waking in the morning."
B) "Start a clear liquid diet today at 2 p.m. Drink a bottle of magnesium citrate at 2 a.m. and another at 6 a.m., and then do not eat or drink anything after 8 a.m."
C) "Don't eat anything solid starting with lunch today. Give yourself an enema with the preparation at 6 a.m. and again at noon, and do not have anything to eat or drink after 8 a.m."
D) "Start a clear liquid diet with dinner today. Drink the preparation 12 hours and 8 hours before your test at 2 p.m. tomorrow, and be sure not to eat anything solid after you get up in the morning."

Question 15

While supervising a student nurse providing morning medications to patients in the long-term care facility, the nurse would intervene if the student was observed performing which of the following actions? (Select all that apply.)

A) The student checks the patient's wristband to verify identity.
B) The student verifies the medication order.
C) The student scans the medication with the computer scanner.
D) The student checks the medication's expiration date.
E) The student prepares a medication scheduled for 18:00.
F) The student asks the patient to state his first name prior to giving the medication.

Question 16

While working in a surgical clinic, the nurse notes orders that read, ".25 mg digoxin (Lanoxin) IV now." Which action by the nurse is best?

A) Give .25 mg of digoxin intravenously.
B) Give 25 mg of digoxin as an injection into the skin.
C) Contact the physician for clarification of the order.
D) Ask the charge nurse to verify the order.

Question 17

A nurse is working with a group of male veterans participating in a smoking-cessation program. The nurse recognizes that which of the following statements related to medications in these patients is true? (Select all that apply.)

A) An increased number of medications will have teratogenic effects in this population.
B) Medications are likely to be absorbed and distributed more rapidly in this population.
C) This population has a decreased lipase secretion.
D) These patients may need larger doses of liver-metabolized medications.
E) Medications will be metabolized more slowly by this population.

Question 18

While providing medications in the clinical laboratory, a student would perform actions related to safe administration that include which of the following? (Select all that apply.)

A) Right medication
B) Right dose
C) Right time
D) Right room
E) Right patient
F) Right route

Question 19

When providing medications from floor stock to a patient on the Alzheimer's unit of a long-term-care facility, the nurse demonstrates the principle of drug administration by performing which of the following?

A) Checking the label before taking the medication out of the cabinet, pouring the medication, and placing the bottle back in the cabinet
B) Checking the label before taking the medication out of the cabinet, pouring the medication, and leaving the medication room
C) Checking the label after removing the bottle from the cabinet and pouring the dose of medication, and before closing the cabinet door
D) Checking the label while removing the bottle from the cabinet, after pouring the dose of medication, and while replacing the bottle in the cabinet

Question 20

While working in an urgent care center, the nurse assists in the care of a patient with allergic rhinitis who has been given a prescription for beclomethasone nasal spray (Beconase), 2 sprays in each nostril 2 to 4 times daily. The nurse would provide further instruction if the patient made which of the following statements?

A) "This will help my nose to not run so constantly."
B) "I should spray this in each nostril whenever my nose starts to drip."
C) "I can use this before I go to work, midday, and again at bedtime."
D) "This medication is a mild steroid. It will reduce swelling and irritation of my nasal passages."

Question 21

Place the following steps of medication administration for an ordered medication in the correct order.

First

A)Ask the patient to state his/her name and birthdate.
B)Open the medication packaging.
C)Verify the medication and dose.
D)Scan the medication with the computer scanner.

Question 22

Place the following steps of medication administration for an ordered medication in the correct order.

Second

A)Ask the patient to state his/her name and birthdate.
B)Open the medication packaging.
C)Verify the medication and dose.
D)Scan the medication with the computer scanner.

Question 23

A RN is working to support clinical trials in patients with cancer. Which of the following would be an anticipated part of this role? (Select all that apply.)

A) Educating the patients about the treatment, its side effects, and alternative therapies
B) Ensuring that informed consent to participate is obtained
C) Documenting patient and family understanding related to the trial
D) Providing payment to the patient for participation in the trial
E) Ordering medications from the pharmacy based on patients' height and weight

Question 24

Place the following steps of medication administration for an ordered medication in the correct order.

Third

A)Ask the patient to state his/her name and birthdate.
B)Open the medication packaging.
C)Verify the medication and dose.
D)Scan the medication with the computer scanner.

Question 25

A nurse working on the orthopedic unit is providing discharge instructions for a patient with a fractured femur. When explaining the patient's narcotic pain medication, the nurse would include which of the following statement(s)? (Select all that apply.)

A) "This medication may make you sleepy, so you cannot drive while taking it."
B) "Narcotics can cause constipation, so be sure to drink extra fluid and eat a high-fiber diet."
C) "Many patients who take this feel dizzy or light-headed, so you must be careful of falls, especially at night."
D) "Only take the number of pills prescribed per day. Taking more can be dangerous."
E) "You can take this medication as many times as needed for pain control."

Question 26

A nurse working in the emergency room is preparing for the admission of a 34-year-old patient with a drug overdose. Which of the following equipment and/or orders will the nurse anticipate will be used for this patient?

A) Telemetry monitoring
B) Blood transfusion
C) Activated charcoal
D) Dialysis machine
E) Nasogastric tube and 60-mL syringe for lavage
F) Contrast for magnetic resonance imaging (MRI) testing

Question 27

Place the following steps of medication administration for an ordered medication in the correct order.

Fourth

A)Ask the patient to state his/her name and birthdate.
B)Open the medication packaging.
C)Verify the medication and dose.
D)Scan the medication with the computer scanner.