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Question 1

The “six rights” of medication administration:

Answer 1

Right drug
Right dose
Right time
Right route
Right patient
Right documentation

Question 2

The nursing process:

Answer 2

Assessment 
Nursing diagnosis
Planning
Implementation
Evaluation

Question 3

The nurse answers a patient’s call light and finds the patient sitting up in bed and requesting pain medication. What will the nurse do first?

A. Check the orders and give the patient the requested pain medication.
B. Provide comfort measures to the patient.
C. Assess the patient’s pain and pain level.
D. Evaluate the effectiveness of previous pain medications.

Answer 3

C
The nurse should always assess a patient before any intervention. Although the nurse will check the orders and possibly give the medication (and possibly even perform the actions in responses B and D), the first priority is assessment.

Question 4

Nursing diagnosis process:

Answer 4

Three part process:

1. Part one is the human response
2. Part two is the defining characteristics and identifies factors related to the response.
3. Part three is a listing if cues, clues, and evidence

Question 5

Planning:

Answer 5

• Goals: Objective, measurable, and realistic with an established time period for achievement of the outcomes that are specifically stated in the outcome criteria
• Outcome criteria: Concrete descriptions of patient goals

Question 6

The patient’s medication administration record lists two antiepileptic medications that are due at 0900, but the patient is NPO for a barium study. The nurse’s coworker suggests giving the medications via IV because the patient is NPO. What will the nurse do?

A. Give the medications PO with a small sip of water.
B. Give the medications via the IV route because the patient is NPO.
C. Hold the medications until after the test is completed.
D. Call the health care provider to clarify the instructions.

Answer 6

D

Question 7

The day shift charge nurse is making rounds. A patient tells the nurse that the night shift nurse never gave him his medication, which was due at 2100. What will the nurse do first to determine whether the medication was given?

A. Call the night nurse at home
B. Check the medication administration record
C. Call the pharmacy
D. Review the nurse’s notes

Answer 7

B
The medication administration record is the legal documentation that the professional nurse uses to sign off medications that are given, so it should be checked first.

Question 8

A nurse makes an error when administering medications to a patient. Which action by the nurse requires the supervising nurse to intervene? The nurse

A. completes an incident report.
B. informs the prescriber of the error.
C. documents adverse effects to the medication error.
D. records completion of an incident report in the medical chart.

Answer 8

D

When you make a med error, you don’t put it in the chart

Question 9

Drug names:

Chemical

Answer 9

Describes the drug’s chemical composition and molecular structure

Question 10

Drug names:

Generic (nonproprietary)

Answer 10

Name given by the United States Adopted Names Council

Question 11

Drug names:

Trade (proprietary)

Answer 11

The drug has a registered trademark; use of the name is restricted by the drug’s patent owner (usually the manufacturer)

Question 12

Pharmacokinetics:

Answer 12

The study of what the body does to the drug;

• Absorption
• Distribution
• Metabolism
• Excretion

A drug’s time to onset of action, time to peak effect, and duration of action
Study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body

Question 13

The nurse is giving a medication that has a high first-pass effect. The health care provider has changed the route from IV to PO. The nurse expects the oral dose to be

A. higher because of the first-pass effect.
B. lower because of the first-pass effect.
C. the same as the IV dose.
D. unchanged.

Answer 13

A
The first-pass effect is the metabolism of a drug before it becomes systemically available, and it reduces the bioavailability of the drug. Therefore, oral doses need to be higher than IV doses because of the first-pass effect.

Question 14

Pharmacodynamics:

Answer 14

The study of what the drug does to the body;

• The mechanism of drug actions in living tissues
• Drug-receptor relationships

Question 15

A patient is complaining of severe pain and has orders for morphine sulfate. The nurse knows that the route that would give the slowest pain relief would be which route?

A. IV
B. IM
C. Subcut
D. PO

Answer 15

D

Parenteral routes result in the fastest absorption and therefore also the fastest effects.

Question 16

Pharmacotherapeutics:

Answer 16

The clinical use of drugs to prevent and treat diseases

Defines principles of drug actions—the cellular processes that change in response to the presence of drug molecules

Drugs are organized into pharmacologic classes

Question 17

Pharmaceutics:

Answer 17

Different drug dosage forms have different pharmaceutical properties.

Dosage form determines the rate of drug dissolution (dissolving of solid dosage forms and their absorption from the GI tract).

• Enteric-coated tablets
• Extended-release forms

Question 18

What type of pills can you NOT crush?

Answer 18

enteric coated or extended release

Question 19

A patient is prescribed ibuprofen 200 mg PO every 4 hours as needed for pain. The pharmacy sends up enteric-coated tablets, but the patient refuses the tablets, stating that she cannot swallow pills. What will the nurse do?

A. Crush the tablets and mix them with applesauce or pudding.
B. Call the pharmacy and ask for the liquid form of the medication.
C. Call the pharmacy and ask for the IV form of the medication.
D. Encourage the patient to try to swallow the tablets.

Answer 19

B
The liquid form is appropriate because it is also given via the oral route. Enteric-coated tablets should not be crushed, and the patient should not be forced to take the tablets. This medication does not have an IV form, but even if it did, the routes cannot be changed without a health care provider’s order.

Question 20

Routes of administration:

Answer 20

Enteral (GI tract)
Parenteral
Topical

Question 21

Enteral routes of administration:

Answer 21

Oral
Sublingual
Buccal
Rectal (can also be topical)

Question 22

Parenteral routes of administration:

Answer 22

Intravenous (fastest delivery into the blood circulation)
Intramuscular
Subcutaneous
Intradermal
Intraarterial
Intrathecal
Intraarticular

Question 23

Topical routes of administration:

Answer 23

Skin (including transdermal patches)
Eyes
Ears
Nose
Lungs (inhalation)
Rectum
Vagina