Question 1

The nurse prepares to administer the following medication to the patient.Which instruction will the nurse be sure to give before the patient takes the medication?

A) "Be sure to swallow the pill whole."
B) "Crush the medication and place the powder in applesauce."
C) "Place the pill under your tongue."
D) "Let the pill slowly dissolve in your mouth."

Accepted Answer

Extended release medications must always be swallowed whole without crushing or dissolving the tablet.MS Contin is always to be administered orally rather than sublingually.

Question 2

The nurse is caring for a patient who was just made NPO.The nurse is to administer carvedilol (Coreg)25 mg PO to the patient for control of high blood pressure.What is the best action of the nurse?
A) Crush the medication and administer it to the patient mixed with applesauce.
B) Administer the medication to the patient with a small sip of water.
C) Contact the patient's physician to clarify the order.
D) Administer the equivalent medication dose through the patient's IV.

Accepted Answer

The nurse should contact the patient's physician to clarify the order.Oral medications should never be administered to NPO patients without specific orders to do so from the physician.Coreg may not be administered intravenously.

Question 3

The nurse is caring for a patient who is in agonizing pain.All of the following options are listed on the patient's medication order sheet to relive pain.Which will provide the most rapid pain relief for the patient?
A) Morphine 10 mg PO
B) Dilaudid 1 mg IV push
C) Demerol 75 mg IM
D) Duragesic 50 mcg transdermal patch

Accepted Answer

IV administration has the most rapid onset of action and will provide the patient with the quickest pain relief.

Question 4

The nurse is caring for a patient who will give himself medication injections at home after discharge.How can the nurse best determine that the patient understands the technique and can administer the injections correctly?
A) Provide written instructions about how to administer the injections.
B) Watch the patient give himself an injection.
C) Call the patient the next day to ask if he is having difficulty with the injections.
D) Ask the patient if he understands how to administer the injections.

Accepted Answer

The nurse should watch the patient give himself an injection to make sure that he is doing it correctly.This will give the nurse an opportunity to point out and correct any mistakes and offer the patient reassurance about his technique.

Question 5

When administering phenytoin (Dilantin)through the patient's IV line,the nurse carefully flushes the IV with normal saline before and afterward to avoid crystal formation of the medication that occurs when it mixes with dextrose in water (D₅W)solution.Which type of drug interaction is the nurse being careful to avoid? A) Antagonism B) Potentiation C) Synergism D) Incompatibility

Accepted Answer

When medications combine to form crystals or adverse chemical reactions,the result is a drug incompatibility.Compatibility must be assessed prior to medication preparation and administration.

Question 6

The nurse administers a medication to a patient.Shortly afterward,the patient develops an itchy rash all of his body and reports feeling very unwell.What is the priority action of the nurse?
A) Leave the patient to notify the physician and the pharmacist.
B) Determine if the patient is having any difficulty breathing.
C) Document the reaction in the patient's chart.
D) Obtain an order for hydrocortisone cream to relieve the itching.

Accepted Answer

The nurse must first determine if the patient is having any difficulty breathing,since the patient may be starting to have an anaphylactic reaction to the medication.Anaphylaxis is life threatening and requires immediate treatment;the nurse must recognize this potential and plan to initiate emergency interventions right away.

Question 7

The nurse begins a shift on a busy medical-surgical unit.The nurse will be caring for multiple patients.Which patient will the nurse assess first?
A) A patient who would like some acetaminophen (Tylenol)for a mild headache
B) A patient who has a question about her daily medications
C) A patient who needs discharge teaching about an antibiotic
D) A patient who just received nitroglycerin for chest pain

Accepted Answer

The nurse's first priority is always: ABCs- Airway,Breathing,and Circulation.This includes any patients who are having chest pain and/or difficulty breathing.The nurse needs to see this patient first to determine if the chest pain has been relieved or not.An assessment should be done right away to determine if the patient is now stable or if additional interventions need to be done.The other patients' needs are less critical and can be met after this patient is assessed.

Question 8

The nurse is caring for a patient who is receiving vancomycin (Vancocin)to treat a severe infection.The next vancomycin dose is due to be administered at 10:00 A.M.What time will the nurse draw the vancomycin serum trough level?
A) 7:30 A.M.
B) 9:30 A.M.
C) 11:30 A.M.
D) 1:30 P.M.

Accepted Answer

Serum trough levels are to be drawn just prior to the administration of the medication in order to determine the lowest blood level of the drug within the patient's system.

Question 9

The nurse administers a medication to the patient.Which symptoms indicate that the patient is having an allergic reaction rather than a side effect?
A) Hair loss and sweaty skin
B) Nausea and constipation
C) Heartburn and nasty taste in the mouth
D) Itchy rash and difficulty breathing

Accepted Answer

Itchy rash and difficulty breathing are indicative of an allergic reaction to a medication.The other symptoms are common side effects of medications.

