Deck 20: Safe Medication Preparation

Question 1

The nurse is caring for a patient who has liver disease and a decreased albumin level.She is concerned that the patient:

A) May become toxic on normal doses of medication
B) May have less active medication available in the body
C) May be resistant to medication crossing into the cerebrospinal fluid (CSF)
D) May have accelerated biotransformation of the medication

Answer 1

May become toxic on normal doses of medication

Question 2

When the metric system is used in calculating medication dosages,which of the following is true?

A) Always include trailing zeroes, for example, 1.0.
B) Always include a zero before a decimal point.
C) For medication calculation, use length, volume, and weight units.
D) Use uppercase letters for subdivisions of major units.

Answer 2

Always include a zero before a decimal point.

Question 3

The patient has a diagnosis of chronic back pain that he has been treating at home for the past 2 years with oral morphine sulfate (MS Contin).Upon admission to the hospital,the patient is medicated with morphine sulfate for his back pain,but the patient states that he has received no relief.The nurse notifies the physician,realizing that the reason for the lack of relief may be:

A) A side effect of the morphine
B) A result of drug dependence
C) An idiosyncratic response to the morphine
D) A result of medication tolerance

Answer 3

A result of medication tolerance

Question 4

During the admission process,the patient states that he is supposed to be on daily aspirin but stopped taking it because it nauseated him.The nurse recognizes that the patient stopped taking his medication because:

A) The patient is noncompliant
B) Of the medication's toxic effects
C) Of the medication's side effects
D) The patient is allergic

Question 5

When implementing appropriate technique for medication administration,the nurse is:

A) Administering medication prepared by other nurses
B) Using sterile technique for nonparenteral medications
C) Leaving medication at the bedside when the client is in the bathroom
D) Documenting the reason for medication refusal in the nurse's notes

Question 6

In using the system of household measurements in preparing medications,it is important for the nurse to understand that:

A) Household units of measure are familiar to most people
B) Household units of measurement are extremely accurate
C) Household units are used for critical medications only
D) Household units cannot be used in the home care environment

Question 7

The nurse is preparing to administer medication to her patient.He is alert and oriented.When the medications are reviewed with the patient,the patient says that he does not take metoprolol.The nurse should:

A) Ignore the patient's statement and give the medication
B) Withhold the medication
C) Convince the patient that the doctor ordered it, and he should take it
D) Give the medication and check the order afterward

Question 8

The name Tylenol is known as this medication's:

A) Chemical name
B) Trade name
C) Generic name
D) United States Pharmacopeia

Question 9

The patient is receiving vancomycin IV every 8 hours.The order is for a serum peak and trough level after the third dose.The medication is given on an 8 AM,4 PM,and midnight schedule.The third dose will be given at 4 PM.The nurse knows that she has to order the trough level for:

A) 4:30 PM
B) 6:00 PM
C) 11:30 PM
D) 12:00 AM

Question 10

Aspirin is known as Aspergum™'s:

A) Chemical name
B) Trade name
C) Generic name
D) United States Pharmacopeia

Question 11

While preparing a liquid medication,the nurse:

A) Pours the liquid medication toward the label
B) Draws the liquid quickly into a syringe
C) Holds the medication cup at eye level
D) Measures the poured liquid to the top of the meniscus

Question 12

Administration of controlled substances requires that the nurse:

A) Discard and sign for unused quantities
B) Count the amount of medication daily
C) Keep narcotics to be given with other client medications
D) Report immediately discrepancies in narcotic counts

Question 13

When using the Apothecary System for medication calculation,the nurse realizes that:

A) The system uses only Roman numerals
B) The system uses only fractions
C) The abbreviations always comes after the quantity
D) The symbol "ss" is used for the fraction ½

Question 14

A medication that is ordered "t.i.d." may be given at:

A) 10 AM
B) 10 AM and 6 PM
C) 10 AM, 6 PM, and 2 AM
D) 10 AM, 2 PM, and 6 PM

Question 15

A medication that is ordered pc is given:

A) STAT
B) prn
C) On call
D) After eating

Question 16

The patient is admitted to hospital with pneumonia and is ordered to receive IV doses of antibiotics.He receives his first dose without any problems,but during his second dose,he begins to complain of shortness of breath and difficulty breathing.The nurse notes wheezes throughout his lung field.The nurse stops administration of the antibiotic and calls for help.She recognizes these symptoms as part of:

A) An idiosyncratic reaction
B) A toxic effect of the antibiotic
C) A side effect of the medication
D) An anaphylactic reaction

Question 17

The hospital utilizes a unit dose system for medication distribution.The nurse realizes that with this system:

A) All medications are kept in the patient's drawer
B) Liquids are kept in multidose containers to prevent spillage
C) Narcotics are kept in an area separate from the patient's regular medications
D) The nurse is responsible for restocking the medication drawers daily

Question 18

The appropriate way to identify the "right client" is to:

A) Ask the client his or her name
B) Use at least two patient identifiers
C) Ask the primary nurse to identify the client
D) Say the client's name and request client validation

Question 19

The 80-year-old patient complained of feeling "anxious" and was given lorazepam (Ativan)to calm him.Instead,the patient became agitated and delirious.The nurse suspects that this behavior most likely is:

A) A toxic effect of Ativan
B) A side effect of Ativan
C) An idiosyncratic reaction to Ativan
D) An allergic reaction to Ativan

Question 20

The patient is complaining of severe pain in his leg.He does not have any pain medication ordered,so the nurse calls the doctor,who gives an order for a prn medication and a one-time dose of morphine sulfate to be given immediately.The morphine order is known as a:

A) Single one-time order
B) Standing order
C) Stat order
D) PRN order

Question 21

The parenteral route of a drug is ordered.The nurse administers this medication:

A) Orally
B) Topically
C) Sublingually
D) Intramuscularly

Question 22

Oral medications are indicated for the client who is:

A) Having episodes of vomiting
B) Taking a daily dose of vitamins
C) Having gastric suctioning
D) Experiencing an esophageal stricture

Question 23

The client is to receive a medication via the buccal route.The nurse plans to implement the following action:

A) Place the medication inside the cheek.
B) Crush the medication before administration.
C) Offer the client a glass of orange juice after administration.
D) Use sterile technique to administer the medication.

