Question 1

The nurse administered the narcotic meperidine, 50 mg orally (PO) at 1400 to a patient with nausea, vomiting, and pain rated as 9 on a 0-to-10 scale. At 1430, the patient stated that the medication was not working and requested to have intravenous (IV) morphine, which the provider had prescribed for severe pain. What is the nurse's best evaluation of this situation?

Accepted Answer

Administering meperidine PO was not the best intervention because oral medications take longer to act, and the patient is experiencing severe pain and nausea/vomiting, which may affect absorption. IV morphine would provide faster relief.

Question 2

A patient with terminal cancer requires increasing doses of an opioid pain medication to obtain relief from pain. This patient is exhibiting signs of drug:

Accepted Answer

Tolerance occurs when a person needs a higher dose of a medication to achieve the same level of effect. In the context of opioid pain medication for a patient with terminal cancer, increasing doses to obtain relief from pain is indicative of tolerance, not abuse, misuse, or dependence.

Question 3

The nurse is preparing to administer a medication for a client with cystic fibrosis. The nurse is not familiar with the drug. Which is the best action that the nurse should take?

Accepted Answer

The best action for the nurse to take when unfamiliar with a medication is to refer to a reliable and comprehensive drug reference source such as the Physician's Desk Reference (PDR). This ensures the nurse gets accurate and detailed information about the medication, including its indications, dosages, contraindications, and side effects, which is essential for safe administration.

Question 4

The primary care provider orders peak and trough levels for a patient who is receiving intravenous vancomycin every 12 hours. When should the nurse obtain a blood specimen to measure the trough?

Accepted Answer

Trough levels are measured to determine the lowest concentration of a drug in the patient's bloodstream, ensuring it remains above the minimum inhibitory concentration (MIC) but below toxic levels. For accurate measurement, the blood specimen for a trough level should be drawn approximately 30 minutes before the next dose of the medication is due. This timing ensures that the drug concentration is at its lowest point right before the next dose is administered.

Question 5

A patient who just returned from the postanesthesia care unit is reporting severe incision pain. Which drug contained in the medication administration record will offer the patient the fastest relief?

Accepted Answer

Intravenous morphine sulfate offers the fastest relief because IV medications bypass the digestive system and are directly absorbed into the bloodstream, providing quicker onset of action compared to oral, liquid, or intramuscular routes.

Question 6

A surgeon prescribes heparin 2,500 mEq intramuscularly (IM) every 12 hours (q12hr). What is the nurse's best action?

Accepted Answer

Heparin is typically dosed in units (not milliequivalents, mEq) and is usually administered subcutaneously (not intramuscularly) to prevent or treat thrombosis. Therefore, the nurse should clarify both the dose and the route with the surgeon to ensure patient safety.

Question 7

A patient is given furosemide 40 mg orally at 0900. The duration of action for this drug is approximately 6 hours after oral administration. At which time in military hours should the nurse no longer expect to see the effects of this drug?

Accepted Answer

Given that furosemide has a duration of action of approximately 6 hours after oral administration, and it was given at 0900, the effects would last until approximately 1500 hours (or 3:00 PM).

Question 8

While receiving an intravenous dose of an antibiotic, levofloxacin, a patient develops severe shortness of breath, wheezing, and severe hypotension. Which action should the nurse take first?

Accepted Answer

Stopping the infusion of medication is the first and immediate action to take in response to a severe allergic reaction, such as anaphylaxis, indicated by symptoms like severe shortness of breath, wheezing, and severe hypotension. This action helps prevent further exposure to the allergen (in this case, levofloxacin).

Question 9

After receiving diphenhydramine, a patient reports experiencing a very dry mouth. This is not uncommon in patients taking this medication. Which drug effect is this patient experiencing?

Accepted Answer

Dry mouth is a known side effect of diphenhydramine, a common antihistamine, due to its anticholinergic properties. Side effects are secondary, often predictable effects of a drug, not necessarily harmful in the context of the drug's therapeutic effect.

Question 10

A nurse is preparing a medication that is supplied in ounces but the prescription is in milliliters. How many milliliters equal 1 ounce?

Accepted Answer

1 ounce is equivalent to approximately 30 milliliters.

Question 11

A patient with end-stage cancer is prescribed morphine sulfate to reduce pain. For which effect is this medication prescribed?

Accepted Answer

Morphine sulfate is prescribed for its palliative effect in this context, aiming to relieve the symptoms of end-stage cancer and improve the quality of life without curing the disease.

Question 12

Which factor in a patient's medical history is most likely to prolong the half-life of certain drugs?

Accepted Answer

Liver disease can significantly impact the metabolism of drugs, leading to a prolonged half-life. The liver is a primary site for drug metabolism, and its impairment can reduce the body's ability to process and eliminate drugs.

Question 13

Before administering a medication, the nurse must verify the six rights of medication administration, which are:

Accepted Answer

The six rights of medication administration are: right patient, right drug, right dose, right route, right time, and right documentation. These ensure patient safety and effective treatment.

Question 14

Teratogenic drugs should be avoided in which patient population?

Accepted Answer

Teratogenic drugs can cause birth defects and developmental problems in a fetus, so they should be avoided in pregnant women.

Question 15

The nurse receives a laboratory report that states the patient's digoxin level is 1.2 mg/mL; therapeutic range for this drug is 0.5 to 2.0 mg/mL. Which action should the nurse take?

Accepted Answer

The patient's digoxin level is within the therapeutic range (0.5 to 2.0 mg/mL), indicating that the current dosage is appropriate. Therefore, the nurse should continue administering the medication as prescribed.

Question 16

An insulin-dependent diabetic female patient tells the nurse that she has been giving herself injections in the same location in her right thigh for the past several months because it is easier. What is the nurse's best action?

Accepted Answer

Rotating injection sites is important for insulin-dependent diabetics to prevent lipodystrophy (changes in fat tissue that can interfere with insulin absorption). Repeated injections in the same site can lead to these issues, so educating the patient on the importance of site rotation is the best action.

Question 17

Laboratory test results indicate that warfarin anticoagulant therapy is suddenly ineffective in a patient who has been taking the drug for an extended period of time. The nurse suspects an interaction with herbal medications. What type of interaction does the nurse suspect?

Accepted Answer

Antagonistic drug interaction occurs when one drug reduces or opposes the effects of another, which could explain why warfarin's effectiveness is suddenly diminished, possibly due to an herbal medication that induces the enzymes metabolizing warfarin, leading to decreased warfarin levels and effect.

Question 18

A patient develops urticaria and pruritus 5 days after beginning phenytoin for treatment of seizures. Which type of reaction is the patient most likely experiencing?

Accepted Answer

This is indicative of a mild allergic reaction, as urticaria (hives) and pruritus (itching) are common symptoms of allergic responses to medications, and they can occur days after initial exposure to the allergen (in this case, phenytoin).

Question 19

Which expected outcome is best for a patient with a nursing diagnosis of Deficient Knowledge related to new drug treatment regimen?

Accepted Answer

The answer of Which expected outcome is best for a...

Question 20

Which term refers to the movement of a drug from the site of administration to the bloodstream?

Accepted Answer

Absorption is the process by which a drug moves from its site of administration into the bloodstream, which is the first step in the drug's journey through the body.

Quiz 26: Administering Medications