Question 1

What is the proper administration when an inhaled corticosteroid and a bronchodilator are scheduled for the same time frame?
A)Take the corticosteroid,allow 1 min to elapse,and then take the bronchodilator.
B)Take bronchodilator,allow 1 min to elapse,and then take the corticosteroid.
C)Take the corticosteroid,allow 5 min to elapse,and then take the bronchodilator.
D)Take bronchodilator,allow 5 min to elapse,and then take the corticosteroid.

Accepted Answer

See Patient/Family Teaching for corticosteroids inhalation route: When taking inhaled corticosteroids and bronchodilators,the bronchodilator should be administered first.Allow 5 min to elapse and then administer the corticosteroid.

Question 2

Mrs.Lawson,a 2nd-grade teacher,tells the school nurse that she has started taking echinacea so that she will not get sick this school year.What is the nurse's best response?
A)"That is terrific.I think you will notice a big difference in how you feel."
B)"Echinacea should only be taken when you feel symptoms of a cold starting."
C)"It is best to get a therapeutic level of echinacea before being exposed to sick children."
D)"Are you taking vitamin C as well,because echinacea needs to be taken in conjunction with vitamin C?"

Accepted Answer

Echinacea is an herbal supplement used to ward off the severity of bacterial and viral infections by stimulating the immune system.It should be taken only when the symptoms of a cold appear.It should not be taken as a preventative and should not be used for more than 10-14 days.Using echinacea for more than 8 weeks may generate an overstimulation of the immune system and cause immunosuppression.

Question 3

The nurse is caring for a patient receiving AlternaGEL (aluminum hydroxide)every 2 hr while awake for the treatment of a peptic ulcer.For which of the following side effects should the nurse monitor?
A)Constipation
B)Headache
C)Insomnia
D)Sedation

Accepted Answer

See Adverse Reactions/Side effects for aluminum hydroxide.Constipation is the most common side effect with this medication.

Question 4

For chondroitin to be effective it should be taken:
A)As needed
B)Once a week
C)Once a month
D)For an extended period of time

Accepted Answer

See Patient/Family Teaching for Chondroitin: Chondroitin helps to build bone cartilage and is often taken in conjunction with glucosamine.In order for chondroitin to be effective,it should be taken consistently for an extended period of time.

Question 5

Which of the following laboratory values requires the closest monitoring with isoniazid therapy?
A)CBC
B)AST and ALT
C)BUN and Cr
D)HbA1c and glucose

Accepted Answer

See Nursing Implications/Assessment/labs for isoniazid: AST and ALT are associated with liver function tests.Isoniazid is an antitubercular medication used for the treatment and prevention of tuberculosis.This medication is primarily metabolized and excreted by the liver.Isoniazid should be used cautiously in those with liver disease or chronic alcoholism.Liver function tests must be evaluated prior to and monthly throughout therapy for drug-induced hepatitis.

Question 6

What is the proper action to prepare for the administration of Pulmicort Respules?
A)Attach medication to a spacer.
B)Place medication in a nebulizer equipped with a mouthpiece or face mask.
C)Rotate diskus unit to proper dose prior to dispensing medication.
D)Shake medication vigorously to mix medication.

Accepted Answer

See Nursing Implications and Patient Family Teaching for Pulmicort Respules: Pulmicort Respules are administered through a nebulizer.Wash face after use of face mask.

Question 7

The nurse on the hospice unit receives an order to administer fentanyl via a transmucosal route.Which of the following actions will the nurse take?
A)Place under the tongue and allow to dissolve.
B)Place between the cheek and lower gum moving it back and forth from one side to another.
C)Place between the cheek and gum and allow to dissolve.
D)Rub on tongue,instruct patient to move tongue in the mouth and then swallow.

Accepted Answer

See Nursing Implications/Patient Family Teaching for transmucosal fentanyl: The administration of transmucosal fentanyl,available as Actiq,should be placed between the cheek and lower gum moving it from one side to another using the handle of the applicator.The medication is consumed by sucking on the applicator over a period of 15 min or longer.The patient should not chew or swallow the medication.

Question 8

A young man with an allergy to sulfa was recently diagnosed with ulcerative colitis.What medication is he likely to receive?
A)Bactrim
B)Dipentum
C)Glyburide
D)Sulfasalazine

Accepted Answer

See Indications and action for Dipentum (olsalazine): Dipentum is a gastrointestinal anti-inflammatory used in the treatment of ulcerative colitis for those who have an allergy to sulfa.Sulfasalazine is frequently the drug of choice for the treatment of ulcerative colitis but cannot be used in this scenario because of the allergy to sulfa.