Question 24

The nurse is caring for a patient who has been getting morphine sulfate regularly every 4 hours for the last 2 weeks.The patient has a history of renal failure and liver disease.While on rounds,the nurse finds the patient is lethargic with a respiratory rate of 6 breaths per minute.The nurse expects that the physician will order naloxone (Narcan)to counter the ______________ of the morphine.

A) Toxic effects
B) Idiosyncratic reaction
C) Allergic reaction
D) Side effect

Question 25

To prevent medication errors,the nurse should:

A) Clarify illegible orders with the prescriber
B) Document the medication before administration
C) Read medication labels two times when preparing
D) Prepare all of the client's medication for the shift at the same time

Question 26

The eighth leading cause of death in the United States is _______________.

Question 27

The most common type of medical error is a _______________.

Question 28

Factors that affect the rate of distribution of a medication depend on which of the following? (Select all that apply.)

A) Circulation
B) Cell membrane permeability
C) Protein binding
D) Lipid solubility
E) None of above

Question 29

______________ are predictable and often unavoidable secondary effects of a medication produced at a usual therapeutic drug dose.

Question 30

The six rights of medication administration include which of the following? (Select all that apply.)

A) The right medication
B) The right patient
C) The right route
D) The right documentation
E) None of above

Question 31

To avoid penalties and prevent the delay of accreditation,hospitals need to comply with the ______________ set by The Joint Commission.

Question 32

The intended or desired physiological response of a medication is known as its _________________.

Question 33

Any response to a drug that is harmful,unintended,and occurs at doses normally used in humans for prophylaxis,diagnosis,or therapy for disease is known as an ________________.

Question 34

In the context of medication interactions,the term summation refers to two drugs being given to produce a result equal to the sum effects of each drug.This allows for: (Select all that apply.)

A) A smaller dose of each drug
B) Reduction in the risk of adverse effects
C) Higher risk for medication tolerance
D) Higher risk for medication dependence

Question 35

______________ is the study of how medications enter the body,reach their site of action,are metabolized,and exit the body.

Question 36

The hospital has implemented a computerized physician order entry system (CPOE)to eliminate the need for written orders.The benefits of this system include which of the following? (Select all that apply.)

A) Automatic drug allergy checks
B) Automatic dosage indications
C) Identification of potential drug interactions
D) Reduced number of medical errors

Question 37

A potentially fatal adverse drug event (ADE)is known as ___________________.

Question 38

Medication errors include which of the following? (Select all that apply.)

A) Administration of the wrong medication
B) Administration via the wrong medication
C) Inaccurate prescribing
D) Failing to administer a medication
E) None of above

Question 39

When do most medication errors occur? (Select all that apply.)

A) During hospital admission
B) During transfer from one unit to another
C) During discharge home
D) During discharge to another facility
E) None of above

Question 40

Patients who are at increased risk for adverse medication effects include: (Select all that apply.)

A) Very young patients
B) Patients taking more than four medications
C) Patients with renal and/or hepatic disease
D) Patients who treat themselves with over-the-counter medications
E) None of above

Question 41

The _________________ of a drug is the blood serum concentration reached and maintained after repeated,fixed doses.

Question 42

Medication dependence in which there is a physiological adaptation to a medication is known as _______________.

Question 43

A common problem for older adult patients is the use of a number of different medications,prescribed or not,for one or more health problems.This problem is known as ______________.

Question 44

The point at which the lowest amount of drug is in the serum is the _______________.

Question 45

The period of time it takes after a medication is administered for it to produce a therapeutic effect is known as the _____________________.

Question 46

The length of time during which the medication is present in a concentration great enough to produce a therapeutic effect is known as that drug's _______________.

Question 47

A medication distribution system that utilizes individual patient drawers and whereby medication is packaged according to what the patient would receive at one time is known as the ____________ system.

Question 48

The time it takes for a medication to reach its highest effective level of concentration is known as its _________________.

Question 49

An unpredictable effect of a medication in which a patient overreacts or underreacts to a medication or has a reaction different from normal is called an ____________.

Question 50

A drug interaction in which the combined effect of drugs is greater than the sum of each individual agent acting independently is known as a _____________.

Question 51

The dose ordered for a client is 75 mg IM.The medication is available in a 50 mg/mL solution.The nurse prepares ________________.

Question 52

A decreased physiological response that occurs after repeated administration of a medication is known as __________________.

Question 53

When a medication accumulates in the blood because of impaired metabolism or excretion,the patient may be at risk for ______________ of that medication.

Question 54

Medication dependence by which a person has an emotional desire for a drug to maintain an effect is known as ______________.

Question 55

The highest serum concentration of a medication in the body is known as the ____________.

Question 56

All medications have a ______________,which is the time it takes for excretion processes to lower the serum medication concentration by half.

Question 57

Calculation indicates that 2 tsp of a medication is to be administered to the client.The nurse pours _________________.

Question 58

The client is to receive 200 mg of a medication.There are 100 mg scored tablets available.The nurse prepares _____________________.

Question 59

A spoken order for a medication or treatment delivered by a prescriber directly to a nurse on a face-to-face basis is known as a _____________.