Deck 7: Responsibilities and Principles of Drug Administration
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Deck 7: Responsibilities and Principles of Drug Administration
1
Adequate, up-to-date information about all medications to be administered includes ____.
i.Purpose
ii.Potential side effects
iii.Cautions
iv.Contraindications
v.Possible interactions
A) All of the above.
B) None of the above.
C) i, ii, iii
D) ii, iii, iv, v
E) iii, iv, v
i.Purpose
ii.Potential side effects
iii.Cautions
iv.Contraindications
v.Possible interactions
A) All of the above.
B) None of the above.
C) i, ii, iii
D) ii, iii, iv, v
E) iii, iv, v
All of the above.
2
When a medication is ordered orally, it is acceptable for the health care professional to substitute another route of administration (e.g., IM or IV) if the patient is unable to eat or drink.
False
3
Health care practitioners have a responsibility to ______. i.
Provide quality care and patient safety at all times
Ii)
First do no harm
Iii)
Conceal medication errors when they occur
Iv)
Prevent medication errors
A) All of the above.
B) None of the above.
C) i, ii, iv
D) i, ii, iii
Provide quality care and patient safety at all times
Ii)
First do no harm
Iii)
Conceal medication errors when they occur
Iv)
Prevent medication errors
A) All of the above.
B) None of the above.
C) i, ii, iv
D) i, ii, iii
i, ii, iv
4
Adverse reactions to a medication should always be noted in the patient's record.
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5
Administering the right drug to the right patient at the wrong time is not considered a medication error.
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6
A medication error may include _________.
A) administration of the wrong drug
B) administration of the right drug at the wrong time
C) improper documentation in the patient's record
D) Any of the above.
A) administration of the wrong drug
B) administration of the right drug at the wrong time
C) improper documentation in the patient's record
D) Any of the above.
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7
Every medication given must be recorded on the patient's record along with the following EXCEPT ______.
A) dose
B) cost
C) time
D) route
E) medication name
A) dose
B) cost
C) time
D) route
E) medication name
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8
The Six Rights of medication administration include the following EXCEPT _______.
A) right time
B) right patient
C) right provider
D) right amount
A) right time
B) right patient
C) right provider
D) right amount
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9
What steps should be taken in the case of a medication error?
A) Report the error immediately according to institutional policy.
B) Alter the record to conceal the error if no harm was done.
C) Document the error in the patient's record.
D) Do not discuss the error, but take actions to safeguard the patient in the event of an adverse reaction.
A) Report the error immediately according to institutional policy.
B) Alter the record to conceal the error if no harm was done.
C) Document the error in the patient's record.
D) Do not discuss the error, but take actions to safeguard the patient in the event of an adverse reaction.
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10
When a patient is sleeping, it is acceptable to leave the prepared medication at the bedside to avoid confusing with other patients' medications.
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11
One method of discerning that the right patient is receiving the ordered medication is to ask the patient to verify their name and birth date and compare it to the wristband and/or chart information.
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12
Safe and accurate administration of medications INCLUDES _________. i.
Adequate, up-to-date information about all medications to be administered
Ii)
Judgment to accurately assess the patient's needs, evaluate the response, and plan appropriate interventions
Iii)
Skill in delivery of the medication accurately
Iv)
Patient education to the patient and family
A) All of the above.
B) None of the above.
C) i, ii, iii
D) ii, iii, iv
E) iii only
Adequate, up-to-date information about all medications to be administered
Ii)
Judgment to accurately assess the patient's needs, evaluate the response, and plan appropriate interventions
Iii)
Skill in delivery of the medication accurately
Iv)
Patient education to the patient and family
A) All of the above.
B) None of the above.
C) i, ii, iii
D) ii, iii, iv
E) iii only
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13
The health care worker should question medication orders if _________.
A) orders are confusing or illegible
B) orders seem inappropriate
C) orders include doses that are outside what is customary
D) All of the above.
A) orders are confusing or illegible
B) orders seem inappropriate
C) orders include doses that are outside what is customary
D) All of the above.
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14
Safe and accurate administration of medications requires all of the following EXCEPT ______.
