Question 1

#1 
Assess cues:
Oral Patient is not fully alert, has dysphagia, does not follow directions well.
Rectal Recent rectal abnormalities, such as anal fissures
Intramuscular 80-year-old, 102-lb patient with deltoid as the only available site for injection

Accepted Answer

ICNP Diagnosis/Hypothesis:
Risk for Injury as a result of inappropriate route of administration for the patient’s current condition

Question 2

#2
Assessment cues:
Patient has not had the prescribed medication before; reports seasonal allergies and itchy lips and mouth when cantaloupe or watermelon is eaten; told as a child they had allergy to sulfur.

Accepted Answer

ICNP Diagnosis/Hypothesis:
Risk for allergic reaction

Question 3

#3
Assessment cues: 
Prescription for a buccal (inner-cheek) medication is written; patient has history of periodically biting the inside of the cheek.

Accepted Answer

ICNP Diagnosis/Hypothesis:
Risk for impaired tissue integrity

Question 4

#4
Assessment cues:
Patient has infection in left eye and uses once-daily prescription eye drops (one in each eye) for treatment of glaucoma.

Accepted Answer

ICNP Diagnosis/Hypothesis:
Risk for cross-contamination of infection

Question 5

#5
Assessment cues:
Patient is unable to identify medications taken by name and dose, does not have a primary health care provider, uses different pharmacies in different locations, and takes a variety of supplements “from the health food store.”

Accepted Answer

ICNP Diagnosis/Hypothesis:
Risk for Adverse Medication Interaction

Question 6

#6
Assessment cues:
Patient: "I don’t take the anxiety pill or the pain pill very often. I’m not sure about their names except they are hard to say. I don’t know the doses, just that I take one of each"

Accepted Answer

ICNP Diagnosis/Hypothesis:
Lack of Knowledge of Medication Regime

Question 7

#7
Assessment cues:
Patient is age 78 years, lives alone, has hypertension and rheumatoid arthritis, and states that “some days my fingers just won’t open my medication bottles and some days I can’t remember if I got them open and took the pills.”

Accepted Answer

ICNP Diagnosis/Hypothesis:
Impaired Ability to Manage Medication Regime

Question 8

#8
Assessment cues:
Patient undergoing radiation therapy for cancer says, “I’ve done a little reading about radiation therapy, and I have a few questions about it.”

Accepted Answer

ICNP Diagnosis/Hypothesis:
Ready to Learn

Question 9

What are the 3 classes of prioritizing medication administration-related hypotheses?

Accepted Answer

1. Life-threatening
2. Immediate concern
3. Eliminates other hypotheses if removed

Question 10

What is the class of prioritizing medication administration-related hypothesis for #1?

Accepted Answer

Urgent/immediate concern

Question 11

What is the class of prioritizing medication administration-related hypothesis for #2?

Accepted Answer

Life-threatening

Question 12

What is the class of prioritizing medication administration-related hypothesis for #3?

Accepted Answer

Needs to be addressed to prevent a problem over the long term but no immediate threat

Question 13

What is the class of prioritizing medication administration-related hypothesis for #4?

Accepted Answer

Immediate concern

Question 14

What is the class of prioritizing medication administration-related hypothesis for #5?

Accepted Answer

Potentially life-threatening

Question 15

What is the class of prioritizing medication administration-related hypothesis for #6?

Accepted Answer

Needs to be addressed when patient's condition is stable and before discharge

Question 16

What is the class of prioritizing medication administration-related hypothesis for #7?

Accepted Answer

Urgent/immediate concern

Question 17

What are the solution for:
Diagnosis - risk for allergic reaction
Expected outcomes: Signs of allergic reaction promptly treated, leaving pt in stable condition

Accepted Answer

Monitor for and report signs of allergic reaction.
Administer prescribed medications.

Question 18

What are the solutions for:
Diagnosis - Risk for impaired tissue integrity
Expected outcomes - Pt remains free of tissue damage related to medication use

Accepted Answer

Monitor tissue condition; rotate sites.

