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?

Accepted Answer

Evaluating the laboratory values for liver and kidney function is crucial because older adults often have decreased liver and kidney function, which affects medication metabolism and excretion, necessitating lower doses to prevent toxicity.

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?

Accepted Answer

Adderall and Advair are not related in terms of their therapeutic uses but are known to have look-alike/sound-alike names, which can increase the risk of medication errors. Adderall is a stimulant medication used primarily for ADHD, and Advair is a combination inhaler used for asthma and COPD. There are no specific contraindications for giving them at the same time, Adderall does not reduce bronchospasms, and Advair does not need to be given with food.

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?

Accepted Answer

Taking the medication at set time intervals helps maintain consistent blood levels, which is important for the effectiveness of antibiotics like cefditoren.

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?

Accepted Answer

In cases of suspected poisoning, it is important to immediately seek emergency medical attention. Therefore, the nurse's first priority should be to call emergency personnel for the young woman and the child.

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?

Accepted Answer

A low serum protein level can indicate malnutrition, which can increase the risk of medication side effects. Therefore, increasing awareness and assessment of potential medication side effects is the best action by the nurse. Option A is not appropriate as this patient still requires appropriate symptom management and comfort care. Option B and C are not as relevant to addressing the low serum protein level.

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?

Accepted Answer

Muscle soreness can be a sign of a serious side effect of atorvastatin, such as rhabdomyolysis. It is important for the patient to be evaluated by a healthcare provider to rule out any serious complications.

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?

Accepted Answer

Patient privacy is important in healthcare settings. To maintain privacy and confidentiality, it is important to pull the curtain and talk in subdued tones while providing medications. This will help to avoid the disclosure of personal health information to the roommate and visitors. While identifying the medication and side effects, verifying the patient's identity, and addressing the patient's questions are important, maintaining privacy comes first in this situation.

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?

Accepted Answer

Tetracycline antibiotics should not be taken with calcium supplements, as calcium can interfere with the absorption of the medication. The patient's multivitamin with calcium should be taken at a separate time from the tetracycline. The patient can take tetracycline with food and should drink plenty of water, but timing is important to avoid interference with absorption. Taking it at roughly the same time each day can help with adherence.

Question 9

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

Accepted Answer

The confusion in the 72-year-old patient who was given a sleeping pill is concerning because older adults are at increased risk for adverse effects from medications, including sedative-hypnotics like sleeping pills. Confusion is a common symptom of medication toxicity or overdose in the elderly. The other options are common and appropriate for geriatric patients: polypharmacy (taking multiple medications) is common and requires careful management; anticoagulation is used to prevent complications from thrombosis; and a fasting glucose of 88 g/dL is within the normal range.

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?

Accepted Answer

Diclofenac does not come in liquid form, so it cannot be administered through a g-tube. The nurse should ensure that the medication is available in a form that can be administered through the g-tube, or ask the provider to prescribe an alternative medication. Option B is not necessary since there is no needle involved in administering medication through a g-tube. Option C and D are important steps of medication administration, but are not specific to g-tube administration.

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?

Accepted Answer

The best action to take when uncertain about an abbreviation used in orders is to contact the physician and ask for clarification. This ensures the safe administration of medications and avoids errors.

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?

Accepted Answer

An anaphylactic reaction is a severe, potentially life-threatening allergic reaction that can occur rapidly after exposure to an allergen. It often involves respiratory symptoms, such as increased respiratory rate and difficulty breathing, which are indicated by the patient's respiratory rate being 28 breaths/min and slightly labored. This suggests the patient may be experiencing anaphylaxis.

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?

Accepted Answer

Keeping medications in a daily pill box on the kitchen windowsill poses a risk for accidental ingestion by children and can also be affected by light and heat, potentially degrading the medication's effectiveness.

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?

Accepted Answer

This option accurately conveys the instructions given by the provider. It specifies a clear liquid diet starting on the day before the exam, 1 bottle of magnesium citrate to be taken 12 hours before and another 8 hours before the exam, and NPO for 6 hours prior to the test. Option A instructs the patient to use an enema preparation instead of magnesium citrate and to remain NPO after waking up, which is incorrect. Option C advises the patient to give themselves enemas instead of taking magnesium citrate and has the patient drink/eat nothing after noon, which is not accurate. Option D advises the patient to begin a clear liquid diet with dinner the day before the test, but does not specify the exact timing of the magnesium citrate preparation, and says nothing about the NPO period before the exam.

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.)

Accepted Answer

The student should not prepare a medication scheduled for 18:00 because it is not the correct time to administer the medication. The student should also ask the patient to state their full name, not just their first name, to verify their identity.

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?

Accepted Answer

The correct action is to contact the physician for clarification of the order. The order for ".25 mg digoxin (Lanoxin) IV now" is clear in terms of the medication, dose, and route. However, it is always important for nurses to verify orders that could potentially be unsafe or unclear. In this case, the order is clear, but if there was any uncertainty or concern about the appropriateness of the dose or route, contacting the physician for clarification would be the best course of action. Digoxin is a medication where dosing accuracy is critical due to its narrow therapeutic index, and any ambiguity or potential for error should prompt verification.

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.)

Accepted Answer

Smoking can increase the metabolism of certain medications, leading to faster absorption and distribution, and may require larger doses of liver-metabolized medications due to enzyme induction.

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.)

Accepted Answer

The five rights of medication administration include right medication, right dose, right time, right patient, and right route. Right room is not a factor in safe administration.

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?

Accepted Answer

The answer of When providing medications from floor stock to...

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?

Accepted Answer

The patient should not use the medication "whenever my nose starts to drip." The medication should be used according to the prescribed frequency (2 sprays in each nostril 2 to 4 times daily) for maximum effectiveness and minimal side effects.

Quiz 3: Patient Safety in Medication Administration