medication administration overview practice questions Flashcards
- Which of the following patients is at the highest risk for a medication error?
a) A 30-year-old receiving antibiotics for pneumonia
b) A 68-year-old with polypharmacy for chronic conditions
c) A 45-year-old on short-term pain management
d) A 22-year-old receiving vaccinations
b) A 68-year-old with polypharmacy for chronic conditions
Rationale: Elderly patients with multiple medications (polypharmacy) are at higher risk due to drug interactions, altered pharmacokinetics, and cognitive impairments.
- A nurse prepares to administer a medication and notices the label is smudged and partially unreadable. What is the nurse’s best action?
a) Administer the medication if most of the label is visible
b) Estimate the dosage based on patient history
c) Contact the pharmacy for clarification
d) Ask another nurse for assistance
c) Contact the pharmacy for clarification
Rationale: When labels are unreadable, contacting the pharmacy ensures the correct medication is administered and prevents potential harm.
- During shift change, a nurse reports giving 10 mg of a medication instead of the prescribed 1 mg. What is the priority nursing action?
a) Notify the patient’s family
b) Complete an incident report
c) Monitor the patient for adverse effects
d) Inform the physician immediately
c) Monitor the patient for adverse effects
Rationale: Monitoring the patient takes priority to detect and treat any adverse effects promptly. The incident should also be reported, but patient safety is paramount.
- What is a primary reason pediatric patients are at high risk for medication errors?
a) Children refuse medication frequently
b) Medication doses are based on weight and age
c) Pediatric medications are only available in liquid form
d) Pediatric patients are often unable to express side effects
b) Medication doses are based on weight and age
Rationale: Pediatric dosing is complex, and errors can occur due to incorrect calculations based on weight or age.
- A nurse is preparing to administer a high-alert medication. Which strategy is most effective in preventing errors?
a) Administering the medication slowly
b) Double-checking the dose with another nurse
c) Providing detailed verbal instructions to the patient
d) Checking the patient’s vital signs before administration
b) Double-checking the dose with another nurse
Rationale: For high-alert medications, a second nurse verifying the dose is a key safety practice to prevent errors.
- A nurse receives a medication order that is unclear. What should the nurse do first?
a) Administer the most likely dose based on previous experience
b) Call the pharmacist for clarification
c) Contact the prescribing provider to clarify the order
d) Ask another nurse what they would do
Answer: c) Contact the prescribing provider to clarify the order
Rationale: The nurse must clarify any unclear orders directly with the provider to prevent medication errors.
- Which of the following strategies can most effectively reduce medication errors?
a) Relying on memory for drug interactions
b) Using barcode scanning technology during administration
c) Administering medications before documenting orders
d) Skipping double-checks for low-risk medications
Answer: b) Using barcode scanning technology during administration
Rationale: Barcode scanning helps ensure the right medication is administered to the right patient, reducing errors.
- A nurse administers a medication to the wrong patient. What is the first action the nurse should take?
a) Notify the nurse manager
b) Inform the patient about the error
c) Monitor the patient for adverse effects
d) Complete an incident report
Answer: c) Monitor the patient for adverse effects
Rationale: Patient safety is the top priority. The nurse must immediately monitor for any potential harm before taking further steps.
- Which factor is most likely to contribute to a medication error in children?
a) Parents administering the medication at home
b) Pediatric medications being prepared in adult doses
c) Children refusing to take their medications
d) Using color-coded syringes
Answer: b) Pediatric medications being prepared in adult doses
Rationale: Children’s doses are typically weight-based, and using adult doses increases the risk of overdose.
- A nurse prepares a liquid medication but finds the label difficult to read. What is the best action?
a) Dilute the medication to ensure accuracy
b) Administer the dose and monitor the patient
c) Discard the medication and order a new one
d) Contact the pharmacy for a replacement
Answer: d) Contact the pharmacy for a replacement
Rationale: The nurse should ensure the label is readable to avoid errors and must contact the pharmacy for a clear label.
- Which communication technique can reduce the risk of medication errors during handoffs?
a) Verbal communication only
b) SBAR (Situation-Background-Assessment-Recommendation)
c) Written notes with shorthand
d) Asking the patient to describe their medications
Answer: b) SBAR (Situation-Background-Assessment-Recommendation)
Rationale: SBAR ensures concise, structured communication during handoffs, reducing errors.