Question 19

What are the solutions for:
Diagnosis - Risk for cross-infection
Expected outcomes - Right eye remains free of infection

Accepted Answer

Use aseptic technique

Question 20

What are the solutions for:
Diagnosis - Risk for adverse medication interactions
Expected outcomes - Signs of any adverse medication interaction are detected promptly and treated effectively, leaving the patient in stable condition.

Accepted Answer

Monitor for and report any signs of adverse drug reactions
Administer prescribed treatments

Question 21

What are the solutions for:
Diagnosis - Lack of knowledge of medication regime
Expected outcomes - Patient can state the name of each prescription and nonprescription medication and supplement taken
Patient can state the reason each medication is taken

Accepted Answer

Explain use and purpose of each medication in patient's language of choice

Question 22

What are the solutions for:
Diagnosis: Impaired ability to manage medication regime
Expected outcomes - Patient report no difficulty opening med bottles 
Pt states that they no longer have a problem remembering if medications have bee taken each day

Accepted Answer

Arrange for easy-open bottles or container openers designed for arthritic patients and use of weekly medication dispenser

Question 23

What 4 question classes might be asked to gain information from a PT about medication history?

Accepted Answer

1. Background information
2. Medications used
3. Allergic Reactions/Adverse Reactions/ Side Effects
4. Adherence with Medication Plan

Question 24

The Proadministration Assessment allows the nurse to mentally ask questions to verify that a prescribed medication is appropriate for the patient by doing what 2 things?

Accepted Answer

1. Verifying Appropriateness of Medication
2. Determining Risk for Adverse Reaction

Question 25

The Assessment at Point of Administration focuses on what two factors?

Accepted Answer

1. Safety of administration of the medication, given pt's immediate condition
2. Collection of baseline assessment data, which is used to evaluate the medication's therapeutic effects

Question 26

The Postadministration Assessment continues after medication administration to monitor side/adverse effects and evaluate therapeutic effect. What are the 3 ongoing assessments related to medications?

Accepted Answer

1. Physical examination, with a focus on medication effects on the body
2. Review of relevant laboratory test results
3. Review of changes in the patient's use of both prescription and nonprescription medications and supplements

Question 27

What are the 4 commonly used designations for medications?

Accepted Answer

1. Chemical name
2. Generic name
3. Official name
4. Trade name

Question 28

1906 Pure Food and Drug Act, did what?

Accepted Answer

Drugs must be free of adulteration

Question 29

1962 Harris-Kefauver Amendment to the Federal Food, Drug, and Cosmetic Act, did what?

Accepted Answer

Drugs must be proven to be effective before they can be put on the market

Question 30

1938 Federal Food, Drug, and Cosmetic Act, did what?

Accepted Answer

New drugs must be tested, with results reviewed by the FDA. The FDA approves the drug for marketing based on test results showing that drugs are safe.

Question 31

1970 Comprehensive Drug Abuse Prevention and Control Act, did what?

Accepted Answer

The manufacture and distribution of drugs that have the potential for abuse must be regulated

Question 32

1970 Controlled Substances Act, did what?

Accepted Answer

Controlled substances are grouped by schedules (categories)

Question 33

Schedule I drugs have a high potential for abuse, and have no current accepted use in medical treatment in the US, examples:

Accepted Answer

Heroin, LSD, and Methaqualone

Question 34

Schedule II drugs have a high potential for abuse that may lead to phycological of physical dependence, and has accepted medical use with severe restrictions, examples:

Accepted Answer

Narcotics: morphine, methadone, oxy, fentanyl
Stimulants: Methamphetamine
Other: Pentobarbital

Question 35

Schedule III drugs have lower potentials for abuse, but has low phycological and physical dependence and is currently accepted in medical use, examples:

Accepted Answer

Narcotics: codeine, hydrocodone
Non-narcotics: anabolic steroids, some barbiturates

Question 36

Schedule IV drugs have low potential for abuse, but may lead to limited dependence, examples:

Accepted Answer

Pentazocine, meprobamate, diazepam, alprazolam

Question 37

Schedule V drugs have lower potentials for abuse, examples:

Accepted Answer

OTC drugs

Question 38

Define Pharmacokinetics:

Accepted Answer

The study of how a medication moves into, through, and out of the body

Question 39

Define Pharmacodynamics:

Accepted Answer

The study of how a medication interacts with the body's cells to produce a biologic response

Question 40

What are the 4 processes of Pharmacokinetics?

