Quiz 70: Safe Medication Preparation
Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition
Instructor Verified Answers Included
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1. The prescribed dose of Tylenol is given to a patient. The nurse recognizes the name Tylenol as which of the following?
a. Chemical name
b. Trade name
c. Generic name
d. United States Pharmacopeia
2. The nurse is aware that a patient with liver disease and a decreased albumin level may develop which of the following effects?
a. Toxicity on normal doses of medication
b. Less active medication available in the body
c. Reduction in therapeutic effect
d. Accelerated biotransformation of the medication
3. 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?
b. Toxic effects of the medication
c. Side effects of the medication
d. Allergic reaction to the medication
4. 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 Ativan as which of the following?
b. Side effect
c. Idiosyncratic reaction
d. Allergic reaction
5. A patient admitted to the hospital with pneumonia has IV antibiotics ordered. 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?
a. Idiosyncratic reaction
b. Toxic effect of the antibiotic
c. Side effect of the medication
d. Anaphylactic reaction
6. A patient with chronic back pain has been taking oral morphine sulfate for the past 2 years. Upon admission to the hospital, the patient receives morphine sulfate 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?
a. Side effect of the morphine
b. Drug dependence
c. Idiosyncratic response to the morphine
d. Medication tolerance
7. A patient is receiving vancomycin IV every 8 hours at 0800, 1600, and 2400. A serum peak and trough level is ordered after the third dose, which will be given at 1600. When should the nurse order the trough level?
8. The hospital uses a unit-dose system for medication distribution. The nurse recognizes that this system includes which safety feature?
a. All medications are kept in the patient’s drawer.
b. Liquids are kept in multi-dose containers to prevent spillage.
c. Narcotics are kept in an area separate from the patient’s regular medications.
d. The nurse is responsible for restocking the medication drawers daily.
9. 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?
b. .5 mL
c. 0.5 mL
d. 0.50 mL
10. 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?
11. The patient is complaining of severe leg pain. No pain medication is ordered, so the nurse calls the health care provider. An order for Tylenol with Codeine prn is given, in addition to a one-time order for morphine sulfate to be given stat. Which action by the nurse is most appropriate?
a. Give the morphine sulfate and Tylenol with Codeine immediately.
b. Give the Tylenol with Codeine now.
c. Give the morphine sulfate immediately.
d. Ask the patient which medication he would like first.
12. 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?
a. Ignore the patient’s statement and give the medication.
b. Withhold the medication.
c. Convince the patient that the doctor ordered it, and he should take it.
d. Give the medication and check the order afterward.
13. The nurse is preparing a liquid medication. Which action is most appropriate?
a. Pour the liquid medication toward the label.
b. Draw the liquid quickly into a syringe.
c. Place the medication cup on a flat surface at eye level.
d. Measure the poured liquid to the top of the meniscus.
14. The nurse enters the patient’s room to give medications. Which action is most appropriate to identify the “right patient”?
a. Ask the patient to state his name.
b. Ask the patient to state his name and birth date.
c. Ask the primary nurse to identify the patient.
d. Say the patient’s name and date of birth and request patient validation.
15. When medications are administered, which action by the nurse is appropriate?
a. Administering medications prepared by another nurse
b. Using sterile technique for nonparenteral medications
c. Leaving medication at the bedside when the patient is in the bathroom
d. Documenting the reason for medication refusal in the nurse’s notes
16. When controlled substances are administered, which action is required by the nurse?
a. Discard and sign for unused quantities.
b. Count the amount of medication daily.
c. Keep narcotics to be given with other patient medications.
d. Have a second nurse witness disposal of unused portions and sign the record.
17. To prevent medication errors, which action should be taken by the nurse?
a. Clarify illegible orders with the prescriber.
b. Document the medication before administration.
c. Read medication labels 2 times when preparing.
d. Prepare all of the patient’s medications for the shift at the same time.
18. The patient is to receive a medication via the sublingual route. Which action by the nurse is appropriate?
a. Placing the medication under the tongue
b. Crushing the medication before administration
c. Offering the patient a glass of orange juice after administration
d. Using sterile technique to administer the medication
19. The nurse is caring for several patients. The patient in which situation can safely receive oral medications?
a. Nausea with frequent episodes of vomiting
b. Taking a daily dose of vitamins
c. Nasogastric tube connected to suction
d. Diagnosed with an esophageal stricture
20. The nurse receives an order to give a drug parenterally. The nurse will administer this medication by which route?
1. A patient with a history of renal failure and liver disease has been receiving morphine sulfate every 4 hours for the past 2 weeks. The nurse finds the patient lethargic with a respiratory rate of 6 breaths per minute. The health care provider orders naloxone. The nurse anticipates which effects when naloxone is given? (Select all that apply.)
