Question 1

The nurse manager on a surgical unit suspects one of the nurses may be dealing with a substance abuse problem. Which of the following symptoms would support this suspicion? (Select all that apply.)&#10;A) The individual's uniform is frequently wrinkled or disheveled.&#10;B) The individual has called in sick three times in the past month.&#10;C) The individual has made two medication errors in the past week.&#10;D) The individual is irritable and withdrawn.&#10;E) The individual was seen crying in the medication room after a patient death.&#10;F) The individual has lost an estimated 10 pounds in the past 8 weeks.

Accepted Answer

Symptoms that may support the suspicion of a substance abuse problem include a disheveled appearance (A), frequent absences (B), medication errors (C), changes in mood such as irritability and withdrawal (D), and significant weight loss (F). These signs can indicate a nurse may be struggling with substance abuse, affecting their professional performance and personal well-being. Crying in the medication room after a patient death (E) is more indicative of emotional distress related to a specific event rather than substance abuse.

Question 2

A patient with advanced colorectal cancer is going to start taking long-acting morphine sulfate (MS Contin). Which of the following statements by the nurse is best?&#10;A) &#34;I will call the prescription into your local pharmacy.&#34;&#10;B) &#34;You are only allowed to have one refill on this medication before you have to see the doctor again.&#34;&#10;C) &#34;This is considered a Schedule IV medication, so there are strict guidelines we must follow.&#34;&#10;D) &#34;I am faxing the prescription to the pharmacy, but you must also take this written prescription with you to pick it up.&#34;

Accepted Answer

Morphine sulfate, a Schedule II controlled substance, requires a written prescription for dispensing due to its high potential for abuse and dependence. The statement about faxing the prescription and requiring a written prescription aligns with regulatory guidelines for Schedule II medications.

Question 3

While shopping for an over-the-counter cough suppressant, the nurse identifies the medication will be classified as a:&#10;A) Schedule I medication&#10;B) Schedule III medication&#10;C) Schedule V medication&#10;D) Nonscheduled medication

Accepted Answer

Schedule V medication

Question 4

A patient with a compressed disc in the lumbar region takes Vicodin every 6 hours for pain control. The patient tells the nurse, "This pain medication just doesn't seem to be working anymore." Which response by the nurse is best?

A) "Are you taking the medication with a full glass of water?"
B) "You may be developing a tolerance to the medication."
C) "We will draw some blood to see if you are absorbing the medication."
D) "How did you rank your pain on a 0 to 10 scale with your original injury?"

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Accepted Answer

Tolerance is a common side effect of narcotic pain medications and can occur with long-term use. The nurse should educate the patient on this possibility and discuss alternative pain management options with the healthcare provider. Asking about water intake or blood tests may not address the underlying issue of tolerance. Asking about the patient's pain rating may provide some information, but the best course of action is to address the possibility of tolerance.

Question 5

A co-worker tearfully confides that she is struggling with a growing dependence on sleeping medication and other drugs to maintain her work schedule on the night shift. Which action by the nurse is best?

A) Refer the co-worker to the employee assistance program.
B) Encourage the co-worker to switch to herbal remedies.
C) Suggest the co-worker try to get a daytime position.
D) Ask if the co-worker needs help with childcare.

Accepted Answer

Referring the co-worker to the employee assistance program is the best option as it provides support and resources to address substance abuse and addiction issues. Encouraging the use of herbal remedies is not a safe or effective solution, and suggesting a daytime position or childcare assistance may not be feasible or practical options for the co-worker.

Question 6

The nurse provides a patient who was admitted with gastroesophageal reflux a dose of intravenous pantoprazole (Protonix). Fifteen minutes later, the patient calls for help and is gasping for breath. Emergency measures are instituted, and the patient is transferred to the intensive care unit. Which action should be included in the nurse's follow-up activities?

A) Notify the nursing supervisor that the patient experienced a common side effect to the medication.
B) Identify the episode as an adverse reaction and ensure it is reported to the FDA.
C) Call the hospital administrator to report an act of medication fraud.
D) Contact the local news channel to arrange an investigation.

Accepted Answer

The patient's reaction to the medication is severe and potentially life-threatening, suggesting an adverse drug reaction. The nurse should report this to the FDA as part of their post-marketing surveillance of medications. Option A is incorrect because gasping for breath is not a common side effect of pantoprazole. Option C and D are incorrect and unethical as they involve reporting false information or causing unnecessary harm to the hospital's reputation.

Question 7

A nurse working with a patient who is experiencing withdrawal from a medication would track which of the following symptoms? (Select all that apply.)&#10;A) Tremors&#10;B) Pinpoint pupils&#10;C) Hallucinations&#10;D) Low blood pressure&#10;E) Emotional distress&#10;F) Feelings of euphoria

Accepted Answer

Tremors, hallucinations, and emotional distress are common symptoms of medication withdrawal. Pinpoint pupils, low blood pressure, and feelings of euphoria may be indicative of other conditions or side effects of medication, but are not typically associated with withdrawal.

Question 8

A clinical trial nurse is helping to register a patient to a phase II double-blind trial comparing a new medication to a placebo. Which of the following would the nurse include in the patient teaching? (Select all that apply.)

A) "Neither you, the doctor, nor I will know if you are getting the real medication or not."
B) "A computer will randomly determine which people get the actual study drug."
C) "This trial is designed to determine if a benefit is found when using the drug."
D) "Fewer than 100 people will be participating in this study."
E) "The results of the study will not be known for at least 5 years."

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Accepted Answer

A) It is important to inform the patient that the trial is double-blind, meaning that neither the patient nor the healthcare providers will know if the patient is receiving the real medication or a placebo. This is done to reduce bias and ensure that the results of the study are accurate.
B) Randomization is also important in ensuring that the study results are accurate, as it helps to eliminate potential confounding factors that may lead to biased results. 
C) It is important for the patient to understand that the goal of the trial is to determine if the new drug is effective in treating the condition it is intended for. This helps the patient understand why the trial is being conducted and what the expected outcome is. 
D) The number of participants in the trial is not as important for the patient to know, as it does not impact their participation in the study. 
E) The length of time it will take to obtain results is not as important for the patient to know, as they will not be actively involved in the trial for the entire duration.

Question 9

Which of the following best describes the role of the Drug Enforcement Administration (DEA) in maintaining patient safety?&#10;A) Determining which medication needs a prescription for the patient to obtain.&#10;B) Providing specific requirements for manufacturing of generic medications.&#10;C) Indicating which medications are controlled substances and enforcing the laws.&#10;D) Ensuring the patient taking a medication has an option for generic medications.

Accepted Answer

The DEA is responsible for determining which medications are controlled substances and enforcing the laws surrounding those medications. This helps to maintain patient safety by ensuring that these drugs are not being misused or abused, which could be detrimental to a patient's health. While the DEA does play a role in regulating prescription drugs in general, such as requiring a prescription for certain medications, this is not their primary role in maintaining patient safety. Similarly, while the DEA may provide regulations for manufacturing of drugs, this is not their primary focus in maintaining patient safety. Finally, the DEA does not have any specific role in ensuring patients have access to generic medications.

Deck 4: Regulations