Accepted Answer

1. Absorption
2. Distribution
3. Metabolism
4. Excretion

Question 41

In Pharmacodynamics, what are the 2 types of biologic responses a medication can produce on the body?

Accepted Answer

1. Systemic (affects the whole body)
2. Localized (Affects only limited parts of the body)

Question 42

The therapeutic effect of a medication is influenced by what 7 factors?

Accepted Answer

1. Medication dose
2. Route of administration
3. Frequency of administration
4. Function of metabolizing organs (liver/kidneys)
5. Age
6. Sex
7. Genetics

Question 43

For a therapeutic effect to occur, a certain concentration of drug in the body must be reached, what is this called?

Accepted Answer

Minimum Effective Concentration (MEC)

Question 44

What 5 concepts relate to therapeutic effect and maintenance of drug concentration?

Accepted Answer

1. Onset of Action
2. Peak
3. Trough
4. Half-life
5. Therapeutic Range

Question 45

Define Onset of Action:

Accepted Answer

The time it takes for the MEC of a drug to be reached

Question 46

Define Peak:

Accepted Answer

The highest concentration of a drug in the blood after administration

Question 47

Define Trough:

Accepted Answer

The lowest concentration of a drug in the blood after administration

Question 48

Define Half-life:

Accepted Answer

The time it takes for a drug's concentration to decrease by half, reflecting how quickly a drug is being metabolized by the body

Question 49

Define Therapeutic Range:

Accepted Answer

The concentration of a drug in the blood between the MEC and the minimum TOXIC concentration

Question 50

What are the 3 types of medication interactions?

Accepted Answer

1. Synergistic effect (where drug's effect increases because of other substances in the body)
2. Antagonistic effect (where drug's effect decreases)
3. Incompatibility (where a combination of drugs causes an adverse reaction)

Question 51

Define Pharmacogenetics:

Accepted Answer

A general term referring to the study of different responses to drugs based on genetic variation

Question 52

Define Pharmacogenomics:

Accepted Answer

A related field focusing on the development of individualized drug therapy based on genetic composition

Question 53

Name the 4 forms of medication:

Accepted Answer

1. Tablet
2. Capsule
3. Troches (lozenges)
4. Solutions

Question 54

Name 4 additional forms of medication:

Accepted Answer

1. inhalants
2. Skin preparations
3. Suppositories
4. Powders

Question 55

Name the 7 routes of medication administration

Accepted Answer

1. Oral
2. Sublingual (under tongue) or Buccal (against cheek)
3. Via Tube
4. Topical
5. Transdermal (patch)
6. Parenteral (needle into body)
7. Inhalation

Question 56

What are the four Parenteral routes of medical administration?

Accepted Answer

1. Intradermal (in the skin)
2. Subcutaneous (beneath the skin)
3. Intramuscular (the interior of the muscle tissue)
4. Intravenous (the interior of the vein)

Question 57

What are the 3 statements of evaluation?

Accepted Answer

1. Improving
2. Declining
3. Unchanged

Question 58

Define Ophthalmic Medication:

Accepted Answer

Medications used in the eyes

Question 59

What are the 4 types of ophthalmic medications?

Accepted Answer

1. Eye drops
2. Ointments
3. Irrigations
4. Disks

Question 60

Define Otic Medications:

Accepted Answer

Medications used in the ears

Question 61

How many minutes should you wait before administered another ophthalmic eye drop in the same eye?

