Help
Options
Question
Nurse is caring for 76yr. old patient being treated for depression, elevated cholesterol, renal failure. Placed on new medication to lower cholesterol. Takes nine different medications, sleep aids, herbal remedies, smokes. Which factors increase risk?
click to flip
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't know
Question
A health care provider has ordered Astramorph and Vistaril. When smaller doses of each are administered together, the effect is greater than if they were given separately. This effect is an example of which of the following?
Remaining cards (103)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Concepts of Nursing
| Question | Answer |
|---|---|
| Nurse is caring for 76yr. old patient being treated for depression, elevated cholesterol, renal failure. Placed on new medication to lower cholesterol. Takes nine different medications, sleep aids, herbal remedies, smokes. Which factors increase risk? | Gender, number of medications, renal failure diagnosis, depression, new medication, her age, and smoking habit. |
| A health care provider has ordered Astramorph and Vistaril. When smaller doses of each are administered together, the effect is greater than if they were given separately. This effect is an example of which of the following? | Synergistic effect. Two meds working together to produce a greater result. |
| The nurse is reviewing a patient's prescribed medications. The patient states that she quit taking her blood pressure medication because it made her "too weak and tired." What type of medication action was the patient most likely experiencing? | Side effect. |
| Which of the following patients is at highest risk for a toxic medication effect? | The patient who has liver and kidney problems and takes high doses of aspirin to relieve pain. |
| A patient has been taking vancomycin (Vancomycin HCl) for an infection. The health care provider has ordered a peak and trough level to be drawn. When should the nurse expect the phlebotomist to draw the patient’s blood for the trough level? | 30 minutes before administering the vancomycin. |
| The nurse selects a med according to MAR for the correct drug name, dosage, and route. . The nurse administers the med orally because it is a pill and then documents the medication administration. Which of the following six rights did the nurse violate? | The right time. |
| The following medications are to be administered. Which patient receives medication the most often? The patient who: | Receives antibiotics q4h. |
| A patient has an order to receive nystatin oral suspension PC. When will the nurse administer this medication? | After meals. |
| The health care provider has ordered an antibiotic to be given 3 times in a 24-hour period. Which would be the best dosing schedule for this medication in order to maintain a therapeutic blood level? | Q8h. |
| A nurse is administering daily medications when a patient states, “I never took a little yellow pill before.” What is the nurse’s best action? | Stop and recheck the medication that is correct according to the health care provider's order. |
| An alert patient has refused to take her prescribed medications, stating, "The medication isn't doing me any good!" What should the nurse do? | Assess further as to why the patient feels this way and notify the health care provider of the patient's refusal. |
| When should the nurse document medication administration? | Immediately after the medication is given. |
| The nurse finished administering meds at 1030 when they realized that she gave all of his meds at 1000, including some that should've been administered at 1200 and some at 1400. Which of the six rights of medication administration did the nurse violate? | The right time. |
| A nurse manager is reviewing with the nurse measures used to prevent medication errors. Which of the following statements indicate a correct understanding of steps used to prevent medication errors? | "I will shut the door of the medication room when I am preparing medications." |
| The nurse finished administering medications to a patient when she realized she gave the medications to the wrong patient. What should the nurse do first? | Assess the patient's condition. |
| How can the nurse determine a patient's history of allergies? (Select all that apply.) | By looking at the front of the chart of in the patient's electronic health record (EHR). By looking at the patient's allergy bracelet. By looking at the MAR. By asking the patient. |
| The nurse brings the patient's meds but patient refuses to take them, stating, "I'll take them later. Right now my stomach feels a little upset. Could you please bring me some crackers?" What is best action the nurse should take? (Select all that apply.) | Offer the patient some crackers and see if the patient has any medications that could help relieve nausea. Lock the patient's medications up temporarily and document the incident. |
| Identify the 6 rights of medication administration. | The right medication, dose, patient, route, time, and documentation. |
| The patient who is to receive a medication BID will receive the medication: | Twice a day. |
