QBV Medication Administration

Question 1

What factor can most significantly impact the absorption of an oral medication?
A. The route of administration
B. The pH of the medication
C. The lipid solubility of the medication
D. The blood flow to the absorptive site

Answer 1

Answer: D. The blood flow to the absorptive site

Rationale: Higher blood flow to the absorption site increases the rate at which a medication is absorbed. While factors like pH and lipid solubility are also important, they don’t directly impact absorption speed as significantly as blood flow.

Question 2

Which of the following routes of administration provides the fastest rate of absorption?
A. Oral
B. Subcutaneous
C. Intramuscular
D. Intravenous

Answer 2

Answer: D. Intravenous

Rationale: Intravenous administration delivers the medication directly into the circulatory system, bypassing absorption barriers, making it the fastest route for absorption.

Question 3

Why are oral medications often designed to be absorbed in the small intestine rather than the stomach?

A. Because the stomach has a smaller surface area
B. Because the stomach is too acidic
C. Because the small intestine has a larger surface area and is more alkaline
D. Because oral medications can’t be absorbed in the stomach

Answer 3

Answer: C. Because the small intestine has a larger surface area and is more alkaline

Rationale: The small intestine’s larger surface area and its alkaline environment allow for more efficient absorption, particularly for weak bases.

Question 4

What is the main concern when administering oral medication to a patient with diarrhea?
A. Slower dissolution of the drug
B. Reduced medication absorption
C. Risk of drug toxicity
D. Increased dissolution time

Answer 4

Answer: B. Reduced medication absorption

Rationale: Diarrhea can decrease the time the drug spends in the intestines, reducing absorption.

Question 5

A nurse administers aspirin to a client. In which environment is aspirin more rapidly absorbed?
A. The stomach
B. The small intestine
C. The large intestine
D. The liver

Answer 5

Answer: A. The stomach
Rationale: Aspirin, being non-ionized in an acidic environment, is absorbed more rapidly in the stomach than in the alkaline small intestine.

Question 6

What is the first step in pharmacokinetics after administering a medication?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion

Answer 6

Answer: A. Absorption

Rationale: Absorption refers to the movement of medication from the site of administration into the circulatory system, which is the first step in pharmacokinetics.

Question 7

The nurse notes that a client vomited shortly after receiving an oral medication. What should be the nurse’s first action?
A. Notify the provider
B. Inspect the vomitus for presence of medication
C. Document the incident
D. Administer the dose again

Answer 7

Answer: B. Inspect the vomitus for presence of medication

Rationale: The first step should be to determine whether the medication was expelled. This will guide the next steps, such as notifying the provider or redosing.

Question 8

The process by which a medication is chemically changed, often in the liver, is known as:
A. Absorption
B. Distribution
C. Metabolism
D. Excretion

Answer 8

Answer: C. Metabolism

Rationale: Metabolism involves the chemical alteration of a drug, primarily in the liver, preparing it for excretion or changing its activity.

Question 9

Which patient factor is most likely to influence medication distribution?
A. Age
B. Protein-binding ability
C. Route of administration
D. Blood–brain barrier permeability

Answer 9

Answer: B. Protein-binding ability

Rationale: Protein-binding influences the amount of free, active drug available for distribution. Medications bound to proteins are not available to cross membranes and exert effects.

Question 10

Which of the following is responsible for the first-pass effect?
A. Kidneys
B. Small intestine
C. Liver
D. Heart

Answer 10

Answer: C. Liver

Rationale: The first-pass effect occurs when an orally administered drug is significantly metabolized by the liver before it reaches systemic circulation, reducing its bioavailability.

Question 11

In patients with decreased renal function, what is the primary concern regarding medication administration?
A. Increased absorption
B. Decreased metabolism
C. Delayed excretion
D. Enhanced protein binding

Answer 11

Answer: C. Delayed excretion

Rationale: Decreased renal function leads to slower excretion of drugs, raising the risk of medication toxicity.