Accepted Answer

3 minutes

Question 62

Define 10 rights to medication administration:

Accepted Answer

1. Right drug
2. Right dose
3. Right time or frequency
4. Right patient
5. Right route
6. Right assessment
7. Right documentation
8. Right evaluation
9. Right to refuse treatment 
10. Right patient education

Question 63

What are the two systems of measurement?

Accepted Answer

1. Metric system
2. Household system

Question 64

3 basic measures of the metric system?

Accepted Answer

1. Gram (weight)
2. Liter (volume)
3. Meter (linear)

BSN 225 week 3

Sherpath

Question	Answer
#1 Assess cues: Oral Patient is not fully alert, has dysphagia, does not follow directions well. Rectal Recent rectal abnormalities, such as anal fissures Intramuscular 80-year-old, 102-lb patient with deltoid as the only available site for injection	ICNP Diagnosis/Hypothesis: Risk for Injury as a result of inappropriate route of administration for the patient’s current condition
#2 Assessment cues: Patient has not had the prescribed medication before; reports seasonal allergies and itchy lips and mouth when cantaloupe or watermelon is eaten; told as a child they had allergy to sulfur.	ICNP Diagnosis/Hypothesis: Risk for allergic reaction
#3 Assessment cues: Prescription for a buccal (inner-cheek) medication is written; patient has history of periodically biting the inside of the cheek.	ICNP Diagnosis/Hypothesis: Risk for impaired tissue integrity
#4 Assessment cues: Patient has infection in left eye and uses once-daily prescription eye drops (one in each eye) for treatment of glaucoma.	ICNP Diagnosis/Hypothesis: Risk for cross-contamination of infection
#5 Assessment cues: Patient is unable to identify medications taken by name and dose, does not have a primary health care provider, uses different pharmacies in different locations, and takes a variety of supplements “from the health food store.”	ICNP Diagnosis/Hypothesis: Risk for Adverse Medication Interaction
#6 Assessment cues: Patient: "I don’t take the anxiety pill or the pain pill very often. I’m not sure about their names except they are hard to say. I don’t know the doses, just that I take one of each"	ICNP Diagnosis/Hypothesis: Lack of Knowledge of Medication Regime
#7 Assessment cues: Patient is age 78 years, lives alone, has hypertension and rheumatoid arthritis, and states that “some days my fingers just won’t open my medication bottles and some days I can’t remember if I got them open and took the pills.”	ICNP Diagnosis/Hypothesis: Impaired Ability to Manage Medication Regime
#8 Assessment cues: Patient undergoing radiation therapy for cancer says, “I’ve done a little reading about radiation therapy, and I have a few questions about it.”	ICNP Diagnosis/Hypothesis: Ready to Learn
What are the 3 classes of prioritizing medication administration-related hypotheses?	1. Life-threatening 2. Immediate concern 3. Eliminates other hypotheses if removed
What is the class of prioritizing medication administration-related hypothesis for #1?	Urgent/immediate concern
What is the class of prioritizing medication administration-related hypothesis for #2?	Life-threatening
What is the class of prioritizing medication administration-related hypothesis for #3?	Needs to be addressed to prevent a problem over the long term but no immediate threat
What is the class of prioritizing medication administration-related hypothesis for #4?	Immediate concern
What is the class of prioritizing medication administration-related hypothesis for #5?	Potentially life-threatening
What is the class of prioritizing medication administration-related hypothesis for #6?	Needs to be addressed when patient's condition is stable and before discharge
What is the class of prioritizing medication administration-related hypothesis for #7?	Urgent/immediate concern
What are the solution for: Diagnosis - risk for allergic reaction Expected outcomes: Signs of allergic reaction promptly treated, leaving pt in stable condition	Monitor for and report signs of allergic reaction. Administer prescribed medications.
What are the solutions for: Diagnosis - Risk for impaired tissue integrity Expected outcomes - Pt remains free of tissue damage related to medication use	Monitor tissue condition; rotate sites.
