Exam 3 (Ch 26, 18, 10, 12, 40, 41)

Question 1

1. The primary care provider prescribes furosemide 40 mg IV for a patient with heart failure. Which drug name is used in this prescription?
   1) Chemical
   2) Brand
   3) Trade
   4) Generic

Answer 1

4

Question 2

2. A patient is prescribed fluoxetine 20 mg by mouth daily for treatment of depression. The nurse caring for the patient is unfamiliar with this drug. Which action should she take before administering the medication?
   1) Inform the prescriber that she is not comfortable administering the drug.
   2) Ask a nursing colleague for relevant information about the drug.
   3) Consult the drug formulary accessible to staff at the patient care unit.
   4) Trust the prescriber writes the dose and administer the drug as intended.

Answer 2

3

Question 3

3. A surgeon prescribes potassium chloride 20 mEq by mouth for a patient with a nasogastric (NG) tube for gastric drainage. How should the nurse proceed?

1) Seek clarification from the surgeon about the medication order.
2) Clamp the NG tube while administering the dose by mouth.
3) Instill the medication through the NG tube.
4) Withhold the oral potassium chloride elixir.

Answer 3

1

Question 4

4. A patient calls the nurse because he is having incision pain and wants a dose of analgesic medication. When the nurse checks the patient’s medication administration record, she notes that he is prescribed the opioid, hydromorphone (Dilaudid). Where should the nurse expect to retrieve this drug for administration?
   1) Cabinet in the patient’s room
   2) Double-locked medication drawer
   3) Stock supply cabinet
   4) Portable medication cart

Answer 4

2

Question 5

5. Which term refers to the movement of a drug from the site of administration to the bloodstream?
   1) Absorption
   2) Distribution
   3) Metabolism
   4) Excretion

Answer 5

1

Question 6

6. A patient who just returned from the postanesthesia care unit is complaining of severe incision pain. Which drug contained in his medication administration record will offer him the fastest relief?
   1) Liquid acetaminophen with codeine
   2) Intravenous morphine sulfate
   3) Intramuscular meperidine
   4) Oral oxycodone tablets

Answer 6

2

Question 7

7. The time it takes for drug concentration to reach a therapeutic level in the blood is known as:
   1) Peak action
   2) Duration of action
   3) Onset of action
   4) Half-life

Answer 7

3

Question 8

8. A patient is given furosemide 40 mg orally at 0900. The duration of action for this drug is approximately 6 hours after oral administration. At which time in military hours should the nurse no longer expect to see the effects of this drug?
   1) 0930
   2) 1000
   3) 1100
   4) 1500

Answer 8

4

Question 9

9. Which factor in a patient’s medical history is most likely to prolong the half-life of certain drugs?
   1) Heart disease
   2) Liver disease
   3) Rheumatoid arthritis
   4) Tobacco use

Answer 9

2

Question 10

10. The nurse receives a laboratory report that states her patient’s digoxin level is 1.2 ng/mL; therapeutic range for this drug is 0.5 to 2 ng/mL. Which action should the nurse take?
    1) Notify the prescriber to reduce the dose.
    2) Withhold the next dose of digoxin.
    3) Administer the next dose as prescribed.
    4) Notify the prescribing healthcare provider to increase the dose.

Answer 10

3

Question 11

11. The primary care provider orders peak and trough levels for a patient who is receiving intravenous vancomycin every 12 hours. When should the nurse obtain a blood specimen to measure the trough?
    1) With the morning routine laboratory studies
    2) Approximately 30 minutes before the next dose
    3) Two hours after the next dose infuses
    4) While the drug infuses

Answer 11

2

Question 12

12. Teratogenic drugs should be avoided in which patient population?
    1) Pregnant women
    2) Elderly
    3) Children
    4) Adolescents

Answer 12

1

Question 13

13. A patient with end-stage cancer is prescribed morphine sulfate to reduce pain. For which effect is this medication prescribed?
    1) Supportive
    2) Restorative
    3) Substitutive
    4) Palliative

Answer 13

4

Question 14

After receiving diphenhydramine, a patient complains that his mouth is very dry. This is not uncommon for patients taking this medication. Which drug effect is this patient experiencing?