Question 12

Why should a nurse be cautious when administering medication to an elderly client with impaired liver function?
A. They may experience faster metabolism
B. The drug’s half-life will be prolonged
C. They are more likely to vomit the medication
D. They will absorb the medication more quickly

Answer 12

Answer: B. The drug’s half-life will be prolonged

Rationale: Impaired liver function slows metabolism, which can lead to prolonged drug effects and an increased risk of toxicity due to delayed excretion.

Question 13

When a medication has a narrow therapeutic range, what should the nurse be most vigilant about?
A. Monitoring peak and trough levels
B. Administering with food
C. Giving it only via IV
D. Avoiding drug-drug interactions

Answer 13

Answer: A. Monitoring peak and trough levels

Rationale: Drugs with a narrow therapeutic range require precise dosing, and monitoring peak and trough levels ensures the medication remains effective without reaching toxic levels.

Question 14

Which of the following best describes an agonist?
A. A drug that binds to a receptor and activates it
B. A drug that prevents a receptor from being activated
C. A drug that only affects ion channels
D. A drug that only affects the kidneys

Answer 14

A. A drug that binds to a receptor and activates it
Rationale: Agonists activate receptors to produce a physiological response, while antagonists block receptor activation.

Question 15

What is a serious adverse drug event (ADE)?
A. A mild rash after medication administration
B. A life-threatening reaction that requires intervention
C. A drug-drug interaction that decreases the therapeutic effect
D. A side effect that leads to minor discomfort

Answer 15

B. A life-threatening reaction that requires intervention
Rationale: Serious ADEs are life-threatening and require immediate medical intervention to prevent further harm or death.

Question 16

A nurse administers a medication that undergoes significant first-pass metabolism. Which route would be most appropriate to bypass this effect?
A. Oral
B. Intramuscular
C. Sublingual
D. Rectal

Answer 16

C. Sublingual

Rationale: Sublingual medications bypass the liver and avoid the first-pass effect, leading to more rapid systemic absorption.

Question 17

What is the half-life of a drug?
A. The time it takes for a drug to be absorbed
B. The time it takes for the drug concentration to decrease by 50%
C. The duration of time a drug remains effective
D. The time it takes for the drug to peak in concentration

Answer 17

B. The time it takes for the drug concentration to decrease by 50%

Rationale: A drug’s half-life is the time required for its plasma concentration to be reduced by half, influencing dosing intervals.

Question 18

Anaphylaxis is best defined as:
A. A mild allergic reaction
B. A severe, life-threatening allergic reaction
C. A reaction that only affects the skin
D. An adverse reaction that resolves on its own

Answer 18

B. A severe, life-threatening allergic reaction

Rationale: Anaphylaxis is a potentially fatal allergic reaction, characterized by respiratory distress and cardiovascular collapse, requiring immediate intervention.

Question 19

What action should a nurse take when a patient reports an herbal supplement while on prescription medication?
A. Ignore the supplement as it has no effects on medications
B. Educate the patient on potential drug-herbal interactions
C. Discontinue the prescription medication
D. Disregard the supplement unless it’s a vitamin

Answer 19

B. Educate the patient on potential drug-herbal interactions

Rationale: Herbal supplements can interact with prescription medications, potentially enhancing or diminishing their effects, so patient education is crucial.

Question 20

What is a black box warning on a medication label?

A. A sign that the medication is ineffective
B. A warning that the medication has potential lethal side effects
C. A routine label for all medications
D. A notice that the medication should only be used in emergencies

Answer 20

B. A warning that the medication has potential lethal side effects

Rationale: A black box warning alerts healthcare providers to serious or life-threatening risks associated with the use of a medication.

Question 21

A nurse is preparing to administer a prescribed medication to a 70-year-old client. Which factor should the nurse prioritize to prevent medication errors in this population?
a) Client’s nutritional status
b) Client’s age-related physiological changes
c) Client’s gender
d) Client’s body mass index (BMI)

Answer 21

b) Client’s age-related physiological changes

Rationale: Older adults experience age-related changes that affect the metabolism, absorption, and excretion of medications. Decreased liver, heart, and kidney functions can alter how medications are processed, leading to increased risk of toxicity. This population is also more prone to adverse drug reactions due to polypharmacy. Age-related physiological changes are a critical consideration in preventing medication errors in this group.