A) judgment
B) knowledge
C) skill
D) personal experience taking the medication
A) judgment
B) knowledge
C) skill
D) personal experience taking the medication
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15
All medications must be administered on an empty stomach to be effective.
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16
If a medication error is considered minimal without resulting in a disability, an error report should not be generated to avoid undue risk to the institution.
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17
Safe administration of medication includes taking a complete history that includes all over-the-counter and herbal preparations being used by the patient.
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18
Safe and accurate administration of medications requires ________.
A) knowing the least expensive pharmacy from which the medication may be purchased
B) recognizing the medication by color
C) adequate, up-to-date information, including purpose and potential side effects
D) None of the above.
A) knowing the least expensive pharmacy from which the medication may be purchased
B) recognizing the medication by color
C) adequate, up-to-date information, including purpose and potential side effects
D) None of the above.
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19
When no time is included in a physician's order, the health care worker should arrange an appropriate schedule for administration, taking into consideration the purposes, action, and side effects of the medication.
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20
MedWatch reports may only be initiated by a physician.
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21
The right time for administration of a medication indicates ___.
A) that it is to be given within 1 hour of the time written
B) a suggested time that may be determined by the health care provider administering the medication
C) the time the patient decides it should be taken
D) the time the prescriber has ordered
A) that it is to be given within 1 hour of the time written
B) a suggested time that may be determined by the health care provider administering the medication
C) the time the patient decides it should be taken
D) the time the prescriber has ordered
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22
When administering a medication, the health care provider _______.
A) does not need to be concerned with herbal preparations as they have no bearing on medications
B) should assess for all over-the-counter drug, vitamins, and herbal remedies
C) should follow the order as written, regardless of any other conditions or medications
D) All of the above.
A) does not need to be concerned with herbal preparations as they have no bearing on medications
B) should assess for all over-the-counter drug, vitamins, and herbal remedies
C) should follow the order as written, regardless of any other conditions or medications
D) All of the above.
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23
Which situation might NOT be considered a medication error?
A) The patient was given a generic form of a medication.
B) A medication was ordered to be given by mouth but the client was on NPO status, so the same dose was provided by injection.
C) The nurse documented the wrong medication in the chart but gave the correct dose, route, and medication.
D) A medication was ordered to be given as 5 mg but was administered in an amount of 50 mcg.
A) The patient was given a generic form of a medication.
B) A medication was ordered to be given by mouth but the client was on NPO status, so the same dose was provided by injection.
C) The nurse documented the wrong medication in the chart but gave the correct dose, route, and medication.
D) A medication was ordered to be given as 5 mg but was administered in an amount of 50 mcg.
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24
If a narcotic has been drawn up, but it is not administered, what is the MOST correct procedure?
A) Discard the medication and note it in the patient's record.
B) Discard the medication with a witness present and chart in the patient record that it was not given and the reason for withholding it.Then record the waste in the controlled substance records.
C) Discard the medication with a witness present and chart in the patient record that it was not given with the reason for withholding it.
D) Discard the medication with a witness present and record the waste in the controlled substance records.
A) Discard the medication and note it in the patient's record.
B) Discard the medication with a witness present and chart in the patient record that it was not given and the reason for withholding it.Then record the waste in the controlled substance records.
C) Discard the medication with a witness present and chart in the patient record that it was not given with the reason for withholding it.
D) Discard the medication with a witness present and record the waste in the controlled substance records.
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25
Responsibility for safe administration of medications requires that the health care practitioner ____.
A) have a physician check all medications prior to administration
B) work with a partner to reduce errors
C) sign off on all of the required releases
D) be familiar with every medication before administering it
A) have a physician check all medications prior to administration
B) work with a partner to reduce errors
C) sign off on all of the required releases
D) be familiar with every medication before administering it
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26
Which element is missing from the following order? "Give Demerol IM every 4-6 hours for complaints of pain."
A) Route
B) Time
C) Dose
D) All of the above.
A) Route
B) Time
C) Dose
D) All of the above.
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27
In administering medications, it is acceptable to _______.
A) give a medication that someone else has prepared as long as you verify that person's credentials.