What are the solutions for: Diagnosis - Risk for cross-infection Expected outcomes - Right eye remains free of infection	Use aseptic technique
What are the solutions for: Diagnosis - Risk for adverse medication interactions Expected outcomes - Signs of any adverse medication interaction are detected promptly and treated effectively, leaving the patient in stable condition.	Monitor for and report any signs of adverse drug reactions Administer prescribed treatments
What are the solutions for: Diagnosis - Lack of knowledge of medication regime Expected outcomes - Patient can state the name of each prescription and nonprescription medication and supplement taken Patient can state the reason each medication is taken	Explain use and purpose of each medication in patient's language of choice
What are the solutions for: Diagnosis: Impaired ability to manage medication regime Expected outcomes - Patient report no difficulty opening med bottles Pt states that they no longer have a problem remembering if medications have bee taken each day	Arrange for easy-open bottles or container openers designed for arthritic patients and use of weekly medication dispenser
****End of "Medication Administration: Analyze Cues and Prioritize Hypotheses; Plan and Generate Solution"
****Start of "Medication Administration: Assess and Recognize Cues"
What 4 question classes might be asked to gain information from a PT about medication history?	1. Background information 2. Medications used 3. Allergic Reactions/Adverse Reactions/ Side Effects 4. Adherence with Medication Plan
The Proadministration Assessment allows the nurse to mentally ask questions to verify that a prescribed medication is appropriate for the patient by doing what 2 things?	1. Verifying Appropriateness of Medication 2. Determining Risk for Adverse Reaction
The Assessment at Point of Administration focuses on what two factors?	1. Safety of administration of the medication, given pt's immediate condition 2. Collection of baseline assessment data, which is used to evaluate the medication's therapeutic effects
The Postadministration Assessment continues after medication administration to monitor side/adverse effects and evaluate therapeutic effect. What are the 3 ongoing assessments related to medications?	1. Physical examination, with a focus on medication effects on the body 2. Review of relevant laboratory test results 3. Review of changes in the patient's use of both prescription and nonprescription medications and supplements
****End of "Medication Administration: Assess and Recognize Cues"
****Start of "Overview of Concepts in Pharmacology"
What are the 4 commonly used designations for medications?	1. Chemical name 2. Generic name 3. Official name 4. Trade name
1906 Pure Food and Drug Act, did what?	Drugs must be free of adulteration
1962 Harris-Kefauver Amendment to the Federal Food, Drug, and Cosmetic Act, did what?	Drugs must be proven to be effective before they can be put on the market
1938 Federal Food, Drug, and Cosmetic Act, did what?	New drugs must be tested, with results reviewed by the FDA. The FDA approves the drug for marketing based on test results showing that drugs are safe.
1970 Comprehensive Drug Abuse Prevention and Control Act, did what?	The manufacture and distribution of drugs that have the potential for abuse must be regulated
1970 Controlled Substances Act, did what?	Controlled substances are grouped by schedules (categories)
Schedule I drugs have a high potential for abuse, and have no current accepted use in medical treatment in the US, examples:	Heroin, LSD, and Methaqualone
Schedule II drugs have a high potential for abuse that may lead to phycological of physical dependence, and has accepted medical use with severe restrictions, examples:	Narcotics: morphine, methadone, oxy, fentanyl Stimulants: Methamphetamine Other: Pentobarbital
Schedule III drugs have lower potentials for abuse, but has low phycological and physical dependence and is currently accepted in medical use, examples:	Narcotics: codeine, hydrocodone Non-narcotics: anabolic steroids, some barbiturates
Schedule IV drugs have low potential for abuse, but may lead to limited dependence, examples:	Pentazocine, meprobamate, diazepam, alprazolam
Schedule V drugs have lower potentials for abuse, examples:	OTC drugs
Define Pharmacokinetics:	The study of how a medication moves into, through, and out of the body