Question 22

A pregnant client at 8 weeks of gestation asks the nurse if she can take over-the-counter cold medicine. What is the most appropriate response by the nurse?
a) “It’s safe to take any cold medicine in the first trimester.”
b) “Check with your health care provider before taking any medication.”
c) “Avoid all medications during pregnancy to prevent harm to your baby.”
d) “Only use natural remedies during pregnancy.”

Answer 22

b) “Check with your health care provider before taking any medication.”

Rationale: Although some medications are safe during pregnancy, others can be harmful, particularly during the first trimester when organogenesis occurs. The health care provider needs to assess the risks and benefits of the medication based on the client’s health condition and gestational age. It is essential for the nurse to avoid giving blanket recommendations without provider consultation.

Question 23

The nurse is caring for a 2-year-old client. When administering medications, the nurse calculates the dose based on the client’s weight in kilograms. Why is this necessary in pediatric clients?
a) Pediatric clients have a higher body surface area.
b) Pediatric clients have a higher rate of metabolism.
c) Pediatric clients have faster renal clearance.
d) Pediatric clients have stronger muscle mass.

Answer 23

b) Pediatric clients have a higher rate of metabolism.

Rationale: Pediatric clients often require higher doses of medications per kilogram of weight due to their faster metabolic rate. Additionally, their organs, such as the liver and kidneys, are still maturing, affecting the processing of medications. Weight-based dosing helps prevent underdosing or overdosing in this vulnerable population.

Question 24

A nurse is about to administer a medication labeled for another client but realizes the label contains the correct drug and dosage as prescribed. What should the nurse do next?
a) Administer the medication as it is correct.
b) Notify the provider of the error.
c) Collaborate with the pharmacist for correction.
d) Ask the client if they have taken the medication before.

Answer 24

C) Collaborate with the pharmacist for correction.

Rationale: Administering a medication that is labeled for another client violates the “right client” of medication administration and can lead to serious errors. It is critical to ensure the medication is correctly labeled for the intended client. The pharmacist should be contacted to correct the error before administration.

Question 25

A nurse is assessing a client before administering warfarin. Which laboratory values should the nurse prioritize to ensure the medication is safe to give?
a) White blood cell count (WBC)
b) Platelet count
c) Prothrombin time (PT) and international normalized ratio (INR)
d) Hemoglobin (Hb) and hematocrit (Hct)

Answer 25

C) Prothrombin time (PT) and international normalized ratio (INR)

Rationale: Warfarin affects blood clotting by prolonging PT and INR. Monitoring these values helps to assess whether the dose is therapeutic or needs adjustment. The goal is to prevent bleeding complications without risking clot formation. While hemoglobin and hematocrit levels may indicate active bleeding, PT and INR provide direct evidence of warfarin’s anticoagulation effect.

Question 26

An older adult client is taking five different medications for various health conditions. Which term best describes the use of multiple medications in this client?
a) Polypharmacy
b) Adverse drug event
c) Contraindication
d) Drug interaction

Answer 26

a) Polypharmacy

Rationale: Polypharmacy is defined as the use of five or more medications in a client, typically seen in older adults with multiple comorbidities. This increases the risk of drug interactions and adverse drug events due to the body’s decreased ability to metabolize and excrete medications as efficiently with age.

Question 27

A client receiving morphine asks why they need to avoid alcohol. What is the most appropriate explanation by the nurse?
a) “Alcohol can increase your risk of liver damage.”
b) “Alcohol can cross the fetal-placental barrier and harm the fetus.”
c) “Alcohol may interact with morphine, increasing the risk of respiratory depression.”
d) “Alcohol will cause the medication to lose its effect.”

Answer 27

c) “Alcohol may interact with morphine, increasing the risk of respiratory depression.”

Rationale: Alcohol can potentiate the effects of CNS depressants like morphine, leading to increased risk of respiratory depression, sedation, and overdose. It is crucial for clients taking opioids to avoid alcohol to prevent these potentially life-threatening interactions.

Question 28

Which statement by a nurse demonstrates a correct understanding of teratogenic substances?
a) “Only prescription medications can be teratogenic.”
b) “Herbal supplements are always safe during pregnancy.”
c) “Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered teratogenic.”
d) “ACE inhibitors are safe for use in pregnancy.”