1) Side effect
2) Adverse reaction
3) Toxic reaction
4) Supportive effect

Answer 14

1

Question 15

15. While receiving an intravenous dose of an antibiotic, levofloxacin, a patient develops severe shortness of breath, wheezing, and severe hypotension. Which action should the nurse take first?
    1) Administer epinephrine IM.
    2) Give bolus dose of intravenous fluids.
    3) Stop the infusion of medication.
    4) Prepare for endotracheal intubation.

Answer 15

3

Question 16

16. A patient develops urticaria and pruritus 5 days after beginning phenytoin for treatment of seizures. Which type of reaction is the patient most likely experiencing?
    1) Mild adverse reaction
    2) Dose-related adverse reaction
    3) Toxic reaction
    4) Anaphylactic reaction

Answer 16

1

Question 17

17. Laboratory test results indicate that warfarin anticoagulant therapy is suddenly ineffective in a patient who has been taking the drug for an extended time. The nurse suspects an interaction with herbal medications. What type of interaction does she suspect?
    1) Antagonistic drug interaction
    2) Synergistic drug interaction
    3) Idiosyncratic reaction
    4) Drug incompatibility

Answer 17

1

Question 18

18. A patient with terminal cancer requires increasing doses of an opioid pain medication to obtain relief from pain. This patient is exhibiting signs of drug:
    1) Abuse.
    2) Misuse.
    3) Tolerance.
    4) Dependence.

Answer 18

3

Question 19

19. Before administering a medication, the nurse must verify the rights of medication administration, which include:
    1) right patient, right room, right drug, right route, right dose, and right time.
    2) right drug, right dose, right route, right time, right physician, and right documentation.
    3) right patient, right drug, right route, right time, right documentation, and right equipment.
    4) right patient, right drug, right dose, right route, right time, and right documentation.

Answer 19

4

Question 20

20. Which expected outcome is best for a patient with a nursing diagnosis of Deficient Knowledge related to new drug treatment regimen?
    1) After an explanation and written materials, describes the expected actions and adverse reactions of his medication
    2) In 1 week after instructional session, describes the expected actions and adverse reactions of his medications
    3) Follows the treatment plan as prescribed
    4) Experiences no adverse effect from his prescribed treatment plan

____

Answer 20

2

Question 21

21. When the nurse enters a patient’s room to administer a medication, he calls out from the bathroom telling her to leave his medication on the bedside table. He reassures her that he will take the medication as soon as he is finished. How should the nurse proceed?
    1) Inform the patient that she will return when he is finished in the bathroom.
    2) Wait outside the bathroom door until the patient is ready for the dose.
    3) Withhold the dose until the next administration time later in the day.
    4) Document that the dose was omitted in the medication administration record.

Answer 21

1

Question 22

22. Which documentation entry related to PRN medication administration is complete?
    1) 6/5/11 0900 morphine 4 mg IV given in right antecubetal fossa for pain rated 8 on a 1–10 scale, J. Williams RN
    2) 0600 famotidine 20 mg IV given in right hand, S. Abraham RN
    3) 9/2/11 0900 levothyroxine 50 mcg PO given
    4) 1/16/11 furosemide 40 mg PO given, J. Smith RN

Answer 22

1

Question 23

23. A patient has difficulty taking liquid medications from a cup. How should the nurse administer the medications?
    1) Request that the physician change the order to the IV route.
    2) Administer the medication by the IM route.
    3) Use a needleless syringe to place the medication in the side of the mouth.
    4) Add the dose to a small amount of food or beverage to facilitate swallowing.

Answer 23

3

Question 24

24. The primary care provider prescribes nitroglycerin 1/150 g SL for a patient experiencing chest pain. How should the nurse administer the drug?
    1) Place the drug in the cheek and allow it to dissolve.
    2) Place the drug under the tongue and allow it to dissolve.
    3) Inject the drug superficially into the subcutaneous tissue.
    4) Give the pill and water to the patient for him to swallow the tablet.