- Which of the following is an example of a prescribing error?
a) Giving a medication at the wrong time
b) Administering the wrong dose to a patient
c) The provider orders a medication the patient is allergic to
d) The nurse forgets to document medication administration
Answer: c) The provider orders a medication the patient is allergic to
Rationale: Prescribing a medication despite an allergy is a prescribing error that can cause harm.
- A nurse gives a patient a double dose of a medication by mistake. What should the nurse do next?
a) Immediately induce vomiting
b) Call the pharmacist for advice
c) Assess the patient and notify the provider
d) Document that the patient tolerated the dose well
Answer: c) Assess the patient and notify the provider
Rationale: The nurse must first assess for adverse effects and inform the provider to receive further instructions.
- A new nurse asks how to prevent medication errors when preparing high-alert medications. What advice is most appropriate?
a) Prepare high-alert medications quickly to avoid delays
b) Use only the medication label to verify the dose
c) Double-check with another nurse before administration
d) Estimate doses for patients based on appearance
Answer: c) Double-check with another nurse before administration
Rationale: Double-checking high-alert medications with another nurse reduces the risk of serious errors.
- Which of the following orders would require clarification before administration?
a) Acetaminophen 650 mg PO every 6 hours
b) Furosemide 20 mg IV push STAT
c) Insulin 10 units IV once
d) Morphine sulfate 2 mg IV every 2 hours PRN pain
Answer: c) Insulin 10 units IV once
Rationale: Insulin IV administration is uncommon and requires clarification to prevent harm.
- What is the most effective way to prevent errors related to look-alike/sound-alike medications?
a) Store them together to save time
b) Rely on memory for correct doses
c) Use “tall man” lettering on labels (e.g., hydrOXYzine vs. hydrALAZINE)
d) Only administer these medications at night
Answer: c) Use “tall man” lettering on labels
Rationale: “Tall man” lettering highlights differences between look-alike drugs, reducing errors.
- Which step of the nursing process is critical in preventing medication errors?
a) Planning
b) Evaluation
c) Documentation
d) Assessment
Answer: d) Assessment
Rationale: Assessing the patient ensures that medications are appropriate and reduces the risk of errors.
- A patient receiving a new medication experiences a severe allergic reaction. What is the nurse’s priority action?
a) Notify the provider
b) Administer epinephrine if ordered
c) Document the allergic reaction
d) Call the pharmacist to discontinue the medication
Answer: b) Administer epinephrine if ordered
Rationale: In life-threatening allergic reactions, epinephrine is the priority treatment.
- A nurse accidentally administers a patient’s bedtime medication at lunchtime. What is the nurse’s first action?
a) Re-administer the medication at bedtime
b) Report the error to the nurse manager
c) Inform the provider and monitor the patient
d) Complete an incident report
Answer: c) Inform the provider and monitor the patient
Rationale: Informing the provider allows for further instructions, and monitoring ensures patient safety.
- Which practice is recommended to reduce medication errors when using automated dispensing cabinets?
a) Allowing multiple medications to be dispensed at once
b) Bypassing overrides to save time
c) Performing independent double-checks before removal
d) Skipping barcodes for frequently used medications
Answer: c) Performing independent double-checks before removal
Rationale: Double-checking ensures the correct medication is dispensed and administered.
- Which aspect of pharmacokinetics refers to how a drug is absorbed into the bloodstream?
a) Distribution
b) Metabolism
c) Absorption
d) Excretion
Answer: c) Absorption
Rationale: Absorption describes how the drug moves from the site of administration into the bloodstream.
- A drug that is highly protein-bound will likely have which characteristic?
a) Rapid onset of action
b) Short half-life
c) Decreased availability for action
d) Immediate excretion by the kidneys
Answer: c) Decreased availability for action
Rationale: Protein-bound drugs are inactive while bound, reducing their availability for therapeutic effects.
- What legal responsibility does a nurse have if a provider writes an incomplete prescription?
a) Administer the medication and document the error
b) Complete the prescription based on prior experience
c) Contact the provider to clarify the order
d) Report the provider to the Board of Nursing
Answer: c) Contact the provider to clarify the order
Rationale: Nurses are legally required to clarify unclear orders to ensure safe medication administration.
