med admin/pharm

Question 1

when do you use a PICC line?

Answer 1

when several weeks of antibiotics is required

Question 2

for clients who have a cast, what should you not do?

Answer 2

do not put anything under cast. no cream, no water, don’t itch it. if it does itch, put a fan/blowdryer close to it or under it, but don’t apply anything under the cast

Question 3

when should you change a PICC line?

Answer 3

every 7 days
nurse and client should wear a mask during dressing change

Question 4

when should you not administer heparin

Answer 4

low platelets (under 25,000)
normal is 150k - 400k
normal aPTT is 30 - 40 seconds

don’t confuse w/ PT & INR; those are for warfarin

Question 5

antidote for the anticoagulant apixaban or rivaroxaban

Answer 5

andexanet: will help stop bleeding or reduce adverse effect of apixaban

Question 6

FFP

Answer 6

liquid part of blood where RBC and platelets have been removed. helps in clotting.
helps pt who are at risk of bleeding.

Question 7

what nutrition can you give a pt who is on NPO?

Answer 7

IV fluids and parenteral nutrition (TPN)
Parenteral nutrition does not affect the GI tract.

ng tube decompresses the bowels, not used for feedings. enteral feedings affect GI tract, pt cannot be NPO.

Question 8

internal disasters

Answer 8

sudden cessation of internal communication
loss of electrical power to the facility
a toxic chemical spill in the lobby of the facility.

medical errors are not considered to be internal disasters

Question 9

antidote for benzos

Answer 9

flumazenil

Question 10

antidote for heparin

Answer 10

protamine sulfate

Question 11

neutropenia

Answer 11

avoid fresh flowers, fruits, meds are given rectally, catheters are used.
assigned clients to a private room, not semi private.

Question 12

antidote for warfarin

Answer 12

vitamin K

you can also give fresh frozen plasma in combination.

avoid excess leafy greens and organ meats (liver, kidney, etc..)
leafy greens: spinach, kale, broccoli

Question 13

adenosine

Answer 13

can treat cardiac arrhytmias
preferred drug for SVT: supraventricular tachycardia

Question 14

amiodorone is indicated for

Answer 14

preferred drug for VTACH & AFIB

Question 15

all ulcers worsened w/

Answer 15

hot compresses

Question 16

polycythermia

Answer 16

increase w/ red blood cells

Question 17

which med can you give for pain in deep partial thickness and/or full thickness

Answer 17

opiods (morphine sulfate)

oral cycloogenase cox 2 inhibitor (nsaid) will not work

Question 18

esmolol for abdominal aortic aneurysm and develops flank pain

Answer 18

esmolol is a beta blocker that reduces heart rate and hypertension. it is given in AAA to control blood pressure.
if the patient develops flank pain, that can indicate that the aneurysm has ruptured, immediate surgical intervention required.

Question 19

nitroglycerin side effects and indication

Answer 19

for chest pain, you may give every 5mn up to 3x.
if chest pain does not improve 5mn after 1 dose, call 911

headache, shortness of breath, fainting, blurred vision, heart arrhytmia, rapid heart rate, weakness.
if BP is under 90/60, stop transfusion
headache is an expected adverse effect, so give acetaminophen but continue w/ the nitroglycerin

Question 20

what are some meds that can be given to sedate patient during endotracheal tube procedure (pt requiring intubation usually icu patient)?

Answer 20

propofol: an IV anesthetic given for sedation.
can be given to sedate an individual requiring ventilation (to provide comfort and prevent them from fighting the procedure, its very painful)

alternative to it is midazolam, lorazepam, benzo med that has rapid onset

Question 21

what muscle relaxer can be used for MS

Answer 21

baclofen
can also be given for chronic back pain

side effects: diarrhea, dizziness, blurred vision, etc..

Question 22

what meds can be given for tourettes, shrizophrenia and delirium?

Answer 22

haldol

first gen antipsychotic
side effects: diarrhea, weight gain, dizziness, slow movement
adverse effects: extrapyrimidal symptoms like tardive dyskenia, neuroleptic malignant syndrome

Question 23

what is Prednisone for?