Answer 28

c) “Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered teratogenic.”

Rationale: NSAIDs, along with other medications like ACE inhibitors, can be teratogenic and should be avoided during pregnancy unless the benefits outweigh the risks. These drugs can cause fetal harm, such as developmental abnormalities, when used during critical periods of fetal development.

Question 29

The nurse is administering insulin to a diabetic client before breakfast. The client refuses the medication. What should the nurse do next?
a) Document the refusal and do nothing further.
b) Administer the insulin after breakfast.
c) Educate the client on the importance of insulin and document the refusal.
d) Contact the provider immediately.

Answer 29

c) Educate the client on the importance of insulin and document the refusal.

Rationale: While clients have the right to refuse medications, it is important for the nurse to educate them on the consequences of such actions, especially in cases where medication is crucial to their condition. The nurse should document the refusal and the education provided in the client’s chart.

Question 30

What is the importance of the “right route” in medication administration?
a) It ensures the medication has no adverse effects.
b) It prevents medication interactions.
c) It determines how quickly the medication takes effect.
d) It guarantees that the medication is eliminated properly.

Answer 30

c) It determines how quickly the medication takes effect.

Rationale: The route of administration affects the absorption rate and onset of action of the medication. For example, intravenous medications act more quickly than oral medications. Administering a drug via the correct route ensures it has the intended therapeutic effect within the expected time frame.

Question 31

A 65-year-old client with hypertension is prescribed metoprolol. During the assessment, the nurse notes that the client has gained significant weight, has reduced muscle mass, and increased body fat. How should the nurse anticipate these changes to affect the drug therapy?

a) The medication will work more efficiently due to fat absorption.

b) The medication will likely have reduced efficacy due to storage in adipose tissue.

c) There is no effect; the drug will be metabolized normally.

d) The client may need a higher dose to reach therapeutic levels.

Answer 31

Rationale: As clients age, increased body fat can reduce the efficacy of certain medications because drugs may be stored in fat, reducing plasma levels and therapeutic effect

(b). Nurses should monitor older adults for signs of drug accumulation and potential toxicity.

Question 32

A pregnant client is 12 weeks along and is prescribed a new medication. Which factor should the nurse prioritize when evaluating the safety of the drug?

a) The potential teratogenicity of the medication.

b) The client’s current symptoms.

c) The client’s age and weight.

d) The possibility of polypharmacy.

Answer 32

Rationale: During pregnancy, the most critical concern is the teratogenic potential of a drug, especially in the first trimester when organ development is taking place (a). Teratogens can cause fetal defects, pregnancy loss, or developmental disabilities.

Question 33

A client refuses their prescribed medication, citing concerns about potential side effects. What is the nurse’s best course of action?

a) Document the refusal in the medical record and notify the provider.

b) Insist that the client take the medication for their own safety.

c) Educate the client on the importance of the medication and re-administer later.

d) Ask the client’s family to convince them to take the medication.

Answer 33

Rationale: The nurse must respect the client’s right to refuse any medication, document the refusal, and notify the provider
(a). However, it’s also essential to explore the reasons for refusal and provide education to address any misconceptions or fears the client may have.

Question 34

A. client with renal failure is prescribed a drug that is excreted primarily through the kidneys. What should the nurse anticipate regarding this client’s medication dosing?

a) The medication dose will need to be increased.

b) The medication may have a delayed onset of action.

c) The dose may need to be decreased to prevent toxicity.

d) No changes to the medication dosing will be required.

Answer 34

Rationale: Clients with renal failure may not effectively excrete medications, leading to drug accumulation and toxicity. Therefore, the dose may need to be decreased (c) and the client closely monitored for signs of adverse effects.

Question 35

A pediatric client weighing 15 kg is prescribed an antibiotic dosed at 10 mg/kg. The available suspension is 50 mg/mL. How much of the suspension should the nurse administer?

a) 3 mL

b) 2.5 mL

c) 1.5 mL

d) 1 mL

Answer 35

Rationale: The total dose for the child is calculated by multiplying the weight (15 kg) by the dosage (10 mg/kg), which equals 150 mg. To determine the volume, divide the total dose (150 mg) by the concentration (50 mg/mL), which equals 3 mL (a).