| What is the best way for nurses to prevent medication errors? | Adhere to the right 6 rights of medication administration. |
| If the patient refuses a medication, what should the nurse do? (Select all that apply) | Document the reason for refusal in the patient's health record. Determine the reason for refusal. Notify the health care provider. |
| Which of the following patients are at risk for developing drug toxicity? (Select all that apply) | 65-year-old male, who has been on high doses of antibiotics for 3 weeks. 75-year-old female who swallowed Caladryl lotion. 82-year-old male, who has renal disease. 43-year-old male with liver failure. |
| The patient is to receive 120 mg of IV Lasix. You calculate that this will be 12 mL. The drug book states that the usual dosage is 20 to 40 mg. What steps should the nurse take to avoid medication errors in this situation? (Select all that apply.) | Double-check all calculations. Question unusually small or large doses. |
| The home care nurse is reviewing the patient's prescribed medications. The patient reports he doesn't take his antihypertensive (blood pressure) medication anymore. What is the best response by the nurse? | "What is the reason you are no longer taking the blood pressure medication?" |
| The health care provider has ordered amoxicillin 250 mg PO q8h. The drug label states 125 mg amoxicillin per 5 mL. Based on this information, which of the following would be correct actions by the nurse? (Select all that apply.) | Administer 10mL of amoxicillin per dose. Compare the patient's name and date of birth on the armband with the MAR. |
| Which of the following are contraindications to oral medication administration? (Select all that apply.) | Nausea/vomiting. Postoperative after gastrointestinal surgery. Inability to swallow. Continuous gastric suction. |
| The nurse administers a sublingual tablet and instructs the patient to avoid swallowing the tablet but rather to allow it to dissolve. The patient asks why. The nurse’s best response is: | "It is designed to be absorbed through the vessels of the undersurface of the tongue. and if it is swallowed, the medication will be destroyed by the gastric juices." |
| The nurse is administering medication to a patient when the patient accidentally drops the tablet on the floor. What should the nurse do? | Discard the tablet and get another one. |
| A patient is on a fluid restriction. When giving oral medications, which of the following considerations are needed? | Allow the patient to take medications with a small amount of water and document the amount of the patient's record. |
| A patient states that she has difficulty swallowing pills and asks the nurse to crush them. Which of the following medications would it be okay to crush? | A scored tablet of Lanoxin (digoxin). |
| A nurse is preparing to administer medication through a feeding tube. Which of the following supplies should the nurse include, besides the medication, to perform this procedure? (Select all that apply) | Gastric test strip. MAR. Water. Appropriately sized medication syringe. Graduated container and straw. |
| A family caregiver is observing a nurse preparing to administer medications through her father’s feeding tube. The caregiver asks, “What is the purpose of the pH paper?” Which of the following is the best response? | “It is used to verify correct placement of the feeding tube in the stomach.” |
| The nurse is giving report to another nurse regarding a patient who receives meds through a feeding tube. The nurse states that preventive measures need to be continued. The nurse knows this would include which of the following? | Administering 30 to 60 mL of tepid water following the last dose of medication. |
| A nurse is preparing medications to be administered through a patient’s feeding tube. The patient is to receive nifedipine XL. Which of the following would be a correct action by the nurse? | Hold the drug and notify the health care provider. |
| Which patient is at lowest risk for a systemic effect from a topical agent? A patient who: | Is very mobile and receiving a drug in low concentration. |
| A patient has been hospitalized for several days after a motor vehicle accident. The patient has several fractured bones and has cuts and scratches across the chest area. Where should you apply the fentanyl (Duragesic) patch to treat the patient's pain? | On the upper back in an area that is free of hair. |
| What should the nurse do to maximize the effectiveness of medicated lotions and/or ointment? | First wash area with nondrying soap and water. |
| The hospice nurse comes to the home of a patient with terminal cancer. She discovers several fentanyl (Duragesic) pain patches on the patient’s body. What should the nurse do first? | Remove the patches except for the most recent and provide patient teaching. |
| The nurse is going to administer eye drops into the eye of a confused elderly patient. What safety precautions should the nurse take? | Rest hand holding the eyedropper on the patient's forehead and hold the eyedropper 1 to 2 cm (0.4 to 0.8 inches) above the conjunctival sac. |