a. Increase in alertness
b. Decrease in urine output
c. Complaints of pain
d. Increase in respiratory rate
2. When do most medication errors occur? (Select all that apply.)
a. During hospital admission
b. During transfer from one unit to another
c. During discharge home
d. During discharge to another facility
3. The nurse recognizes that patients with which conditions will have a reduction in the distribution of drugs? (Select all that apply.)
a. Peripheral vascular disease
b. Heart failure
c. Liver disease
4. The hospital has implemented a computerized physician order entry system (CPOE) to eliminate the need for written orders. The benefits of this system include which of the following? (Select all that apply.)
a. Automatic drug allergy checks
b. Automatic dosage indications
c. Identification of potential drug interactions
d. Reduced number of medical errors
5. The nurse reviews a medication administration record for an anticoagulant that is ordered at 0900 daily. The medication record indicates that the drug was given at the following times over the past 4 days. Which times follow the “right time” of medication administration? (Select all that apply.)
6. Medication errors include which of the following? (Select all that apply.)
a. Administration of the wrong medication
b. Administration via the wrong route
c. Inaccurate prescribing
d. Failing to administer a medication
7. The nurse administers a medication to the wrong patient but the patient suffers no harm from the medication error. What actions should the nurse take? (Select all that apply.)
a. Prepare a written incident report.
b. Document in the nurses’ notes that an incident report was completed.
c. Report the incident to a manager only if the patient is harmed.
d. Notify the prescriber.
1. A patient receives the usual dose of a medication for the first time and develops severe hypotension and bradycardia. The nurse reports this event as an __________ type of medication action.
2. Medication safety is always one of the ______________ set by The Joint Commission.
3. The intended or desired physiological response to a medication is known as its ____________.
4. ______________ are predictable and often unavoidable secondary effects of a medication produced at a usual therapeutic drug dose.
5. The patient reports taking an opioid medication in large dosages for the past several years. While in the hospital, the patient is not prescribed the medication and develops tachycardia, hypertension, sweating, and tremors. He becomes confused and experiences visual hallucinations. The nurse recognizes these signs as indicative of _____________.
6. A drug interaction in which the combined effect of drugs is greater than the sum of the effects of each individual agent acting independently is known as a _____________.
7. The prescriber orders an IV antibiotic every 8 hours. The nurse administers the medication at 0900. The medication’s onset of action is 5 minutes, peak action is 30 minutes, and duration is 6 to 24 hours. An order for peak and trough levels is written. The nurse will have the peak level drawn at _________.
8. The nurse administers 100 mg of a drug at 0800. The drug’s biological half-life is 4 hours. A serum drug level is drawn at 1600. The nurse should anticipate ___________ milligrams will be left in the body at 1600?
9. A patient reports a pain level of 7 out of 10 and receives 10 mg of morphine IV. The nurse knows that IV morphine has an onset of 1 to 2 minutes, a peak of 20 minutes, and a duration of 4 to 5 hours. The patient asks when he will start to feel some pain relief. The nurse should respond that relief should begin in _____________.
10. The nurse administers 650 mg of acetaminophen orally to a patient with a pain level of 4 out of 10. The nurse is aware that the onset of action is 30 minutes to 1 hour, the peak action is 1 to 3 hours, and the duration of action is 3 to 8 hours. After _____ hours, the nurse should assess the patient to determine the maximum effectiveness of the drug.
11. A patient is prescribed diltiazem tablets, which have an onset of 30 minutes, a peak of 2 to 3 hours, and a duration of 6 to 8 hours. The nurse anticipates that the medication will be prescribed ____________ per day.
12. The _________________ of a drug is the blood serum concentration reached and maintained after repeated, fixed doses.
13. A medication distribution system that uses individual patient drawers and whereby medication is packaged according to what the patient would receive at one time is known as the _______ system.
14. The patient is to receive 200 mg of a medication. There are 100-mg scored tablets available. The nurse prepares _________ tablets.
15. The dose ordered for a patient is 75 mg IM. The medication is available in a 50-mg/mL solution. The nurse prepares ________________ mL.
16. The prescriber orders 3 mg/kg/d of a medication to be given in 3 equal doses. The patient weighs 44 pounds. The nurse calculates that the proper amount per dose is ___________.
17. The nurse calculates that the proper dosage of a medication is 2 tsp. The nurse prepares _______ mL to administer to the patient.