- Which phase of pharmacokinetics involves the chemical alteration of a drug in the body?
a) Absorption
b) Metabolism
c) Distribution
d) Excretion
Answer: b) Metabolism
Rationale: Metabolism (often in the liver) transforms drugs into more water-soluble forms for easier elimination.
- A drug labeled by its chemical name represents what classification?
a) Generic name
b) Trade name
c) Chemical name
d) Pharmacologic classification
Answer: c) Chemical name
Rationale: The chemical name describes the molecular structure of the drug.
- Which regulatory body ensures that medications are safe and effective for public use?
a) Centers for Disease Control (CDC)
b) Food and Drug Administration (FDA)
c) American Nurses Association (ANA)
d) Drug Enforcement Agency (DEA)
Answer: b) Food and Drug Administration (FDA)
Rationale: The FDA is responsible for approving drugs and ensuring their safety and efficacy.
- What is the primary purpose of the generic name of a drug?
a) To reflect the manufacturer’s brand
b) To describe its chemical properties
c) To provide a universal name for the drug
d) To indicate the medication’s strength
Answer: c) To provide a universal name for the drug
Rationale: Generic names are standardized to be recognized internationally, regardless of brand.
- A nurse gives a narcotic analgesic but forgets to document it. What legal principle has been violated?
a) Autonomy
b) Veracity
c) Accountability
d) Nonmaleficence
Answer: c) Accountability
Rationale: Nurses are accountable for documenting medication administration to ensure accurate records and patient safety.
- What is the difference between pharmacokinetics and pharmacodynamics?
a) Pharmacokinetics describes drug actions, while pharmacodynamics describes movement through the body
b) Pharmacokinetics describes drug movement, while pharmacodynamics describes the drug’s effects on the body
c) Pharmacokinetics focuses on drug receptors, while pharmacodynamics focuses on metabolism
d) Both terms mean the same thing
Answer: b) Pharmacokinetics describes drug movement, while pharmacodynamics describes the drug’s effects on the body
Rationale: Pharmacokinetics focuses on absorption, distribution, metabolism, and excretion; pharmacodynamics describes how the drug interacts with the body to produce effects.
- Which of the following describes the time it takes for a drug concentration to reduce by half in the body?
a) Onset
b) Peak
c) Half-life
d) Duration
Answer: c) Half-life
Rationale: Half-life refers to the time required for the drug’s concentration to be reduced by 50%.
- Which type of medication order must be carried out immediately?
a) PRN order
b) STAT order
c) Standing order
d) Single order
Answer: b) STAT order
Rationale: A STAT order indicates that the medication must be administered immediately.
- What does the term bioavailability refer to?
a) The extent to which a drug is metabolized in the liver
b) The ability of a drug to bind with plasma proteins
c) The amount of active drug that reaches systemic circulation
d) The ability of a drug to cause adverse effects
Answer: c) The amount of active drug that reaches systemic circulation
Rationale: Bioavailability measures how much of the drug is available to exert its effect.
- Which nursing regulation ensures that medication errors are reported and analyzed?
a) HIPAA
b) QSEN initiative
c) The Nurse Practice Act
d) The Patient Safety and Quality Improvement Act (PSQIA)
Answer: d) The Patient Safety and Quality Improvement Act (PSQIA)
Rationale: The PSQIA promotes reporting of errors to improve healthcare quality and prevent future errors.
- A nurse notes that a medication has a narrow therapeutic index. What does this indicate?
a) The drug must be given with food
b) It has a wide safety margin
c) Small changes in dose could cause toxicity
d) It is excreted rapidly by the kidneys
Answer: c) Small changes in dose could cause toxicity
Rationale: Drugs with a narrow therapeutic index require careful monitoring due to the small difference between therapeutic and toxic doses.
- Which of the following drug routes has the fastest absorption?
a) Oral
b) Subcutaneous
c) Intramuscular
d) Intravenous
Answer: d) Intravenous
Rationale: Intravenous administration delivers the drug directly into the bloodstream, leading to the fastest absorption.
- What is the primary function of the DEA (Drug Enforcement Agency)?
a) Ensuring all drugs are labeled correctly
b) Regulating controlled substances
c) Monitoring adverse drug reactions
d) Developing new medications
Answer: b) Regulating controlled substances
Rationale: The DEA enforces laws related to controlled substances to prevent misuse and abuse.