Question 9

While admitting a client with a history of osteoporosis,the nurse notes a physician's order reading,"Acetaminophen extra strength (500 mg),two tabs every 8 hr as needed for pain." Which of the following actions by the nurse is best?
A)Call the physician to question the total daily dose.
B)Call the pharmacy to verify that this is a safe dose.
C)Transcribe the order as written.
D)Schedule the pain medication TID to maximize pain control.

Accepted Answer

See Route/Dosage for acetaminophen.This order should be transcribed as written.Since it is a safe daily dose,there is no reason to question the safety of the order unless hepatic or renal insufficiency is suspected.Nurses cannot alter physician's orders,and since this is written as a prn order,it cannot be scheduled TID.PO (adults and children greater than 12 yrs): 325-650 mg q 4-6 hr or 1 g 3-4 times daily or 1,300 mg q 8 hr (not to exceed 4 g or 2.5 g/24 hr in patients with hepatic/renal impairment).

Question 10

The nurse is caring for a 72-year-old woman admitted for a cerebral vascular accident who has dysphasia with orders to follow a diet of pureed foods.The patient takes Xanax (alprazolam)0.5 mg TID.Which of the following actions by the nurse is best?
A)Crush the medication and administer it in pudding.
B)Hold the medication.
C)Contact the physician.
D)Give the medication with a small sip of water.

Accepted Answer

See Implementation for alprazolam.Tablets may be crushed and taken with food or fluids if patient has difficulty swallowing.

Question 11

When taking Catapres (clonidine),which of the following exercise activities should be avoided?
A)Weight lifting
B)Squat thrusts
C)Bicycling
D)Jogging

Accepted Answer

See Indications,and Patient Family Teaching for Clonidine: Clonidine is an antihypertensive.People taking clonidine should avoid activities that require sudden change in body positions because of risk for orthostatic hypotension.Squat thrusts require a person to go from an upright erect position to a squat with the legs extended and return to an upright position in a fluid motion.

Question 12

The nurse is caring for a patient with a long history of asthma.Which of the following medications should the nurse question?
A)Inderal (propanolol)
B)Proventil (albuterol)
C)Serevent (salmeterol)
D)Pulmacort (budesonide)

Accepted Answer

See Contraindications propanolol.Beta blockers (olol)are contraindicated in the presence of pulmonary disease including asthma due to the potential interaction with beta receptors in the pulmonary tissue.

Question 13

What should the nurse communicate to the patient when teaching the proper technique for administration of two simultaneous doses of beclomethasone?
A)Allow at least 1 min between inhalations.
B)Allow at least 5 min between inhalations.
C)Take second dose immediately following the first dose.
D)Rinse mouth between doses.

Accepted Answer

See Implementation for Corticosteroids (nasal)/beclomethasone: Beclomethasone is an inhaled corticosteroid used for those with asthma.Inhaled doses of corticosteroids should be spaced by at least 1 min.

Question 14

When taking Lunesta (eszopiclone),the following instructions should be followed.
A)Take at the same time every morning.
B)Take 1 hr before meals.
C)Take with food.
D)Take immediately before going to bed.

Accepted Answer

See Indications and Nursing Implications/Implemention for Lunesta: given for the treatment of insomnia.Because of its rapid onset,Lunesta should be taken immediately before going to bed and during a time frame that allows for at least 8 hr of sleep.To maximize effectiveness,Lunesta should not be taken with a high-fat or heavy meal.

Question 15

A 26-year-old female prescribed Axert (almotriptan)for use with migraine headache attacks,calls the nurse,stating,"I took a home pregnancy test last week and I know I'm pregnant but I haven't seen the doctor yet.I have a terrible migraine starting and I don't know what I should do." Which of the following statements by the nurse is best?
A)"When was your last menstrual cycle?"
B)"It is usually safe to take medications early in a pregnancy."
C)"What other migraine treatments have worked in the past?"
D)"You should not take Axert if you think you are pregnant."

Accepted Answer

See Patient/Family Teaching for almotriptan.A female patient should not use almotriptan if she is pregnant,suspects she is pregnant,plans to become pregnant,or is breastfeeding.

Question 16

Which cranial nerve needs to be routinely evaluated while a person is receiving Vancomycin?
A)I
B)II
C)IV
D)VIII
E)XII

Accepted Answer

See Nursing Implications/Assessment for Vancomycin: The eighth cranial nerve must be monitored during use of Vancomycin because of risk for permanent hearing loss.Vancomycin is an anti-infective.