| The nurse is administering eye medication. Which nursing action requires further intervention by the nurse? (Select all that apply.) | The patient blinks and the eye drop falls on the outer lid after instillation. The nurse applies the ointment along the inner edge of the lower eyelid from the outer to inner canthus. |
| The patient asks why the nurse applies the drops in the conjunctival sac. What is the nurse’s best response to the patient’s question? | “Applying drops to the conjunctival sac provides even distribution of medication across the eye.” |
| The nurse is going to administer eye ointment in the newborn’s eyes. Which action by the nurse is the correct procedure? | The nurse applies a ribbon of ointment along the lower eyelid on the conjunctiva from inner to outer canthus. |
| The nurse is going to instill eardrops in a 7-year-old child. In which direction should the nurse pull the pinna of the ear? | Up and back. |
| The mother of a 10-year-old calls the doctor's office stating that she just administered eardrops to her child and the child is crying, stating that the ear hurts worse than it did before the eardrops were applied. What should the nurse tell the mother? | "I will notify the health care provider. It is possible the eardrum may have ruptured." |
| What is the purpose of massaging the tragus of the ear after eardrop instillation? | It helps move the medication inward. |
| At what temperature should the solution be when eardrops are instilled? | Body temperature. |
| What is the primary danger associated with occluding the ear canal with the ear dropper during the administration of eardrops? | It can create too much pressure within the canal with subsequent injury to the eardrum. |
| What additional instruction should you include for the patient who is receiving steroids via an MDI? The patient: | Should rinse the mouth after use of the MDI. |
| When should the patient depress the canister when using an MDI? | The patient should depress the canister simultaneously with slow inhalation. |
| You are planning to teach a patient about using an MDI without a spacer device. What are some points you should include in the teaching plan? (Select all that apply.) | Instruct patient how to time inhalation with depression of medication canister. Instruct patient to shake canister before administration. Warn patient about overuse of the inhaler, including side effects. Show the patient how canister fits into inhaler. |
| How far should the nurse insert a rectal suppository in an adult? (Select all that apply.) | Approximately 10 cm (4 inches). Past the internal anal sphincter. |
| What position should the patient assume for insertion of a rectal suppository? | Left Sims' position. |
| What can the nurse do to help the patient relax the anal sphincter before administering a rectal suppository? | Ask the patient to take slow, deep breaths through the mouth. |
| The nurse is instructing the patient on how to insert a vaginal suppository. Which statement if made by the patient indicates further instruction is needed? (Select all that apply.) | “I should warm suppository to body temp by putting it under warm running water while it is still in the wrapper.” “I should insert rounded end of suppository along side wall of vagina approx. 1 inch or 2.5 cm (approx. to first knuckle of index finger).” |
| The nurse has obtained the patient's oral medications from the automated dispensing system. What should the nurse do with the medication prior to going to the patient's room? | Place the packaged tablets or capsules into the medication cup. |
| The nurse is reviewing medication administration through a feeding tube with the caregiver. Which of the following statements indicates further instruction is needed? | "After crushing all medications, I will mix them together with 30 mL of tepid water." |
| Which medication administration activity can be delegated to nursing assistive personnel (NAP)? | Application of a skin barrier cream to the perineal area. |
| The ear canal should be straightened when instilling eardrops to provide direct access to deeper ear structures. In what direction should the auricle be pulled in an infant to straighten the ear canal? | Downward and back. |
| Why is it important to hold a transdermal patch by the edge after it is removed from its protective covering? (Select all that apply.) | So the patch will adhere well to the patient's skin. So the medication dosage will remain unchanged. |
| Which would be a contraindication for inserting a rectal suppository? A patient with: (Select all that apply.) | Diarrhea. Rectal bleeding. Recent rectal surgery. |
| The patient is to receive a transdermal patch, nitroglycerin (Nitrodisc) 0.4 mg/hr topically. The nurse has been teaching the patient about the medication. Which is accurate information to review with the patient? | It is recommended that nitroglycerin transdermal patches be removed after 10 to 12 hours to allow for a nitrate-free interval. |
| A patient has been prescribed eye drops for the treatment of glaucoma. The nurse is observing the patient self-administer the eye drops. Which action by the patient requires further teaching? | The patient touches the conjunctival sac with the eyedropper to make sure she is in the correct location. |
