NCLEX - Week 5 Flashcards
A nurse is preparing to administer a medication to a patient. Which of the following actions by the nurse is considered the first check of medication administration?
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(a) Comparing the medication label with the MAR before preparing the medication
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(b) Checking the patient’s ID band before administering the medication
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(c) Asking the patient to state their name and date of birth
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(d) Checking the medication label again at the bedside before administering it
(a) Comparing the medication label with the MAR before preparing the medication
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Rationale:
The first check involves comparing the medication label to the MAR before preparing the medication.
This helps ensure that the correct medication, dose, route, and time are selected before any preparation takes place.
A nurse receives a verbal prescription from a healthcare provider. What is the most appropriate action for the nurse to take?
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(a) Administer the medication as prescribed.
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(b) Ask another nurse to verify the prescription.
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(c) Write down the prescription, read it back to the provider, and obtain the provider’s signature.
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(d) Refuse to take the verbal prescription.
(c) Write down the prescription, read it back to the provider, and obtain the provider’s signature.
Rationale:
To minimize errors, verbal orders should be written down, read back to the prescriber for verification, and signed by the prescriber as soon as possible, typically within 24 hours or according to agency policy.
This helps ensure the accuracy and completeness of the prescription.
Which of the following medications is classified as a Schedule II controlled substance according to the U.S. Drug Enforcement Agency (DEA)?
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(a) Robitussin AC with hydrocodone and atropine sulfate
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(b) Morphine sulfate
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(c) Diazepam
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(d) Ibuprofen
(b) Morphine sulfate
Rationale:
Morphine sulfate is an opioid analgesic and is classified as a Schedule II drug due to its high potential for abuse and dependence.
A patient is receiving a medication that has a half-life of 4 hours. If the initial dose was 100 mg, how much medication will remain in the patient’s body after 8 hours?
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(a) 100 mg
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(b) 75 mg
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(c) 50 mg
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(d) 25 mg
(d) 25 mg
Rationale:
The half-life of a drug is the time it takes for half of the drug to be eliminated from the body.
After 4 hours (one half-life), 50 mg would remain.
After another 4 hours (a total of 8 hours or two half-lives), 25 mg would remain.
Which of the following routes of medication administration will result in the fastest onset of action?
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(a) Oral
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(b) Intramuscular
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(c) Subcutaneous
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(d) Intravenous
(d) Intravenous
Rationale:
Intravenous administration delivers the medication directly into the bloodstream, bypassing absorption barriers and resulting in the fastest onset of action.
Other routes, such as oral, intramuscular, and subcutaneous, involve slower absorption processes.
A nurse is administering an enteric-coated tablet to a patient. Which of the following actions by the nurse is appropriate?
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(a) Crush the tablet and mix it with applesauce.
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(b) Dissolve the tablet in water before administering.
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(c) Break the tablet in half to make it easier to swallow.
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(d) Administer the tablet whole with a full glass of water.
(d) Administer the tablet whole with a full glass of water.
Rationale:
Enteric-coated tablets are designed to dissolve in the small intestine, not the stomach.
Crushing, dissolving, or breaking the tablet would disrupt the protective coating and could lead to gastric irritation or altered drug absorption.
The tablet should be swallowed whole.
A nurse is preparing to administer an intramuscular injection to an adult patient. Which of the following sites is the preferred location for this injection?
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(a) Deltoid
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(b) Ventrogluteal
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(c) Dorsogluteal
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(d) Vastus lateralis
(b) Ventrogluteal
Rationale:
The ventrogluteal site is considered the safest and most preferred site for intramuscular injections in adults.
It offers a large muscle mass, is free of major nerves and blood vessels, and is associated with less pain and fewer complications.
A patient is receiving a medication that is known to cause orthostatic hypotension. Which of the following instructions should the nurse provide to the patient?
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(a) “Take this medication with food.”
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(b) “Rise slowly from a lying or sitting position.”
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(c) “Avoid driving or operating machinery after taking this medication.”
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(d) “Report any signs of dizziness or lightheadedness to your doctor immediately.”
(b) “Rise slowly from a lying or sitting position.”
Rationale:
Orthostatic hypotension is a drop in blood pressure upon standing, leading to dizziness and lightheadedness.
Patients should be instructed to change positions slowly to allow their bodies to adjust and minimize the risk of falls.
A nurse is administering a sublingual medication to a patient. Which of the following actions by the nurse is appropriate?
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(a) Place the medication on the patient’s tongue and encourage the patient to swallow immediately.
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(b) Crush the medication and mix it with a small amount of food or liquid.
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(c) Place the medication under the patient’s tongue and instruct the patient to allow it to dissolve completely.
