Question 1

The prescribed dose of Tylenol is given to a patient.The nurse recognizes the name Tylenol as which of the following?

Accepted Answer

Tylenol is a trade name for the generic drug acetaminophen.

Question 2

The patient is to receive a medication via the sublingual route.Which action by the nurse is appropriate?

Accepted Answer

The sublingual route involves placing the medication under the tongue, allowing it to dissolve and be absorbed directly into the bloodstream. Crushing the medication or offering juice afterward could alter its effectiveness, and sterile technique is not necessary for this route of administration.

Question 3

To prevent medication errors,which action should be taken by the nurse?

Accepted Answer

Clarifying illegible prescriptions with the prescriber ensures that the nurse administers the correct medication and dosage, thereby preventing medication errors.

Question 4

The nurse enters the patient's room to give medications.Which action is most appropriate to identify the "right patient"?

Accepted Answer

Asking the patient to state their name and birth date is a standard practice to ensure correct patient identification and prevent medication errors.

Question 5

An 80-year-old patient who complains of feeling "anxious" is given lorazepam.The patient becomes agitated and delirious.The nurse documents this reaction to lorazepam as which of the following?

Accepted Answer

An idiosyncratic reaction is an uncommon response to a drug that is not related to the pharmacological action of the drug, often due to genetic differences. In this case, the agitation and delirium are unexpected reactions to lorazepam, which is typically used to reduce anxiety.

Question 6

The nurse receives a prescription to give a medication parenterally.The nurse will administer this medication by which route?

Accepted Answer

Intramuscular injections are a type of parenteral administration, which means that the medication is given directly into the muscle tissue.

Question 7

The nurse is caring for several patients.The patient in which situation can safely receive oral medications?

Accepted Answer

The patient taking a daily dose of vitamins can safely receive oral medications because they are already ingesting substances orally and are likely able to tolerate further oral medication. The other options suggest complications or contraindications to oral medication administration. A patient who is experiencing nausea and frequent vomiting may not be able to keep the medication down, a patient with a nasogastric tube connected to suction bypasses the stomach and therefore cannot absorb oral medications, and a patient with an esophageal stricture may have difficulty swallowing pills and risk choking.

Question 8

A patient is receiving vancomycin intravenously (IV)every 8 hours at 0800,1600,and 2400.A serum peak and trough level is prescribed after the third dose,which will be given at 1600.When should the nurse draw up the trough level?

Accepted Answer

The trough level should be drawn just before the next dose, which is at 2400, so it should be drawn at 2330.

Question 9

The nurse is preparing to administer medication to a patient who is alert and oriented.When medications are reviewed with the patient,the patient states that he does not take metoprolol.Which action by the nurse is most appropriate?

Accepted Answer

The patient is alert and oriented and states that he does not take metoprolol. The nurse should withhold the medication and notify the prescriber.

Question 10

A patient with persistent back pain has been taking oral morphine sulphate for the past 2 years.On admission to the hospital,the patient receives morphine sulphate for back pain but reports no pain relief.The nurse notifies the health care provider,recognizing that the reason for the lack of pain relief is which of the following?

Accepted Answer

The patient has likely developed medication tolerance due to long-term use of morphine, requiring higher doses for the same pain relief.

Question 11

The patient is complaining of severe leg pain.No pain medication is prescribed,so the nurse calls the health care provider.A prescription for Tylenol with Codeine prn is given,in addition to a one-time prescription for morphine sulphate to be given stat.Which action by the nurse is most appropriate?

Accepted Answer

The morphine sulphate is prescribed to be given stat, meaning immediately, to address the severe pain.

Question 12

The nurse is calculating a medication dosage using the metric system.A vial contains 1 mL of fluid,and the nurse calculates the correct dosage to be half of the medication in the vial.How should the nurse document the correct dosage?

Accepted Answer

The correct dosage is 0.5 mL, which should be documented as 0.5 mL. It is important to include a zero before the decimal point to avoid confusion with larger dosage units (e.g. 5 mL vs. 0.5 mL). Choice A is not specific enough, while choices B and D do not include a leading zero.

Question 13

The nurse is aware that a patient with liver disease and a decreased albumin level may develop which of the following effects?

Accepted Answer

Most medications bind to albumin to some extent.When medications bind to albumin,they are unable to exert pharmacological activity.Only the unbound or "free" medication is active.Older adults and patients with liver disease or malnutrition have reduced albumin,which increases their risk for medication toxicity.With less albumin to bind with the medication,more "free" or active medication is present in the body.This would result in an increase in therapeutic effect and possibly in toxicity.Most biotransformation occurs in the liver,although the lungs,kidneys,blood,and intestines also play a role.Patients (e.g. ,elderly,those with chronic disease)are at risk for medication toxicity if their organs that metabolize medications do not function correctly.

Question 14

The nurse is teaching a patient how to measure medication dosages at home.The prescription is written for 30 mL of the medication.Which household measurement will the nurse teach the patient to use?

Accepted Answer

The equivalents of measurement are as follows: 15 drops = 1 mL,1 teaspoon = 5 mL,1 tablespoon = 15 mL,and 1 cup = 240 mL;therefore,a tablespoon is most appropriate,with 2 tablespoons = 30 mL.

Question 15

When medications are administered,which action by the nurse is appropriate?

Accepted Answer

It is important for the nurse to document any medication refusals by the patient, including the reason for refusal. This helps to ensure that the healthcare team is aware of any potential issues with medication administration and can make appropriate changes if necessary. Administering medications prepared by another nurse is not recommended, as it is important for the administering nurse to verify the medication order and ensure accuracy. Using sterile technique for nonparenteral medications is unnecessary and may increase the risk of infection. Leaving medication at the bedside when the patient is in the bathroom is not safe, as the medication could be accidentally ingested by someone else or misplaced.

Question 16

The nurse is preparing a liquid medication.Which action is most appropriate?

Accepted Answer

The answer of The nurse is preparing a liquid medication.Which...

Question 17

The hospital uses a unit-dose system for medication distribution.The nurse recognizes that this system includes which safety feature?

Accepted Answer

The unit-dose system includes the safety feature of keeping narcotics in a separate area from the patient's regular medications. This helps prevent medication errors and ensures that controlled substances are securely stored. The other options mentioned are not specific to the unit-dose system and do not necessarily contribute to medication safety in the same way.

Question 18

When controlled substances are administered,which action is required by the nurse?

Accepted Answer

When controlled substances are administered, the nurse should have a second nurse witness disposal of unused portions and sign the record. This helps to ensure accountability and prevent diversion or misuse of controlled substances. Discarding and signing for unused quantities (A), counting the medication daily (B), and keeping narcotics with other patient medications (C) are also important measures, but are not specific to requirements for administering controlled substances.

Question 19

A patient admitted to the hospital with pneumonia has intravenous (IV)antibiotics prescribed.He receives the first dose with no problem,but during the second dose,he begins to complain of shortness of breath and difficulty breathing.The nurse notes wheezes throughout the lung fields.The nurse documents these symptoms as which of the following?

Accepted Answer

The symptoms of shortness of breath, difficulty breathing, and wheezing after receiving an antibiotic dose are indicative of an anaphylactic reaction, which is a severe allergic response.

Question 20

During the admission process,the patient states that he stopped taking daily aspirin because of nausea.The nurse documents the nausea as which of the following?

Accepted Answer

Nausea is a common side effect of aspirin, not an allergic reaction or toxic effect. Nonadherence refers to not following the prescribed treatment plan, but the reason here is due to side effects.

Quiz 20: Safe Medication Preparation