Answer 23

PREDNISONE IS A STEROID, it may raise blood pressure since steroids raises BP(sodium retention), (may Dec. K+ mildly as well overtime), it raises blood sugar as well. and it may make the ind. gain weight

it can be given for arthritis, blood disorders, inflammation, severe allergies, etc..

its best to take this medication in the morning.
don’t take this med w/ nsaids since it inc. risk for an ulcer tremendously when combined w/ an nsaid.

Question 24

medication for siadh

Answer 24

diuretic

conivaptan, tolvaptan: these meds deplete water

conivaptan can treat low sodium levels caused by siadh

Question 25

methylphenidate is indicated for?

Answer 25

ADHD

Question 26

chemotherapy meds

Answer 26

cisplatin

makee sure IV patency

Question 27

hypoglassal

Answer 27

tongue

damage is tongue deviation

Question 28

how to reduce performance bias

Answer 28

get feedback from peers, other nurses, etc..

Question 29

haloperidol symptoms

Answer 29

poor muscle coordination, stooped posutre, slow movements (extrapyrimidal symptoms)

tardive dyskinesia, dystonia, akathissia

Question 30

nifedipine

Answer 30

CCB for htn
also used to stop preterm labor (terbutaline & itrhacin as well)

Question 31

name 9 blood pressure meds

Answer 31

prazosin: treats htn and ptsd
clonidine: can cause rebound htn if one dose missed or more
lisonopril
nifedipine: treat high BP and stop preterm labor (tocolytic drugs). magnesium sulfate also manage preterm labor

Question 32

tardive dyskinesia

Answer 32

side effects of long term meds like antipsychotics
tardive refers to slow onset of movements
grimacing, eye blinking, slow movements or chorea, eye blinking, buldging cheeks

Question 33

when does regular insulin peak

Answer 33

2 - 4hrs
while NPH peaks in 4 - 12hrs

Question 34

when giving intradermal injection, position the needle

Answer 34

15 degrees

Question 35

subcue and intramuscular degrees

Answer 35

subcue: 45 or 90 but 45 preferred
90 degrees if you can pinch 2 inches of skin
intramuscular or IM: 90 degrees only

Question 36

1 ounce is how many gallons
1 inch is how many cm

Answer 36

1 ounce or 1 oz = 30ml
1 inch = 2.5cm

Question 37

how to administer albuterol or triptomium bromide

Answer 37

ensure that the client holds their breath for at least 10 seconds after inhaling the medication then breathe out slowly.
if you are suppose to use more than 1 puff, wait 1 minute before inhaling the second puff

Question 38

medication to resolve respiratory acidosis

Answer 38

theophyline is a bronchodilor that treats respiratory acidosis. it promotes the exhalation of co2.

Question 39

lumbar puncture
position? risks?

Answer 39

risks: bleeding, infection (has to be sterile, nerve damage)
also known as a spinal tap. position: sitting up or left lateral recumbent position. local anesthetics given.

s/s: headache, pain around the injection side, should go away. pain meds should help. headache may go away when you lie down.

csf sample is used to determine presence of medical conditions.
also used to inject meds into the fluids around the CNS.

void before because you have to lie after procedure for 30mn
you may be asked to stop anticoagulants, warfarin, aspirin & clopidogrel (super aspirin), rivarozaban, dabigatran, tinzaparin

Answer 40

cut ileostomy allowing 1/16th of an inch of room around it

Question 41

interventions: stress incontinence, urge incontinence

Answer 41

stress incontinence: sneezing, pregnancy

urge incontinence: have the pt hold their urine or pee at time intervals

Question 42

what happens when you place water in a sterile field

Answer 42

its no longer sterile

even if its sterile water, its no longer sterile.

Question 43

strabismus med

Answer 43

atropine, Botox injections, glasses, eye patch (on good eye)

Question 44

are pain and smell psychological or physiological?

Answer 44

pain and smell are PSYCHological
ex: the psychology of pain

Question 45

stoma problems or risk

Answer 45

pale and gray stoma: poor circulation
impaired skin integrity: risk of irritation, infection, especially when skin around stoma is red.

My wafer should be cut ⅛ inch larger than my stoma.”
The skin around the stoma should be cleansed and patted dry.
“The clamp should be applied to the bag prior to securing it to the wafer.
“I will apply pressure for about 30 seconds to ensure the wafer is secured around my stoma.