Define Pharmacodynamics:	The study of how a medication interacts with the body's cells to produce a biologic response
What are the 4 processes of Pharmacokinetics?	1. Absorption 2. Distribution 3. Metabolism 4. Excretion
In Pharmacodynamics, what are the 2 types of biologic responses a medication can produce on the body?	1. Systemic (affects the whole body) 2. Localized (Affects only limited parts of the body)
The therapeutic effect of a medication is influenced by what 7 factors?	1. Medication dose 2. Route of administration 3. Frequency of administration 4. Function of metabolizing organs (liver/kidneys) 5. Age 6. Sex 7. Genetics
For a therapeutic effect to occur, a certain concentration of drug in the body must be reached, what is this called?	Minimum Effective Concentration (MEC)
What 5 concepts relate to therapeutic effect and maintenance of drug concentration?	1. Onset of Action 2. Peak 3. Trough 4. Half-life 5. Therapeutic Range
Define Onset of Action:	The time it takes for the MEC of a drug to be reached
Define Peak:	The highest concentration of a drug in the blood after administration
Define Trough:	The lowest concentration of a drug in the blood after administration
Define Half-life:	The time it takes for a drug's concentration to decrease by half, reflecting how quickly a drug is being metabolized by the body
Define Therapeutic Range:	The concentration of a drug in the blood between the MEC and the minimum TOXIC concentration
What are the 3 types of medication interactions?	1. Synergistic effect (where drug's effect increases because of other substances in the body) 2. Antagonistic effect (where drug's effect decreases) 3. Incompatibility (where a combination of drugs causes an adverse reaction)
Define Pharmacogenetics:	A general term referring to the study of different responses to drugs based on genetic variation
Define Pharmacogenomics:	A related field focusing on the development of individualized drug therapy based on genetic composition
Name the 4 forms of medication:	1. Tablet 2. Capsule 3. Troches (lozenges) 4. Solutions
Name 4 additional forms of medication:	1. inhalants 2. Skin preparations 3. Suppositories 4. Powders
Name the 7 routes of medication administration	1. Oral 2. Sublingual (under tongue) or Buccal (against cheek) 3. Via Tube 4. Topical 5. Transdermal (patch) 6. Parenteral (needle into body) 7. Inhalation
What are the four Parenteral routes of medical administration?	1. Intradermal (in the skin) 2. Subcutaneous (beneath the skin) 3. Intramuscular (the interior of the muscle tissue) 4. Intravenous (the interior of the vein)
****End of "Overview of Concepts in Pharmacology"
****Start of "Medication Administration: Implement and Take Action; Evaluate"
What are the 3 statements of evaluation?	1. Improving 2. Declining 3. Unchanged
Define Ophthalmic Medication:	Medications used in the eyes
What are the 4 types of ophthalmic medications?	1. Eye drops 2. Ointments 3. Irrigations 4. Disks
Define Otic Medications:	Medications used in the ears
How many minutes should you wait before administered another ophthalmic eye drop in the same eye?	3 minutes
Define 10 rights to medication administration:	1. Right drug 2. Right dose 3. Right time or frequency 4. Right patient 5. Right route 6. Right assessment 7. Right documentation 8. Right evaluation 9. Right to refuse treatment 10. Right patient education
What are the two systems of measurement?	1. Metric system 2. Household system
3 basic measures of the metric system?	1. Gram (weight) 2. Liter (volume) 3. Meter (linear)
3 basic measures of household system?	1. 1 teaspoon = 5 mL 2. 1 tablespoon = 15 mL 3. 1 cup = 240 mL
What are 4 actions when dealing with a medication error?	1. Provide immediate assessment of PT 2. Notify the health care provider of error 3. Initiated interventions to offset adverse effects 4. Complete documentation related to error
15 drops (gtt) equals how many mL's?	1 mL
1 teaspoon (tsp) equals how many mL's?	5 mL
1 tablespoon (tbsp) equals how many mL's?	15 mL
1 cup (c) equals how many mL's?	240 mL
1 pint (pt) equals how many mL's?	480 mL
1 quart (qt) equals how many mL's?	960 mL
1 gallon equals how many mL's?	3840 mL
1 lbs equals how many kilograms?	0.45 kgs

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