B) leave the medication at the bedside of a competent sleeping patient so as not to disturb them.
C) return an opened, single-dose packet if the patient is unable to take the medication.
D) None of the above.
A) give a medication that someone else has prepared as long as you verify that person's credentials.
B) leave the medication at the bedside of a competent sleeping patient so as not to disturb them.
C) return an opened, single-dose packet if the patient is unable to take the medication.
D) None of the above.
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28
Patients must understand the importance of taking their medicine in the proper dosage, on time, and in the proper way if ____.
A) the insurance company mandates patient education
B) they are to benefit from drug therapy
C) they expect to be discharged
D) the doctor orders patient education
A) the insurance company mandates patient education
B) they are to benefit from drug therapy
C) they expect to be discharged
D) the doctor orders patient education
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29
Cyndy notices that the doctor has ordered the administration of 400 mg of meperidine hydrochloride (Demerol) every 2 hours.She knows that the usual dose is 50 to 150 mg every 3-4 hours.What should she do?
A) Administer the drug as ordered but include your concerns in your documentation.
B) Administer the drug as ordered.
C) Administer the usual dose, chart the change, and ask the doctor at rounds.
D) Question the dose in accordance with the facility's procedures.
A) Administer the drug as ordered but include your concerns in your documentation.
B) Administer the drug as ordered.
C) Administer the usual dose, chart the change, and ask the doctor at rounds.
D) Question the dose in accordance with the facility's procedures.
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30
Luca, a new nurse at the nursing home, explains to you that he injured his hands over the weekend with some garage tools.He is responsible for medication administration and asks you to open all of the unit dose packages for him before he makes rounds.What should you tell him?
A) Of course.Nurses need to be able to rely on each other.
B) Yes, but only for drugs that are not controlled substances.
C) No, but I will get you a sharp blade so that you can open the packages more easily before rounds.
D) No.Unit dose packages should only be opened when the patient is ready to take them, not before.
A) Of course.Nurses need to be able to rely on each other.
B) Yes, but only for drugs that are not controlled substances.
C) No, but I will get you a sharp blade so that you can open the packages more easily before rounds.
D) No.Unit dose packages should only be opened when the patient is ready to take them, not before.
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31
Miguel's prescription states that he is to take his anticonvulsant every 12 hours.He asks if he can take the medication first thing in the morning (usually around 7) and then when he goes to bed (usually around 11) to avoid his usual forgetfulness.What should you tell Miguel?
A) This should not be a problem.Instructions about the timing of medication are just general guidelines.
B) As long as he remembers to take it on an empty stomach, the medication can be taken anytime in the morning and evening.
C) If he cannot remember to take his medication, he should seek assistance from a home health nurse.
D) He should take his medication every 12 hours in order to maintain a therapeutic level of the anticonvulsant and prevent convulsions.
A) This should not be a problem.Instructions about the timing of medication are just general guidelines.
B) As long as he remembers to take it on an empty stomach, the medication can be taken anytime in the morning and evening.
C) If he cannot remember to take his medication, he should seek assistance from a home health nurse.
D) He should take his medication every 12 hours in order to maintain a therapeutic level of the anticonvulsant and prevent convulsions.
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32
Four-year-old Patrick is at the doctor for an IM injection, and begs you to use one of the tiny needles he remembers from a skin test for allergies because that did not hurt much.What should you do?
A) Agree to the change but only if the molecules of the medicine will fit through the tiny lumen of the needles.
B) Agree to the change as long as he will be cooperative, as his comfort is important.
C) Carefully explain to Patrick and his parents why you cannot do this, and give the injection as ordered.
D) Document the incident as medication refusal and do not give the shot.
A) Agree to the change but only if the molecules of the medicine will fit through the tiny lumen of the needles.
B) Agree to the change as long as he will be cooperative, as his comfort is important.
C) Carefully explain to Patrick and his parents why you cannot do this, and give the injection as ordered.
D) Document the incident as medication refusal and do not give the shot.
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33
Physicians are notorious for their illegible handwriting.What innovation helps reduce errors associated with misreading prescriptions?