Question 36

What is pharmacokinetics?

Answer 36

The study of the absorption, distribution, metabolism, and excretion (ADME) of medications in the human body.

Question 37

What is ionization?

Answer 37

The pH of the medication and the site of absorption.

Question 38

What is dissolution?

Answer 38

The medication must be dissolved before absorption takes place.

Question 39

WHat is toxicity?

Answer 39

An adverse effect in which the body is unable to metabolize or excrete a medication

Question 40

What are prodrugs?

Answer 40

Drugs that Contain inactive chemicals that are activated through metabolism to exert their therapeutic effects.

Question 41

What are therapeutic effects?

Answer 41

The desired effects of a medication.

Question 42

What is the first-pass effect?

Answer 42

The passage of oral medications from the small intestine to the hepatic circulation via the mesenteric and portal veins flowing into the liver, before reaching systemic circulation.

Question 43

What is pharmacodynamics?

Answer 43

The study of how a drug works, its relationship to drug concentrations, and how the body responds.

Question 44

What is a therapeutic range?

Answer 44

A method used by health care providers to monitor drug concentrations to determine therapeutic dose and avoid toxicity.

Question 45

What is therapeutic drug monitoring (TDM)?

Answer 45

Method used by health care providers to monitor drug level concentrations.

Question 46

peak blood level

Answer 46

Highest level of a drug in the bloodstream without being at a toxic level.

Question 47

trough blood level

Answer 47

Lowest concentration of a medication in the systemic circulation.

Question 48

adverse drug reactions (ADR)

Answer 48

Unwanted and non-therapeutic effects of the medication. They can range from mild to severe.

Question 49

iatrogenic

Answer 49

An unforeseeable or unintended physical condition, injury, or disorder caused by a treatment or procedure.

Question 50

Allergic reaction

Answer 50

A reaction resulting from a hypersensitivity to an antigen or foreign substance, such as a medication

Question 51

drug–drug interactions

Answer 51

The effect that two or more drugs that the client is administered have on each other (ex. enhance actions or block actions, increase or decrease ADR etc).

Question 52

drug–food interactions

Answer 52

Effects of nutrients on the absorption, distribution, metabolism or excretion of medications.

Question 53

teratogenic

Answer 53

Medications that can cause fetal defects, pregnancy loss, prematurity or developmental disabilities.

Question 54

A nurse is reviewing a prescription for a patient. Which of the following components is missing in the prescription:
Alice Sample, 10/12/2020, Tylenol 650 mg every 6 hours for pain?

a) Route of administration
b) Medication dose
c) Frequency
d) Indication for use

Answer 54

Rationale: The route of administration (e.g., oral, intravenous) is missing from the prescription. Every prescription should include the client’s name, medication, dosage, route, frequency, and provider’s signature.

Question 55

What should the nurse do if a medication alert is triggered when scanning a client’s medication using the barcode system?
a) Override the alert and administer the medication
b) Administer the medication immediately and report the alert later
c) Investigate the alert and resolve the discrepancy before administration
d) Notify the physician and delay the administration until cleared

Answer 55

Rationale: Nurses should never ignore or override alerts unless it’s an emergency. Investigating and resolving discrepancies help prevent medication errors (c).

Question 56

When using an automated medication dispensing system (AMDS), a nurse should be aware of which safety feature?
a) It always dispenses the correct medication
b) It links medication administration to the client’s electronic record
c) It prevents the need for barcode scanning
d) It requires no pharmacist review for medication dispensing

Answer 56

Rationale: The AMDS helps ensure the right medication is dispensed and links the nurse’s actions to the client’s electronic record. Pharmacist review is still required before medication administration (b).

Question 57

Which of the following is NOT a strategy to reduce interruptions during medication preparation?
a) Using labeled areas for medication preparation
b) Decreasing the use of cell phones during preparation
c) Wearing noise-canceling headphones
d) Educating staff not to interrupt during the process unless urgent

Answer 57

Rationale: Wearing noise-canceling headphones is not a recommended strategy. Labeled areas, limiting distractions, and educating staff to avoid unnecessary interruptions are effective measures (c).