Question 10

The nurse carefully reviews the patient's medication list.Which observation about the list indicates the highest risk for serious drug-drug interactions?
A) The patient has been taking the same medications for a long time.
B) The patient is taking a large number of medications.
C) Most of the drugs on the list are prescribed at high doses.
D) The patient takes oral,injected,and inhaled medications.

Accepted Answer

The risk of drug-drug interactions increases when many drugs are taken by the patient.One of the most important ways to prevent adverse drug interactions is to minimize the number of drugs that the patient is taking.

Question 11

During discharge teaching,the nurse is to give the patient a signed,dated,and timed prescription from the physician for medications to be taken at home.Which prescription drug order needs to be corrected before it is given to the patient?
A) Warfarin (Coumadin)5 mg PO daily before dinner
B) Methotrexate (Trexall)8 tablets PO once weekly on Saturdays
C) Levothyroxine (Synthroid)137 mcg PO daily before breakfast
D) Zolpidem (Ambien)5 mg PO at bedtime as needed for sleep

Accepted Answer

All prescriptions must have the name of the drug to be administered along with dosage,route,and frequency.The methotrexate order does not contain a dosage for the drug,just the number of pills to be taken.

Question 12

Which of the following medication orders is to be administered PRN?
A) Zolpidem (Ambien)10 mg PO tonight if the patient cannot sleep
B) Prednisone 10 mg PO today,then taper down 1 mg each day for the next 10 days
C) Humulin R 10 units subcutaneously before each meal and at bedtime
D) Kefzol (Ancef)1 g IVPB 30 minutes prior to surgery

Accepted Answer

The nurse is to give the Ambien if the patient cannot sleep.The nurse uses discretion when deciding when to administer the medication PRN.

Question 13

The nurse makes a medication error.Which action will the nurse take first?
A) Prepare an incident report so that the facility can determine the cause of the error.
B) Explain to the patient that a medication error has occurred,and notify the nurse manager.
C) Assess the patient for any adverse reactions and notify the prescriber.
D) Document the medication given,how the patient responded,and the corrective actions taken.

Accepted Answer

When a medication error occurs,the nurse's first priority is to make sure that the patient is okay.If the patient shows any signs of adverse reaction to the medication error,the doctor/prescriber should be notified right away.Documentation,filling out the facility incident report,and explaining the error to the patient can take place later after the patient's condition is determined to be stable.

Question 14

The nurse is noting an order for a medication to be given TID.Which times will the nurse plan to administer the medication to the patient?
A) 9 A.M. ,1 P.M. ,5 P.M.and 10 P.M.
B) 9 A.M.and 9 P.M.
C) 9 A.M. ,1 P.M.and 5 P.M.
D) Nightly before the patient goes to sleep

Accepted Answer

TID indicates that the medication is to be administered three times daily.Common times for TID medications are 9 A.M. ,1 P.M.and 5 P.M.

Question 15

The nurse is to administer 1 mL of prochlorperazine (Compazine)10 mg IM to an adult patient.Which syringe will the nurse select to administer the medication?
A) 1 mL tuberculin syringe with 27 gauge, inch needle
B) 3 mL syringe with 23 gauge,   inch needle
C) 1 mL syringe with 27 gauge,   inch needle
D) 3 mL syringe with 18 gauge, 1 inch needle

Accepted Answer

Tuberculin syringes are typically used for subcutaneous injections. The 11ec60d2_2b2a_1784_8708_77899eb867b2_TB6390_11  and 11ec60d2_7620_4ed6_8708_cfe6949da8b5_TB6390_11   inch needles are too short for intramuscular injections into adults. The 18 and 27 gauge needles are too small for adult intramuscular injections. A 3 mL syringe with a 23 gauge, 11ec60d2_5254_5645_8708_23453368382d_TB6390_11  inch needle should be used to administer the medication to the adult patient.

Question 16

The nurse suspects that the patient is experiencing a drug toxicity rather than a side effect.Which question will the nurse ask to help confirm this suspicion?
A) "When did you take your last dose of the medication?"
B) "Have you been taking extra doses of the medication?"
C) "Are you taking any other medications?"
D) "Have you ever taken this medication in the past? "

Accepted Answer

Asking if the patient has been taking extra doses of the medication will allow the nurse to determine if the patient has been taking too much of the drug or more than was prescribed.Toxicity occurs when the patient receives/takes excessive amounts of the drug.

Question 17

The nurse is to administer 15 mg of morphine liquid to the patient.How much morphine liquid will the nurse draw up to administer to the patient?