| The nurse is teaching the patient how to use an MDI with a spacer device. Which statement, if made by the patient, indicates further teaching is required? | “I should wait 20 to 30 seconds between puffs and 2 to 5 minutes between inhalations of different medications. I should administer the inhaled steroids first followed by the bronchodilator.” |
| The NAP reports the patient is complaining of dizziness and nausea after the administration of eardrops. What is the most likely cause of the dizziness? | The medication was too cold when it was administered. |
| Which are correct regarding administration of a rectal suppository for relief of constipation? (Select all that apply.) | Lubricate and insert rounded end first. Place patient in left Sims' position. Insert the suppository past the internal sphincter. |
| A medication label states, “For Parenteral Use Only.” What is the correct interpretation of this statement? | The medication should be administered by injection. |
| Nurse is administering flu vaccine. Nurse performs hand hygiene, locates site, swabs it with alcohol. Nurse allows alcohol to dry, uncaps needle, administers injection. Nurse disposes of syringe & needle. Which actions increased risk for infection? | Failed to apply clean gloves after performing hand hygiene. |
| A 65-year-old, 61-kg patient is ready for her annual flu vaccine, which is delivered intramuscularly. What size needle would the nurse use to administer this intramuscular (IM) injection in the deltoid muscle of this patient? | 25-gauge, 1-inch needle. |
| Nurse just completed giving a patient an injection and turns to deposit syringe and uncovered needle into sharps container. Suddenly patient’s daughter runs between nurse and sharps container. Nurse sticks child with the needle. What should the nurse do? | Notify the supervisor, who will be responsible for helping the mother and child through the clinic's needlestick procedure. |
| Where is the correct dosage measured on a syringe? | Where the head of the plunger touches the sides of the barrel of the syringe. |
| Nurse is preparing an IM injection from a liquid vial. Nurse has selected a 25-gauge, 1.5-inch needle but is experiencing great difficulty withdrawing fluid from vial. Nurse notices that the solution in the vial is very thick. What should the nurse do? | Change needles and use a 21-gauge, 1.5-inch needle. |
| While preparing a subcutaneous injection, the nurse accidentally touches the tip of the syringe while attaching the needle. What should the nurse do? | Get a new sterile syringe. |
| The instructor asks the student nurse what the purpose is for using a filter needle. The student’s correct response would be which of the following? | "It prevents entry of glass into the syringe." |
| When withdrawing medication from a vial, why is it important to first inject air into the vial? | It prevents the buildup of negative pressure in the vial. |
| The nurse has the medication administration record, the ampule of medication, alcohol swabs, and a medication label. Identify the remaining equipment needed to deliver 0.6 mL of medication IM from an ampule. (Select all that apply.) | 21- to 25-gauge needle. 1- to 1.5-inch needle. Filter needle. 1-mL syringe. Disposable gloves. |
| The nurse has the medication administration record, the vial of medication, alcohol swabs, and a medication label. Identify the remaining equipment needed to deliver 0.5 mL of medication subcutaneously from a liquid vial. (Select all that apply.) | Disposable gloves. 25- to 27-guage needle. Needle for withdrawing. 1-mL syringe. 3/8- tp 5/8 inch needle. |
| Identify the remaining equipment needed to administer intramuscularly to an average-size adult 1 mL of medication from a vial that requires reconstitution. (Select all that apply.) | Disposable gloves. 21- to 25-gauge needle. 1- to 3-mL syringe. 1- to 1.5-inch needle. Diluent. Needle for withdrawing. |
| Identify the remaining equipment needed to deliver a total volume of 1.4 mL IM injection to an average-size adult from two vials. (Select all that apply.) | 3-mL syringe. Disposable gloves. Needle for withdrawing. 21- to 25-gauge needle. 1- to 1.5- inch needle. |
| Before giving the patient an injection from a vial, the nurse changes needles. This is done to: (Select all that apply.) | Provide a sharper needle for a less painful injection. Prevent medication from tracking through tissues. |
| The nurse is preparing to give an injection for allergy testing; what would be the best needle gauge to use? | 25 or 27. |
| The nurse is giving a tuberculosis test injection; at what angle does the nurse insert the needle? | Bevel up, 5- to 15-degree angle. |
| The nurse has just given an intradermal injection; what does the nurse expect to see? | A raised, fluid-filled bleb resembling a mosquito bite. |
| Why should the nurse avoid massaging the intradermal injection site? | Because it will disperse the medication into the underlying tissues. |