- A nurse is preparing to administer a medication listed as a controlled substance. Which action is required?
a) Administer it without documentation
b) Count the remaining stock after each administration
c) Discard unused portions without witness
d) Report usage directly to the FDA
Answer: b) Count the remaining stock after each administration
Rationale: Controlled substances must be tracked carefully to prevent misuse.
- What does a black box warning on a medication label indicate?
a) The drug is only available over-the-counter
b) The drug is nearing its expiration date
c) The drug carries a significant risk of severe side effects
d) The drug is experimental and under trial
Answer: c) The drug carries a significant risk of severe side effects
Rationale: Black box warnings highlight serious risks that could result from taking the medication.
- Which law ensures that patients are informed about their medications and have the right to refuse treatment?
a) HIPAA
b) Informed Consent Law
c) The Nurse Practice Act
d) The Controlled Substances Act
Answer: b) Informed Consent Law
Rationale: Informed consent ensures that patients understand their medications and can accept or refuse treatment.
- What is the primary goal of pharmacology in nursing practice?
a) To create new medications
b) To promote safe and effective medication use
c) To enforce legal regulations
d) To monitor drug development trials
Answer: b) To promote safe and effective medication use
Rationale: The goal of pharmacology in nursing is to ensure patient safety and optimize therapeutic outcomes.
- Which route of administration results in the fastest absorption?
a) Oral
b) Intramuscular
c) Intravenous
d) Subcutaneous
Answer: c) Intravenous
Rationale: IV administration bypasses absorption, delivering the drug directly into the bloodstream.
- What is the primary site of drug metabolism in the body?
a) Kidneys
b) Liver
c) Stomach
d) Lungs
Answer: b) Liver
Rationale: The liver is the primary organ for metabolizing medications through enzymatic processes.
- Which pharmacokinetic process involves the movement of a drug from the bloodstream to tissues?
a) Absorption
b) Distribution
c) Metabolism
d) Excretion
Answer: b) Distribution
Rationale: Distribution refers to the transport of the drug throughout the body to its target tissues.
- How does renal impairment affect drug excretion?
a) Increases drug excretion
b) Causes faster metabolism
c) Decreases drug elimination
d) Has no effect on pharmacokinetics
Answer: c) Decreases drug elimination
Rationale: Impaired kidneys reduce drug clearance, leading to drug accumulation and possible toxicity.
- What role does albumin play in pharmacokinetics?
a) Enhances metabolism of drugs
b) Binds to drugs, reducing free drug levels
c) Increases the excretion rate
d) Breaks down drug molecules
Answer: b) Binds to drugs, reducing free drug levels
Rationale: Albumin binds to medications, making them inactive until they are released.
- Which type of drug administration is most affected by first-pass metabolism?
a) Intramuscular
b) Oral
c) Subcutaneous
d) Sublingual
Answer: b) Oral
Rationale: Oral drugs pass through the liver before reaching systemic circulation, where some are metabolized and inactivated.
- A drug has a half-life of 6 hours. How much of the drug remains after 12 hours?
a) 100%
b) 75%
c) 50%
d) 25%
Answer: d) 25%
Rationale: After two half-lives (12 hours), 25% of the drug remains in the body.
- Which factor is most likely to decrease drug absorption?
a) High lipid solubility
b) Delayed gastric emptying
c) High blood flow at the absorption site
d) Basic pH in the stomach
Answer: b) Delayed gastric emptying
Rationale: Delayed gastric emptying slows the movement of drugs into the intestine, where most absorption occurs.
- What happens when two highly protein-bound drugs are administered together?
a) They have no effect on each other
b) One drug displaces the other, increasing free drug levels
c) Both drugs become inactive
d) They are excreted more rapidly
Answer: b) One drug displaces the other, increasing free drug levels
Rationale: Competition for protein-binding sites can increase the level of free, active drug, raising the risk of toxicity.
- Which factor enhances the distribution of a drug?
a) Poor blood flow to tissues
b) High plasma protein binding
c) Increased capillary permeability
d) Presence of a blood-brain barrier
Answer: c) Increased capillary permeability
Rationale: Increased capillary permeability allows drugs to move more easily from the bloodstream to tissues.