Question 58

Which of the following scenarios represents a potential medication error?
a) The nurse administers a medication 10 minutes after the scheduled time
b) The nurse administers a medication without verifying allergies
c) The nurse documents administration 5 minutes after giving the medication
d) The nurse gives a medication after double-checking with a second nurse

Answer 58

Rationale: Administering a medication without verifying allergies is a serious risk that can lead to adverse drug events (b).

Question 59

A nurse receives a prescription for “Insulin 10 units SC.” What additional action should the nurse take before administering this high-alert medication?
a) Ask the client to verify the insulin dose
b) Administer the insulin immediately
c) Ask another nurse to double-check the insulin dose
d) Perform a blood glucose test and administer without further checks

Answer 59

Rationale: Insulin is a high-alert medication, requiring an independent double-check by a second nurse to verify the right dose and client (c).

Question 60

A client’s medication is prescribed as “Indomethacin 50 mg by mouth every 12 hours for osteoarthritis.” Which part of the prescription aligns with the right route?
a) 50 mg
b) By mouth
c) Every 12 hours
d) For osteoarthritis

Answer 60

Rationale: “By mouth” indicates the correct route of administration (b).

Question 61

During medication reconciliation, the nurse should focus on which of the following to reduce polypharmacy?
a) Discontinuing all over-the-counter (OTC) medications
b) Reviewing and updating the client’s current medication list
c) Administering all medications as prescribed without question
d) Removing all herbal supplements from the client’s medication list

Answer 61

Rationale: Medication reconciliation involves reviewing, updating, and addressing potential drug interactions, including OTC and herbal medications (b).

Question 62

The nurse is preparing to administer a new medication. Which of the following actions is critical to prevent medication errors?
a) Giving the medication as soon as it arrives
b) Skipping the check if the pharmacy sends the medication
c) Comparing the medication label against the MAR three times
d) Trusting the pharmacy and administering without checking

Answer 62

Rationale: Checking the medication label against the MAR three times ensures that the right medication, dose, and route are given (c).

Question 63

A nurse leaves medications at a client’s bedside due to time constraints. Which medication safety principle is violated?
a) Right route
b) Right documentation
c) Right client
d) Right administration

Answer 63

Rationale: Medications should never be left at the bedside. This violates the right of administration as it allows for the possibility of the medication not being taken or being taken incorrectly (d).

Question 64

Which of the following actions should the nurse take after committing a medication error?
a) Complete an incident report and include it in the client’s chart
b) Assess the client for changes and notify the provider immediately
c) Avoid reporting the error to prevent legal consequences
d) Write a detailed explanation of the error in the client’s chart

Answer 64

Rationale: After a medication error, the nurse must assess the client for any harm, notify the provider, and complete an incident report. The report should not be part of the client’s medical record (b).

Question 65

What is the primary purpose of medication reconciliation?
a) Ensuring clients receive the correct brand of medications
b) Identifying and addressing discrepancies between new and current medications
c) Preventing client refusal of medications
d) Keeping track of medication costs during hospitalization

Answer 65

Rationale: Medication reconciliation ensures accuracy between newly prescribed and current medications, reducing the risk of errors and drug interactions (b).

Question 66

Which of the following represents a high-alert medication?
a) Ibuprofen
b) Insulin
c) Amoxicillin
d) Acetaminophen

Answer 66

Rationale: Insulin is a high-alert medication, meaning that errors in its administration carry a higher risk of serious harm (b).

Question 67

What role does the pharmacist play in preventing medication errors?
a) Administering medications to clients
b) Reviewing and verifying medication orders before administration
c) Supervising nurses during medication preparation
d) Scanning clients’ wristbands to confirm identity

Answer 67

Rationale: The pharmacist is responsible for reviewing and verifying medication orders to ensure accuracy and prevent errors (b).

