Deck 7: Responsibilities and Principles of Drug Administration

Question 1

If a health care practitioner is unfamiliar with a drug,he or she should .

A)administer it regardless,because the physician ordered it
B)consult a standard reference or a pharmacist or similar professional before administering it
C)call the ordering physician and ask why that particular drug was chosen
D)substitute a more familiar drug and document the reason in the chart

Answer 1

consult a standard reference or a pharmacist or similar professional before administering it

Question 2

Mrs.Chen is an older woman who can sometimes be contrary about taking her medication.One morning,she refuses to take her medication,which includes drugs for her high blood pressure,Type 2 diabetes,and seizure disorder.What should you do?

A)Withhold her breakfast and any scheduled activities until she takes her medication.
B)Return the medication to the medication room,make a note of her refusal in the chart,and notify the physician if appropriate.
C)Tell her you will have to give her shots if she does not take her medication.
D)Leave the medications on her bed table.She will eventually take them and then likely show you the empty pill cup.

Answer 2

Return the medication to the medication room,make a note of her refusal in the chart,and notify the physician if appropriate.

Question 3

Isaac,a spry and active 84-year-old,is hospitalized for a knee replacement.He finds it a bit insulting when nurses ask him his name before they give him his medications.Why are the nurses asking for this information?

A)To determine whether he is mentally competent
B)To ensure they are administering the right medicine to the right patient
C)To ensure he will not be given too many pain killers
D)To check his pre-surgery memory for comparison purposes

Answer 3

To ensure they are administering the right medicine to the right patient

Question 4

The nurse on duty has just finished preparing medication for administration as she falls and hits her head badly enough to be taken to the emergency room.The supervisor has given you responsibility for medication administration.What should you do?

A)Standard hospital policy prohibits throwing away drugs,so you should administer but with caution.
B)The nurse on duty is known to be accurate,so you can use what she prepared without concern.
C)Start preparation from the beginning.You should not administer medications someone else has prepared.
D)Use what the nurse on duty prepared,with the exception of controlled substances,which you should prepare yourself.

Question 5

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)Peel back the labels so he can tell which is which.
B)Look the medications up in a drug reference and then administer them.
C)Do not administer the medication.
D)Use the medications if he is familiar with their standard usage.

Question 6

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)the doctor orders patient education
D)they expect to be discharged

Question 7

Physicians are notorious for their illegible handwriting.What innovation helps reduce errors associated with misreading prescriptions?

A)USP/DI
B)MedWatch
C)CPOE
D)PDR

Question 8

What should happen if narcotics are not used due to a partial dosage,error,or cancellation of an order?

A)They should be reviewed by the physician who wrote the order,who will determine next steps.
B)They should be sent back to the pharmacy for inspection and potential reuse.
C)They must be destroyed and two health care practitioners must sign as witnesses of the disposal of the drug.
D)They should be kept in the medication room for other patients for up to one week.

Question 9

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)assessment of need
B)likely survival time
C)effectiveness
D)likelihood of substance abuse

Question 10

Responsibility for safe administration of medications requires that the health care practitioner .

A)have a physician check all medications prior to administration
B)sign off on all of the required releases
C)work with a partner to reduce errors
D)be familiar with every medication before administering it

Question 11

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)Document the incident as medication refusal and do not give the shot.
B)Agree to the change but only if the molecules of the medicine will fit through the tiny lumen of the needles.
C)Agree to the change as long as he will be cooperative,as his comfort is important.
D)Carefully explain to Patrick and his parents why you cannot do this,and give the injection as ordered.

Question 12

Under what circumstances must a MEDWATCH form be completed?

A)when a causal link is established between a medication and an adverse outcome
B)when a death results
C)when a legal complaint has been lodged
D)never,because MEDWATCH is voluntary

Question 13

What is the ultimate goal of safe medication administration?

A)Maximize the effectiveness of the drug with the least discomfort to the patient.
B)Do no harm.
C)Ensure the proper dose is given at the proper time to the proper patient.
D)Cure disease or minimize symptoms if a cure is not possible.

Question 14

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 patient approved the change
B)only with a physician's order
C)when the ordered form is not available
D)anytime that an equivalent is available

Question 15

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)As long as he remembers to take it on an empty stomach,the medication can be taken anytime in the morning and evening.
B)He should take his medication every 12 hours in order to maintain a therapeutic level of the anticonvulsant and prevent convulsions.
C)This should not be a problem.Instructions about the timing of medication are just general guidelines.
D)If he cannot remember to take his medication,he should seek assistance from a home health nurse.

Question 16

The medication order notes the medication is to be administered pc.What does pc mean?

A)after meals
B)as needed
C)separately from other medications
D)when requested by the patient

Question 17

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)No,but I will get you a sharp blade so that you can open the packages more easily before rounds.
C)No.Unit dose packages should only be opened when the patient is ready to take them,not before.
D)Yes,but only for drugs that are not controlled substances.

Question 18

Cyndy notices that the doctor has ordered the administration of 400 mg of meperidine hydrochloride (Demerol)every two hours.She knows that the usual dose is 50 to 150 mg every three to four 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)Question the dose in accordance with the facility's procedures.
D)Administer the usual dose,chart the change,and ask the doctor at rounds.

Question 19

For what types of medication errors must an incident report be completed?

A)for all medication errors
B)only those witnessed by another health care practitioner
C)only if there is an adverse reaction
D)only those that are potentially dangerous

Question 20

What is an innovation that reduces errors by assuring the identity and dose of each drug are prescribed specifically for the correct patient?

A)MedWatch
B)the MER
C)bar codes
D)CPOE

Question 21

Under what circumstances should medication errors be reported?

A)Medication errors must always be reported.
B)Health professionals are responsible for determining whether or not to report an error they have made.
C)Only errors that result in demonstrable harm to the patient should be reported.
D)Errors by nurses or physicians should be reported if required by hospital policy.

Question 22

The process in which the medications a patient is taking are compared to the medications ordered by the patient's physician is .

A)medication check
B)patient auditing
C)care conference
D)medication reconciliation

Question 23

David was prescribed mefloquine hydrochloride to prevent malaria before his trip to India.Unfortunately,he had an adverse reaction to the drug and wound up hospitalized with hallucinations,paranoia,and amnesia.In the United States,what entity is specifically charged with reporting serious adverse events such as the one David experienced?

A)USP
B)MER
C)MedWatch
D)CPOE

Question 24

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)Do nothing;the physician has written the order.
B)Document Nancy's concerns but take no further action.
C)Question the order and explain the potential problems.
D)Advise Ms.Brighton to refuse to take the medication.

Question 25

Sanjit is documenting the administration of a scheduled dose hydromorphone hydrochloride,a narcotic,and has noted the time,dose,route,and location of administration.Has Sanjit completed the necessary documentation?

A)Yes,but another health care professional must countersign the documentation.
B)No,Sanjit must also complete the controlled substance record for narcotics.
C)No,Sanjit failed to record the patient's rating of the effectiveness of the medication.
D)Yes,Sanjit has followed the proper protocols.