A) USP/NF
B) PDR
C) CPOE
D) MedWatch
A) USP/NF
B) PDR
C) CPOE
D) MedWatch
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34
The right documentation of a medication involves _____.
A) charting unusual or adverse patient reactions noted following administration
B) noting the right dose and time of administration
C) recording the location of any injections and the appearance of the injection site
D) All of the above.
A) charting unusual or adverse patient reactions noted following administration
B) noting the right dose and time of administration
C) recording the location of any injections and the appearance of the injection site
D) All of the above.
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35
Logan, who has terminal cancer, has a PRN order for an anxiolytic injection.When it is administered, the hospice nurse should note dose, time, route, location of injection, and ____.
A) patient's mental outlook
B) likely survival time
C) likelihood of substance abuse
D) effectiveness
A) patient's mental outlook
B) likely survival time
C) likelihood of substance abuse
D) effectiveness
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36
Why should the following order be clarified? "Penicillin 6 cc IM 3 times daily"
A) The concentration was not included in the order.
B) An excessive amount per injection was ordered.
C) The time of administration was not ordered.
D) All of the above.
A) The concentration was not included in the order.
B) An excessive amount per injection was ordered.
C) The time of administration was not ordered.
D) All of the above.
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37
Sylvano's hospital has a new packaging system in the pharmacy and, unfortunately, the labels are not dispensed properly.This evening, he receives unit dose medications in which the labels are so crooked that they are overlapping one another.What should Sylvano do?
A) Do not administer the medication.
B) Peel back the labels so he can tell which is which.
C) Use the medications if he is familiar with their standard usage.
D) Look the medications up in a drug reference and then administer them.
A) Do not administer the medication.
B) Peel back the labels so he can tell which is which.
C) Use the medications if he is familiar with their standard usage.
D) Look the medications up in a drug reference and then administer them.
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38
Which statement is correct regarding MedWatch?
A) It is a form designed by the DEA to monitor mistakes regarding narcotics errors.
B) It is a mechanism for reporting clinical trial information.
C) It encourages health care professionals to report unexpected adverse events experienced by patients taking medications.
D) It involves mandatory reporting of adverse outcomes and events related to medications.
A) It is a form designed by the DEA to monitor mistakes regarding narcotics errors.
B) It is a mechanism for reporting clinical trial information.
C) It encourages health care professionals to report unexpected adverse events experienced by patients taking medications.
D) It involves mandatory reporting of adverse outcomes and events related to medications.
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39
Ms.Vasco's arms are covered with bruises and as a result, she begs you to give her a pill rather than another injection.Under what circumstances can a route be changed?
A) When the ordered form is not available
B) Only with a physician's order
C) When the patient approved the change
D) Anytime that an equivalent is available
A) When the ordered form is not available
B) Only with a physician's order
C) When the patient approved the change
D) Anytime that an equivalent is available
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40
MedWatch reports help the FDA to _____.
A) monitor drug safety
B) shut down companies who make defective drugs
C) punish health care providers who administer defective medications
D) keep medication costs down
A) monitor drug safety
B) shut down companies who make defective drugs
C) punish health care providers who administer defective medications
D) keep medication costs down
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41
The process in which the medications a patient is taking are compared to the medications ordered by the patient's physician is ____.
A) patient auditing
B) care conference
C) medication check
D) medication reconciliation
A) patient auditing
B) care conference
C) medication check
D) medication reconciliation
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42
Nancy is reading the doctor's orders for Ms.Brighton, a 72-year-old with COPD, congestive heart failure, Type 2 diabetes, high blood pressure, and high cholesterol.She notices that one of the newly prescribed medications has the potential for life-threatening potentiation of one of Ms.Brighton's other medications.What should Nancy do?
A) Question the order and explain the potential problems.
B) Document Nancy's concerns but take no further action.
C) Do nothing; the physician has written the order.
D) Advise Ms.Brighton to refuse to take the medication.
A) Question the order and explain the potential problems.
B) Document Nancy's concerns but take no further action.
C) Do nothing; the physician has written the order.
D) Advise Ms.Brighton to refuse to take the medication.
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