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(d) Administer the medication with a full glass of water to help with absorption.
(c) Place the medication under the patient’s tongue and instruct the patient to allow it to dissolve completely.
Rationale:
Sublingual medications are designed to be absorbed through the mucous membranes under the tongue.
Placing the medication under the tongue allows for rapid absorption into the bloodstream, bypassing the digestive system.
Which of the following is an example of a medication error?
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(a) Administering a medication 15 minutes before the scheduled time
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(b) Failing to report a patient’s allergy to a medication before administering it
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(c) Administering a medication through a different route than prescribed
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(d) Giving a patient a medication they refuse
(b) Failing to report a patient’s allergy to a medication before administering it
Rationale:
Failing to assess and document a patient’s allergies before administering medication is a serious medication error that could have significant consequences.
A nurse is preparing to administer a medication through a nasogastric (NG) tube. Which of the following actions should the nurse take first?
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(a) Crush the medication and mix it with water.
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(b) Flush the NG tube with 30 mL of water.
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(c) Verify the placement of the NG tube.
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(d) Elevate the head of the bed to 30 degrees.
(c) Verify the placement of the NG tube.
Rationale:
Before administering any medication through an NG tube, it’s crucial to verify that the tube is correctly placed in the stomach to prevent aspiration.
Which of the following statements by a patient indicates an understanding of how to take an extended-release medication?
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(a) “I can crush the tablet if I have difficulty swallowing it.”
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(b) “I should take this medication on an empty stomach for better absorption.”
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(c) “I should swallow the tablet whole and not chew or crush it.”
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(d) “I can take this medication more frequently if my symptoms worsen.”
(c) “I should swallow the tablet whole and not chew or crush it.”
Rationale:
Extended-release medications are formulated to release medication slowly over time.
Crushing or chewing the tablet would disrupt this mechanism and could lead to a rapid release of medication, potentially causing adverse effects.
A nurse is educating a patient about the importance of adhering to their prescribed medication regimen. Which of the following statements by the patient indicates a need for further teaching?
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(a) “I should take my medications at the same time each day.”
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(b) “I should let my doctor know if I experience any side effects.”
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(c) “It’s okay to stop taking my medication once I start feeling better.”
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(d) “I should keep my medications stored in a safe place, away from children.”
c) “It’s okay to stop taking my medication once I start feeling better.”
Rationale:
Stopping medication prematurely without consulting a healthcare provider can lead to relapse or worsening of the condition. Patients should be advised to complete the full course of treatment as prescribed, even if they feel better
A nurse is caring for a patient who is experiencing an allergic reaction to a medication. Which of the following actions should the nurse take first?
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(a) Notify the healthcare provider.
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(b) Administer epinephrine as prescribed.
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(c) Document the allergic reaction in the patient’s medical record.
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(d) Stop the administration of the medication
(d) Stop the administration of the medication
Rationale:
The priority action when a patient exhibits an allergic reaction is to stop the medication immediately.
This prevents further exposure to the allergen and limits the severity of the reaction.
Which of the following is a benefit of using a barcode medication administration (BCMA) system?
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(a) Reduces the need for patient education about medications
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(b) Helps to prevent medication errors by verifying the patient’s identity and the medication being administered
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(c) Eliminates the need for nurses to check medication labels
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(d) Increases the cost of medication administration
(b) Helps to prevent medication errors by verifying the patient’s identity and the medication being administered
Rationale:
BCMA systems use barcode scanning to verify the patient’s identity and the medication being given, enhancing accuracy and reducing medication errors.
A nurse is reviewing a patient’s medication list and notices that the patient is prescribed two medications that have a potential drug interaction. What is the most appropriate action for the nurse to take?
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(a) Administer the medications as prescribed and monitor the patient for adverse effects.
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(b) Notify the healthcare provider of the potential interaction and clarify the prescription.
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(c) Ask the pharmacist to adjust the dosages of the medications.
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(d) Hold both medications until further clarification is received from the provider.
(b) Notify the healthcare provider of the potential interaction and clarify the prescription.
Rationale:
The nurse has a responsibility to identify and address potential drug interactions. Notifying the healthcare provider allows for evaluation of the risks and benefits, potential adjustments to the prescriptions, or alternative medication choices.
A nurse is teaching a patient about the side effects of a new medication. The patient states, “I won’t experience any side effects because I’m healthy.” What is the nurse’s best response?
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(a) “That’s right, healthy people rarely experience side effects from medications.”
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(b) “All medications have the potential to cause side effects, even in healthy individuals.”
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(c) “You’re right, side effects are more common in older adults.”