A) 0.5 mL
B) 0.75 mL
C) 1.3 mL
D) 1.5 mL

Accepted Answer

15 mg x 1 mL = 0.75 mL
Dose 20 mg

Question 18

Which medication has the highest potential for abuse?
A) Methylphenidate (Ritalin)- schedule II
B) Alprazolam (Xanax)- schedule IV
C) Acetaminophen & codeine (Tylenol #3)- schedule III
D) Diphenoxylate & atropine (Lomotil)- schedule V

Accepted Answer

According to the Controlled Substances Act,drugs that have the potential for abuse/dependency are classified as schedule I-V.Schedule I drugs have no approved medical applications in the United States.Schedule II drugs have high potential for abuse/dependency and have multiple restrictions for prescriptions.Schedule III,IV,and V have lower risks of dependency/abuse and fewer restrictions for prescriptions

Question 19

The nurse is caring for a patient who is taking many prescription medications for various health problems.Which direction from the nurse will help the patient avoid dangerous drug interactions?
A) Only take over-the-counter medications.
B) Have all of the prescriptions filled at the same pharmacy.
C) Avoid taking generic preparations of prescribed medications.
D) Only take the medications that the patient feels are necessary.

Accepted Answer

The patient's risk for dangerous drug interactions is increased when many medications are taken.Filling all of the prescriptions at the same pharmacy will allow the pharmacist to check for possible interactions.

Question 20

After administering an antibiotic to the patient,the patient complains of feeling very ill.The nurse notes that the patient is scratching and has hives.The patient soon starts having difficulty breathing and his blood pressure drops.What is the nurse's assessment of the situation?
A) The patient is having a mild allergic reaction and an antihistamine will make the patient feel better.
B) The patient is having an anaphylactic reaction and epinephrine should be administered right away.
C) The patient's infection is worsening and progressing to septic shock so blood cultures should be drawn.
D) The patient has developed toxic shock syndrome and the antibiotic orders must be changed right away.

Accepted Answer

The patient's symptoms are indicative of anaphylaxis: a severe,life-threatening allergic reaction.the airways close up,the throat swells closed,and the blood pressure drops dangerously low.The patient may go into shock and die.Patients may have very mild allergic reactions to medications and experience a rash or itching.

Quiz 35: Medication Administration

The nurse prepares to administer the following medication to the patient.Which instruction will the nurse be sure to give before the patient takes the medication?

The nurse is caring for a patient who was just made NPO.The nurse is to administer carvedilol (Coreg) 25 mg PO to the patient for control of high blood pressure.What is the best action of the nurse?

The nurse is caring for a patient who is in agonizing pain.All of the following options are listed on the patient's medication order sheet to relive pain.Which will provide the most rapid pain relief for the patient?

The nurse is caring for a patient who will give himself medication injections at home after discharge.How can the nurse best determine that the patient understands the technique and can administer the injections correctly?

The nurse administers a medication to a patient.Shortly afterward,the patient develops an itchy rash all of his body and reports feeling very unwell.What is the priority action of the nurse?

The nurse begins a shift on a busy medical-surgical unit.The nurse will be caring for multiple patients.Which patient will the nurse assess first?

The nurse is caring for a patient who is receiving vancomycin (Vancocin) to treat a severe infection.The next vancomycin dose is due to be administered at 10:00 A.M.What time will the nurse draw the vancomycin serum trough level?

The nurse administers a medication to the patient.Which symptoms indicate that the patient is having an allergic reaction rather than a side effect?

The nurse carefully reviews the patient's medication list.Which observation about the list indicates the highest risk for serious drug-drug interactions?

During discharge teaching,the nurse is to give the patient a signed,dated,and timed prescription from the physician for medications to be taken at home.Which prescription drug order needs to be corrected before it is given to the patient?

Which of the following medication orders is to be administered PRN?

The nurse makes a medication error.Which action will the nurse take first?

The nurse is noting an order for a medication to be given TID.Which times will the nurse plan to administer the medication to the patient?

The nurse is to administer 1 mL of prochlorperazine (Compazine) 10 mg IM to an adult patient.Which syringe will the nurse select to administer the medication?

The nurse suspects that the patient is experiencing a drug toxicity rather than a side effect.Which question will the nurse ask to help confirm this suspicion?

The nurse is to administer 15 mg of morphine liquid to the patient.How much morphine liquid will the nurse draw up to administer to the patient?

Which medication has the highest potential for abuse?

The nurse is caring for a patient who is taking many prescription medications for various health problems.Which direction from the nurse will help the patient avoid dangerous drug interactions?

After administering an antibiotic to the patient,the patient complains of feeling very ill.The nurse notes that the patient is scratching and has hives.The patient soon starts having difficulty breathing and his blood pressure drops.What is the nurse's assessment of the situation?