Question 46

treatment for neuroleptic malignant syndrome?

Answer 46

diazepam, muscle relaxer

diazepam is also a treatment for alcohol withdrawal (benzos)

Question 47

amitriptyline is used for

Answer 47

treat depression in older adults
also treats chronic pain, neuropathic pain, ex; fibromylgia

Question 48

how many ml to irrigate wound and what size gauge to use?

Answer 48

30 - 60ml of sterile irrigation syringe. use 18 - 19 gauge

Question 49

placing suppository
which position?
minimum age?
instructions

Answer 49

older than 3: place client in Sims position (side lying position)
guide it along the rectal wall
must be past external and internal sphincter
hold buttocks together after applying

Question 50

what type of med is celecoxib

Answer 50

nsaids: pain meds
with nsaids: take with meal to avoid gastric irritation, notify if tarry stool or bloody stool, etc..
avoid nsaids in coronary artery disease, petic ulcer disease, renal failure etc..
other nsaids are ketorolac, ibuprofen, naproxen.
expect aspirin who can also thin blood while reducing risk of thromboembolic events

Question 51

ezetimibe

SUFLAZINIDE

Answer 51

EZETIMIBE: anticholesterol med.
sulfa antibiotocs: sulfazinide, avoid too much sun.

Question 52

drawing up NPH and regular insulin, how to?

Answer 52

add air into nph
add air into regular insulin and draw up the require dose into the syringue
go back to the NPH, and draw up the require dose into the synrgingue
now the synrige has both regular and NPH insulin
but regular should be drawn up before NPH b/c NPH is cloudy.

remember RN: regular before nph

Question 53

amphotericin b
indication and side effects

Answer 53

antifungal med
side effects: hypotension, fever, chills, nephrotoxic (kidney injury)
if giving blood transfusion, wait till its finished before giving IV amphotericin b, side effects and adverse effects are similar and as a nurse, we wanna be able to distinguish

Question 54

glusiline

Answer 54

rapid acting, give meal within 30mn - 1hr.
regular insulin: 2-4hrs

rapid acting like lispro, aspart
NPH peak at 4-6hr

determine and glargine pretty much has no peak. but i’d say determine 13hr, glargine 20h, no need to eat right away.

Question 55

electronvulsive therapy
1. a bite block is administer during the therapy in case seizure occurs, to prevent injury

during seizure you cannot place anything in the person’s mouth. but during ect therapy a bite block is given to prevent injury.

Question 56

lamotrigine
indication
name an adverse effect

Answer 56

epilepsy medication.
Cameron Boyce and Liv: Liv for lamotrigine

adverse effect: Steven Johnson syndrome

Question 57

multiple sclerosis med

Answer 57

interferons, muscle relaxers, steroids
MIS: I for interferons
MS: muscle relaxers, steroids.

Question 58

med that causes Steven johnson

Answer 58

FLu like symptoms, painful rashes, that may invade oral mucosa
med that can cause that: allopurinol, phenytoin, lamotrigine, phenobarbital

Question 59

metformin
indication
contraindication
side effects

Answer 59

for hyperglycemia, diabetes
contra: no CT contrast, renal failure, liver failure,
side effects: diarrhea,
dizziness, headache, GI issues
heartburn
adverse: lactic acidosis, hypoglycemia
it can cause lactic acidosis by inhibiting first step in gluconegogenesis

Question 60

rule surrounding antacids
-do not give antacids w/ other medications
they reduce the other meds effect. other meds can be given 1 hour before or 2 hours after antacids.

Question 61

percutaneous coronary intervention: they put a needle or catheter in through a major artery (femoral, radial, or brachial) to fix something inside the vessel.
the pt is not cut open but at risk for bleeding through the procedure site

abciximab: anti-clotting (blood thinner, antiplatelet), can be given during this procedure to prevent clot.

-assess invasive procedures sites for bleeding,
-check hemoglobin & platelet
place client on continuous monitoring
report black tarry stools

Question 62

copper iud

Answer 62

non-hormonal iud
-prevents implantation
iud causes heavier menses and more menstrual cramping
-iud doesn’t stop periods, periods are heavier
-you may have cramping or spotting for a short time after iud insertion
check iud strings once a month

if you see a nbr in a sata question, unless you’re really sure, don’t select it