Question 17

Which drug is used in the treatment of scurvy?
A)Ascorbic acid
B)Polyethylene glycol
C)Kava-kava
D)Valerian

Accepted Answer

See Indications for Ascorbic acid (Vitamin C).Ascorbic Acid is administered as a nutritional supplement and in the treatment of vitamin C deficiency as seen with scurvy.

Question 18

Intramuscular iron dextran should be administered in which site?
A)Deltoid
B)Dorsogluteal
C)Ventrogluteal
D)Vastus lateralis

Accepted Answer

See Implementation for Iron dextran: Iron dextran is administered via intramuscular injection and should be given into the ventrogluteal site because it may permanently stain the skin.It should be injected deeply into the tissue using a Z track method.To decrease the staining of subcutaneous tissue,the needle should be changed between withdrawal of the medication prior to injection.The dorsogluteal site is not recommended because of risk for sciatic nerve injury.

Question 19

The nurse is counseling a 55-year-old woman who is to begin taking Fosamax (alendronate)to prevent osteoporosis.Which of the following instructions by the nurse is best?
A)Instruct the patient to take each dose with breakfast.
B)Instruct the patient to take each dose on an empty stomach.
C)Instruct the patient to take each dose with orange juice.
D)Instruct the patient to take each dose just prior to bedtime.

Accepted Answer

See Patient/Family Teaching for alendronate.The medication should be taken first thing in the morning,30 min before any other medications,beverages,or food.Waiting longer than 30 min will improve absorption.Alendronate should be taken with 6-8 oz of plain water (mineral water,orange juice,coffee,and other beverages decrease absorption).

Question 20

As the nurse prepares to administer Ziagen,which of the following would indicate the medication is effective?
A)Decreased creatinine clearance and increased BUN
B)Increased creatinine clearance and decreased BUN
C)Decreased viral load and increased CD4 cell count
D)Increased viral load and decreased CD4 cell count

Accepted Answer

See Indications and Nursing Implications/Lab,Evaluation/Desired Outcomes for abacavir: Abacavir is an antiretroviral used in combination with other drugs to manage HIV infection.The therapeutic action of abacavir is to slow the progression of HIV infection.The effectiveness of abacavir can be determined by a decreased viral load and an increased CD4 cell count.

Quiz 1: Medication Errors: Improving Practices and Patient Safety

What is the proper administration when an inhaled corticosteroid and a bronchodilator are scheduled for the same time frame?

Mrs.Lawson,a 2nd-grade teacher,tells the school nurse that she has started taking echinacea so that she will not get sick this school year.What is the nurse's best response?

The nurse is caring for a patient receiving AlternaGEL (aluminum hydroxide) every 2 hr while awake for the treatment of a peptic ulcer.For which of the following side effects should the nurse monitor?

For chondroitin to be effective it should be taken:

Which of the following laboratory values requires the closest monitoring with isoniazid therapy?

What is the proper action to prepare for the administration of Pulmicort Respules?

The nurse on the hospice unit receives an order to administer fentanyl via a transmucosal route.Which of the following actions will the nurse take?

A young man with an allergy to sulfa was recently diagnosed with ulcerative colitis.What medication is he likely to receive?

While admitting a client with a history of osteoporosis,the nurse notes a physician's order reading,"Acetaminophen extra strength (500 mg) ,two tabs every 8 hr as needed for pain." Which of the following actions by the nurse is best?

The nurse is caring for a 72-year-old woman admitted for a cerebral vascular accident who has dysphasia with orders to follow a diet of pureed foods.The patient takes Xanax (alprazolam) 0.5 mg TID.Which of the following actions by the nurse is best?

When taking Catapres (clonidine) ,which of the following exercise activities should be avoided?

The nurse is caring for a patient with a long history of asthma.Which of the following medications should the nurse question?

What should the nurse communicate to the patient when teaching the proper technique for administration of two simultaneous doses of beclomethasone?

When taking Lunesta (eszopiclone) ,the following instructions should be followed.

Which cranial nerve needs to be routinely evaluated while a person is receiving Vancomycin?

Which drug is used in the treatment of scurvy?

Intramuscular iron dextran should be administered in which site?

The nurse is counseling a 55-year-old woman who is to begin taking Fosamax (alendronate) to prevent osteoporosis.Which of the following instructions by the nurse is best?

As the nurse prepares to administer Ziagen,which of the following would indicate the medication is effective?