Exam

Question 1

Ear drops

Answer 1

remain on side for 5-10 minutes

Question 2

enteral feeding tube

Answer 2

flush line to maintain tube patency, some meds interact with each other or become ineffective if mixed in tube

Question 3

eye drops

Answer 3

drop in lower conjunctival sac, 3-5 minutes between drops, close eye after

Question 4

IM injection

Answer 4

72-90 degree angle

Question 5

subcutaneous injection

Answer 5

45-90 degree angle; rotate sites to prevent fibrous tissue buildup

Question 6

IV piggy back (IVPB)

Answer 6

clean port, flush with 2-3mL NS, administer medication, flush again

Question 7

SR, XR medications

Answer 7

sustained/extended release; chewing or crushing may result in toxic peaks

Question 8

meds that cause GI irritation

Answer 8

oral potassium chloride, prednisone

Question 9

PCA pump Morphine levels

Answer 9

0.01-0.04mg/kg/hr

Question 10

rectal suppository

Answer 10

Sims position, lube, insert 3-4 inches, remain on side for 5 minutes

Question 11

transdermal patch

Answer 11

rotate sites, use gloves, press firmly for 10 seconds, not over hair, don’t put estrogen on breast

Question 12

Lorazepam (Ativan) disease interaction

Answer 12

COPD

Question 13

Food interaction with many meds

Answer 13

grapefruit juice destroys the enzyme that breaks down the medication, therefore, leading to toxic levels

Question 14

Morphine-when to hold and nursing care

Answer 14

Hold RR

Question 15

monitoring aminoglycosides (gentamycin)

Answer 15

laboratory monitoring-peak 4-12 mg/L; trough 1-2 mg/L; BUN, creatine

Question 16

Levofloxacin (Levaquin) adverse drug effects

Answer 16

allergic reaction-difficulty breathing, hives, swelling of the face, lips, tongue, and throat

Question 17

Vancomycin (Vancocin) precautions

Answer 17

vesicant properties, severe tissue injury, necrosis

Question 18

Heparin laboratory monitoring

Answer 18

PTT 38-70 seconds

Question 19

Enoxaparin (Lovenox) compared to Heparin

Answer 19

lasts longer than Heparin

Question 20

Warfarin (Coumadin) laboratory monitoring

Answer 20

PT 18-26 seconds; INR 2.0-3.0; risk for bleeding

Question 21

Divalproex (Depakote) adverse effects

Answer 21

black box warning for hepatic failure

Question 22

Gabopentin (neurontin) class and alternate use

Answer 22

anticonvulsant, also used to treat peripheral neuropathy; need to taper

Question 23

bronchodilators adverse effects

Answer 23

Albuterol (Proventil); tachycardia, anxiety (activates SNS)

Question 24

Atorvastatin (Lipitor) lab tests

Answer 24

liver function tests

Question 25

examples of Beta Blockers

Answer 25

propranalol, Labetalol (Normodyne), Metoprolol (Lopressor)

Question 26

what to monitor with Beta Blockers

Answer 26

BP, hold if systolic is

Question 27

Digoxin (Lanoxin) lab values

Answer 27

Therapeutic level of 0.5-2.0, serum potassium; negative chronotropic, positive inotropic; hold if HR

Question 28

Diltiazem-SR (Cardizem-SR) precautions

Answer 28

do not crush-toxic effects (Ca Channel Blocker)

Question 29

ACE-inhibitor

Answer 29

Enalapril (Vasotec)

Question 30

first does effect of ACE inhibitors (Enalapril)

Answer 30

orthostatic hypotension

Question 31

What insulin cannot be mixed with any other

Answer 31

Lantus--long acting

Question 32

Rapid acting insulin name and onset

Answer 32

Humalog (Lispro) 10-15 min onset

Question 33

When to take short acting insulin

Answer 33

"R" 20-30 mins ac

Question 34

Intermediate acting insulin and when to take

Answer 34

NPH "Humulin N" or Lente "Humulin L" take pc

Question 35

Long acting Ultralente onset

Answer 35

6-8 hours

Question 36

Long acting Glargine (Lantus) onset

Answer 36

1 hr, no peaks

Question 37

Metformin (Glucophage) precaution

Answer 37

hold when patient is NPO; caution with hepatic impairment

Question 38

Glucocorticosteroids (prednisone) patient teaching

Answer 38

take with food or milk

Question 39

inodinated contrast media labs

Answer 39

serum creatinine

Question 40

Fluoxetine (Prozac) patient teaching

Answer 40

taper when discontinuing

Question 41

reversal agent for bezodiazepines

Answer 41

Flumazenil (Romazicon)

Question 42

reversal agent for opioids

Answer 42

Naloxone (Narcan)

Question 43

antidote for Heparin

Answer 43

protamine sulfate

Question 44

risk for long-acting bezodiazepines

Answer 44

falls risk for elderly

Question 45

risk for Lorazepam (Ativan)

Answer 45

respiratory depression and CO2 retention

Question 46

reversal agent for Midazolam (Versed)

Answer 46

Flumazenil

Question 47

Potassium chloride max safe rate

Answer 47

10 mEq/hr

Question 48

infiltration

Answer 48

escape of non-vesicant fluid from IV into subcutaneous tissue

Question 49

Extravasation

Answer 49

infiltration of vesicant fluid from IV into surrounding IV site

Question 50

Phlebitis

Answer 50

inflammation of vein

Question 51

downstream occlusion message on IV pump

Answer 51

kink in tubing or clamp may be closed

Question 52

IV drip rate-calculating drops per minute

Answer 52

volume to be infused (mL) over 1 hour /drop factor constant gtts/min

Question 53

drop factor constant for 60 gtt/mL

Answer 53

1

Question 54

drop factor constant for 10 gtt/mL

Answer 54

6

Question 55

drop factor constant for 15 gtt/mL

Answer 55

4

Question 56

total dosage with morphine drip plus rescue boluses

Answer 56

2.5-15 mg q4h

Question 57

insulin sliding scale protocol

Answer 57

discouraged for lack of effective glycemic control and greater incidence of hypoglycemia

Question 58

use PTT with

Answer 58

Heparin

Question 59

use PT with

Answer 59

Warfarin

Question 60

use INR with

Answer 60

Warfarin

Question 61

use liver function tests with

Answer 61

Statins, Divalproex (Depakote), and Metformin (Glucophage)

Question 62

use peaks and troughs with

Answer 62

antibiotic therapy

Question 63

use serum creatinine with

Answer 63

iodinated contrast media

Question 64

use serum electrolytes with

Answer 64

Digoxin (Lanoxin) and Furosemide (Lasix)

Question 65

use serum glucose with

Answer 65

insulin