- What is the term for the fraction of an administered dose that reaches systemic circulation?
a) Bioavailability
b) Half-life
c) Clearance
d) Distribution
Answer: a) Bioavailability
Rationale: Bioavailability refers to the proportion of a drug that enters the bloodstream and is available for use.
- How does body fat affect drug distribution?
a) It reduces the drug’s effect
b) It accelerates drug excretion
c) Lipophilic drugs accumulate in fat tissue
d) Fat tissue enhances water-soluble drug distribution
Answer: c) Lipophilic drugs accumulate in fat tissue
Rationale: Lipid-soluble drugs can be stored in fat tissue, leading to delayed release.
- A nurse notes that a medication has a short half-life. What does this mean for dosing frequency?
a) The drug will need frequent dosing
b) The drug is administered once a day
c) The drug is given only as a loading dose
d) The drug is likely to accumulate in the body
Answer: a) The drug will need frequent dosing
Rationale: Short half-life drugs leave the body quickly and need more frequent dosing to maintain therapeutic levels.
- Which factor decreases drug metabolism in elderly patients?
a) Increased liver enzyme activity
b) Reduced hepatic blood flow
c) Increased renal function
d) Rapid gastric emptying
Answer: b) Reduced hepatic blood flow
Rationale: Decreased blood flow to the liver in elderly patients slows drug metabolism.
- Which statement about drug excretion is correct?
a) All drugs are excreted through the lungs
b) Renal function is the primary determinant of drug excretion
c) Lipid-soluble drugs are excreted unchanged in urine
d) Bile plays no role in drug excretion
Answer: b) Renal function is the primary determinant of drug excretion
Rationale: The kidneys are the main route for drug elimination, especially water-soluble drugs.
- Which medication characteristic promotes rapid absorption?
a) High molecular weight
b) Poor lipid solubility
c) Large surface area of absorption site
d) Low concentration gradient
Answer: c) Large surface area of absorption site
Rationale: A larger surface area increases drug absorption, as seen in the small intestine.
- Which process describes the movement of a drug from the liver into the bile and back to the intestine?
a) Enterohepatic recycling
b) First-pass effect
c) Hepatic clearance
d) Renal filtration
Answer: a) Enterohepatic recycling
Rationale: Some drugs are excreted into bile and reabsorbed from the intestine, prolonging their effect.
- How does the pH of urine affect drug excretion?
a) Acidic urine enhances elimination of acidic drugs
b) Basic urine enhances excretion of acidic drugs
c) Urine pH has no effect on drug excretion
d) Neutral urine increases drug clearance
Answer: b) Basic urine enhances excretion of acidic drugs
Rationale: Urine pH can alter drug solubility, affecting how quickly they are eliminated.
- A patient with liver disease is prescribed a medication. What should the nurse monitor closely?
a) Reduced heart rate
b) Signs of toxicity
c) Faster drug metabolism
d) Increased renal excretion
Answer: b) Signs of toxicity
Rationale: Liver disease impairs drug metabolism, increasing the risk of drug accumulation and toxicity.
- Which term describes the time it takes for a drug to reach its maximum concentration in the blood?
a) Half-life
b) Onset
c) Peak
d) Duration
Answer: c) Peak
Rationale: Peak time refers to when the highest concentration of the drug is achieved in the bloodstream.
- What is the intended, desired effect of a medication called?
a) Adverse effect
b) Therapeutic effect
c) Side effect
d) Toxic effect
Answer: b) Therapeutic effect
Rationale: The therapeutic effect is the intended, positive outcome the drug is meant to achieve.
- A patient develops hives and shortness of breath after taking an antibiotic. What type of reaction is this?
a) Side effect
b) Toxic reaction
c) Allergic reaction
d) Synergistic effect
Answer: c) Allergic reaction
Rationale: Allergic reactions involve the immune system responding to a medication, sometimes severely.
- Which of the following describes a predictable but often unpleasant drug effect?
a) Therapeutic effect
b) Side effect
c) Adverse effect
d) Synergistic effect
Answer: b) Side effect
Rationale: Side effects are expected, minor reactions to medications, such as nausea or dizziness.
- What term refers to two medications enhancing each other’s effects when taken together?
a) Antagonistic effect
b) Synergistic effect
c) Adverse effect
d) Cumulative effect
Answer: b) Synergistic effect
Rationale: Synergistic effects occur when two drugs increase each other’s effectiveness beyond what either could achieve alone.