| Immediately after an allergy injection, the patient tells the nurse, "I feel funny." What are the nurse’s immediate actions? (Select all that apply.) | Prepare to give epinephrine subcutaneously or an antihistamine such as diphenhydramine (Benadryl) according to health care provider's orders and/or agency protocol. Observe patient. Take vital signs. |
| The nurse prepares to administer a subcutaneous injection to a normal-size adult on the upper left arm. The nurse chooses a needle: | A 5/8 inch in length to insert at a 45-degree angle. |
| After giving a subcutaneous injection of heparin, the nurse refrains from massaging the site so as to prevent: | Tissue damage. |
| At what angle should a subcutaneous injection be delivered in an obese adult? | 90 degrees. |
| The nurse has the medication administration record, the vial of medication, and alcohol swabs. Identify the remaining equipment needed to deliver 0.3 mL of medication subcutaneously from a liquid vial to an average-size adult. (Select all that apply.) | 5/8-inch needle. Needle for withdrawing. 25- to 27-guage needle. 1-mL syringe. Disposable gloves. |
| The nurse is administering a subcutaneous injection of enoxaprin (Lovenox). Which of the following actions would minimize pain and discomfort for the patient? (Select all that apply.) | Inserting the needle quickly. Do not massage the site following administration. |
| Generally with a subcutaneous injection, medication absorption is _______ than that of an IM injection. | Slower. |
| A patient just underwent hip replacement surgery and has an abduction pillow. Provider has ordered an injection of 15 mg morphine intramuscularly. What would be the preferred site for administering an intramuscular (IM) injection to this patient? | Vastus lateralis muscle. |
| While preparing an IM injection, the nurse withdraws the syringe needle from a multi-dose vial and touches the hub of the needle. What should the nurse do? | Administer the injection. |
| Of the three types of injections, intradermal, subcutaneous, and IM, which requires aspiration of the syringe before injecting the prepared pain medication? | IM. |
| A patient is in severe pain. The nurse has an order for morphine sulfate 5 mg intramuscularly or subcutaneously. What is the nurse’s best nursing action? | Give the morphine intramuscularly because this route will allow it to be absorbed more rapidly. |
| An 81-year-old cachetic woman (weighting 40 kg) requires iron dextram 1 mL intramuscularly. How will the nurse administer this injection? | Choose a 21-guage, 0.5- to 1-inch needle and administer the injection with the Z-track technique at a 90-degree angle. |
| The nurse has to give a 1 month old the hepatitis B vaccine. Which is the best site for administration? | Vastus lateralis. |
| The nurse is administering a preoperative medication intramuscularly. As the nurse aspirates, the nurse sees blood return into the syringe. What should the nurse do next? | Withdraw the needle and start over. |
| Nurse has MAR, vial of medication, alcohol swabs, and med label. Choose remaining equipment that nurse will need to administer 1 mL of medication, which first has to be reconstituted, as an IM injection to an average-size adult. (Select all that apply.) | 1- to 3-mL syringe. Disposable gloves. 1- to 1.5-inch needle. 21- to 25-gauge needle. Needle for withdrawing. Diluent. |
| The nursing instructor is reviewing with the students the Z-track method for administering an IM injection. Which statement(s), if made by a student, indicates further instruction is needed? (Select all that apply.) | "A fast injection rate of the medication reduces pain and tissue trauma." "The needle should be removed after the skin is released." |
| Which of the following accurately describes how to locate the ventrogluteal site? | Place heel of hand over the patient’s greater trochanter, thumb toward the patient’s groin; index finger points to the anterior superior iliac spine, and middle finger extends back along the iliac crest. |
| Which of the following is a correct sequence for the description of medication preparation? (Assume that an alcohol swab is being used when appropriate.) | Draw up air and inject it into the modified insulin vial, draw up air and inject it into the regular insulin vial, draw up regular insulin, and draw up modified insulin. |
| Which of the following are correct statements to remember for safely administering an IM injection? (Select all that apply.) | Wear clean gloves when administering the medication. Check the patient's allergies. Check the patient's name band and ask the patient to tell you his or her name. |
| The nurse is working with an NAP she knows has helped care for her diabetic mother. The nurse is busy with the admission of a new patient. What can the nurse delegate to the NAP? | Reporting if the patient is exhibiting signs of hypoglycemia. |
| The nursing student is giving an intramuscular injection. Which action would require correction? (Select all that apply.) | Withdraws needle after administration and lays it on beside table while applying a bandage. Cleans selected site with alcohol allowing it to dry; relocates site touching area with clean gloves on. |
Created by:
rissagibby