Answer 24

2

Question 25

25. Which action should the nurse take immediately after administering a medication through a nasogastric tube?
    1) Verify correct nasogastric tube placement in the stomach.
    2) Auscultate the abdomen for presence of bowel sounds.
    3) Immediately administer the next prescribed medication.
    4) Flush the tube with water using a needleless syringe.

Answer 25

4

Question 26

26. How should the nurse dispose of a contaminated needle after administering an injection?
    1) Place the needle in a specially marked, puncture-proof container.
    2) Recap the needle, and carefully place it in the trash can.
    3) Recap the needle, and place it in a puncture-proof container.
    4) Place the needle in a biohazard bag with other contaminated supplies.

Answer 26

1

Question 27

27. The nurse must administer hepatitis B immunoglobulin 0.5 mL intramuscularly to a 3-day-old infant born to an HB Ag-positive mother. Which injection site should the nurse choose to administer this injection?
    1) Ventrogluteal
    2) Vastus lateralis
    3) Deltoid
    4) Dorsogluteal

Answer 27

2

Question 28

28. Which action should the nurse take to relax the vastus lateralis muscle before administering an intramuscular injection into the site?
    1) Apply a warm compress.
    2) Massage the site in a circular motion.
    3) Apply a soothing lotion.
    4) Have the client assume a sitting position.

Answer 28

4

Question 29

29. The physician prescribes warfarin 5 mg orally at 1800 for a patient who underwent open reduction and internal fixation of his right hip. After administering the medication, the nurse realizes that she administered a 10 mg tablet instead of the prescribed 5 mg PO. Which of the following actions by the nurse is appropriate?
    1) No action is necessary because an extra 5 mg of warfarin is not harmful.
    2) Call the prescriber and ask her to change the order to 10 mg.
    3) Document on the chart that the drug was given and indicate the drug was given in error.
    4) Complete an incident report according to the facility’s policy.

Answer 29

4

Question 30

30. The nurse must administer eardrops to an infant. How should she proceed?
    1) Pull the pinna down and back before instilling the drops.
    2) Pull the pinna upward and outward before instilling the drops.
    3) Instill the drops directly; no special positioning is necessary.
    4) Position the patient supine with the head of the bed elevated 30°.

Answer 30

1

Question 31

31. The nurse is teaching parents ways to give oral medication to their child. Which action would they implement to improve compliance?
    1) Crush time-release capsules to put in his favorite food.
    2) Give medication quickly before he knows what is happening.
    3) Allow the child to eat a frozen pop before receiving the medication.
    4) Mask the flavor of medication in a toddler cup with orange juice.

Answer 31

3

Question 32

32. An adult patient admitted with lower gastrointestinal bleeding is prescribed a unit of packed red blood cells. Which gauge needle should be inserted to administer this blood product?
    1) 18 gauge
    2) 22 gauge
    3) 24 gauge
    4) 26 gauge

Answer 32

1

Question 33

1. The nurse is drawing up a medication from an ampule. Arrange the following steps in the order in which they should be performed.
   A. Use an ampule opener to break ampule neck.
   B. Tap the ampule to remove medication trapped in the top of ampule.
   C. Invert the ampule, and draw up the medication.
   D. Dispose of the top and bottom of the ampule and filter needle in sharps container.
   E. Hold the syringe vertically, and tap it to remove air bubbles.

Answer 33

B,A,C,E,D

Question 34

2. A nurse is administering a medication using a volume-control administration set (e.g., Buretrol, Volutrol). Arrange the following steps in the order in which they would be performed. Number 1 is the one performed first.
   A. Inject the ordered medication into the volume-control chamber.
   B. Fill the volume-control chamber with the correct amount of intravenous fluid from the primary bag.
   C. Cleanse the port on the volume-control chamber.
   D. Prime the volume-control tubing.
   E. Open the lower clamp and start the infusion at the correct flow rate.

Answer 34

B,D,C,A,E