(b) “All medications have the potential to cause side effects, even in healthy individuals.”
Rationale: It’s important to emphasize that any medication can cause side effects, regardless of a person’s overall health.
A nurse is administering a medication that is highly protein-bound. The patient has a low serum albumin level. What effect might this have on the medication’s action?
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(a) Decreased therapeutic effect
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(b) Increased risk of allergic reaction
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(c) Increased risk of toxicity
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(d) Delayed onset of action
(c) Increased risk of toxicity
Rationale:
Medications bind to proteins in the blood, such as albumin. When protein levels are low, there are fewer binding sites available, leading to a higher concentration of free, unbound drug in the bloodstream.
This can increase the risk of adverse effects and toxicity.
A patient is being discharged home on a new medication. What is the most important information for the nurse to include in the discharge teaching?
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(a) The cost of the medication
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(b) The chemical composition of the medication
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(c) The name, dosage, route, and frequency of administration, as well as potential side effects and when to report them
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(d) The history of the development of the medication
c) The name, dosage, route, and frequency of administration, as well as potential side effects and when to report them
Rationale:
Clear and comprehensive instructions regarding medication administration and potential side effects are crucial for patient safety and medication adherence at home.
A nurse is preparing to administer a medication to a pediatric patient. Which of the following factors is most important for the nurse to consider when determining the appropriate dosage?
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(a) The patient’s height
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(b) The patient’s weight
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(c) The patient’s developmental level
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(d) The patient’s preference for liquid or tablet medications
(b) The patient’s weight
Rationale:
Weight-based dosing is crucial for pediatric patients to ensure they receive safe and effective doses of medication.
Their bodies handle medications differently than adults, and dosages need to be adjusted to their smaller size and metabolic differences.
A nurse is caring for an older adult patient who is taking multiple medications. Which of the following interventions is most important to prevent adverse drug effects in this patient?
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(a) Encourage the patient to take their medications with meals.
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(b) Regularly review the patient’s medication list for potential drug interactions and adjust dosages as needed.
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(c) Advise the patient to avoid taking over-the-counter medications.
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(d) Instruct the patient to keep a detailed log of all medications taken.
(b) Regularly review the patient’s medication list for potential drug interactions and adjust dosages as needed.
Rationale:
Older adults are more susceptible to adverse drug effects due to age-related physiological changes.
Polypharmacy increases the risk of interactions.
Regular medication reviews are essential to ensure safety
Which of the following is a strategy for promoting patient adherence to a medication regimen?
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(a) Providing the patient with a detailed explanation of the medication’s chemical structure
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(b) Threatening the patient with negative consequences if they don’t take their medications as prescribed
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(c) Making assumptions about the patient’s understanding of their medications and treatment plan
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(d) Encouraging the patient to ask questions and express any concerns about their medications
(d) Encouraging the patient to ask questions and express any concerns about their medications
Rationale:
Open communication and addressing patient concerns directly can improve adherence.
Patients are more likely to follow treatment plans they understand and feel comfortable with
A patient refuses to take a prescribed medication. What is the nurse’s initial action?
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(a) Document the refusal and notify the healthcare provider.
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(b) Try to persuade the patient to take the medication by explaining its benefits.
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(c) Explore the patient’s reasons for refusing the medication.
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(d) Administer the medication anyway because it is in the patient’s best interest.
(c) Explore the patient’s reasons for refusing the medication.
Rationale:
Understanding the patient’s perspective and reasons for refusal is essential before taking further action.
It allows for respectful communication and potential education or addressing misconceptions.
A nurse is administering a medication that is known to be nephrotoxic. Which of the following laboratory values should the nurse monitor closely?
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(a) Liver function tests
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(b) Serum creatinine and blood urea nitrogen (BUN)
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(c) Complete blood count (CBC)
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(d) Electrolyte levels
(b) Serum creatinine and blood urea nitrogen (BUN)
Rationale:
Nephrotoxic drugs can damage the kidneys.
Monitoring creatinine and BUN levels helps assess kidney function and detect potential toxicity early
A nurse is caring for a patient who is receiving a continuous intravenous infusion of a medication. The patient reports pain and redness at the IV site. What is the nurse’s priority action?
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(a) Slow the infusion rate.
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(b) Stop the infusion and assess the IV site.
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(c) Apply a warm compress to the IV site.
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(d) Notify the healthcare provider.
(b) Stop the infusion and assess the IV site.
Rationale:
Pain and redness at the IV site suggest phlebitis or infiltration.
Stopping the infusion prevents further irritation or potential complications.
The site needs to be assessed to determine the appropriate course of action.