Question 68

A nurse is interrupted while preparing medications. What is the most appropriate action?
a) Continue preparing the medications while addressing the interruption
b) Immediately stop medication preparation to attend to the interruption
c) Politely ask for no interruptions and resume after completing the task
d) Ignore the interruption entirely and proceed with the administration

Answer 68

Rationale: Interruptions increase the risk of medication errors. Nurses should minimize distractions during medication preparation by politely deferring interruptions (c).

Question 69

A nurse prepares a pediatric dose of a high-risk medication. What is the best way to ensure accurate dosing?
a) Use a calculator without double-checking
b) Have another nurse verify the calculation and dose
c) Trust the pharmacy to provide the correct dose
d) Administer half the dose as a precaution

Answer 69

Rationale: Double-checking with another nurse is essential for high-risk medications, especially for pediatric patients, where dosing errors can be serious (b).

Question 70

A client reports they are taking an OTC herbal supplement. Why is it important to document this during medication reconciliation?
a) Herbal supplements have no clinical significance
b) Supplements may interact with prescribed medications
c) The client should stop taking all supplements
d) It is unnecessary to consider OTC supplements

Answer 70

Rationale: Herbal supplements can interact with prescribed medications, and documenting them helps prevent adverse effects (b).

Question 71

Which strategy helps reduce medication errors when multiple alerts and warnings occur during dispensing?
a) Ignoring alerts if the nurse believes they are unnecessary
b) Resolving each alert and determining its cause before continuing
c) Turning off the alert system temporarily
d) Only responding to alerts from the pharmacy

Answer 71

Rationale: Each alert should be resolved and investigated to ensure the client’s safety and prevent potential errors (b)

Question 72

Which of the following medications is most associated with sound-alike errors?
a) Ibuprofen and acetaminophen
b) Heparin and Hespan
c) Penicillin and amoxicillin
d) Metformin and insulin

Answer 72

Rationale: Heparin and Hespan are known for sound-alike errors, making it crucial to clarify and confirm orders (b)

Question 73

What is the nurse’s responsibility if a medication error is identified before administration?
a) Administer the medication quickly to avoid missing the time frame
b) Report the error immediately to the provider before giving the medication
c) Notify the client that an error has occurred and give the medication
d) Correct the error silently without notifying anyone

Answer 73

Rationale: The nurse should report any errors or discrepancies immediately to the provider to prevent client harm (b).

Question 74

A nurse is caring for a group of clients. Which of the following clients should the nurse identify is at the greatest risk of developing medication toxicity?

-A client who has a respiratory infection
-A client who has rheumatoid arthritis
-A client who has impaired kidney function
-A client who has hyperthyroidism

Answer 74

-A client who has impaired kidney function

The nurse should identify that the client who has impaired kidney function is at the greatest risk for medication toxicity because many medications are excreted by the kidneys. A decrease in function of the kidneys can result in a buildup of medication metabolites.

Question 75

A nurse is preparing to administer an intradermal injection to a client. At which of the following degree angles should the nurse insert the needle?

-60 degree angle
-90 degree angle
-45 degree angle
-10 degree angle

Answer 75

-10 degree angle

The nurse should insert the needle at a 5 to 15 degree angle about 1/8 inch under the skin and observe for the tip of the needle, which would indicate that the needle is in the intradermal layer of the client’s skin.

Question 76

A nurse is planning to use the teach-back method to educate a client about a new antihypertensive medication. Which of the following should the nurse include to demonstrate this method?

-Provide the client with an internet link to research the medications
-Refer the client to the American Heart Association
-Give the client written education material about the medication
-Ask the client to explain the information using their own words

Answer 76

-Ask the client to explain the information using their own words

The teach-back method is a teaching approach in which the client repeats the instructions or information back to the nurse using their own words. This method allows the nurse to determine the client’s understanding of the information and whether further education is required.

Question 77

A nurse is providing discharge teaching to a client. Which of the following strategies should the nurse include?

-Use closed-ended questions
-Provide written material at a 9th-grade reading level
-Use passive listening skills
-Encourage the client to ask questions

Answer 77

-Encourage the client to ask questions

The nurse should encourage the client to ask questions to facilitate an active role in their own care and promote an understanding of the education.

Question 78

A nurse is assisting with teaching a client about self-administration of insulin. Which of the following actions should the nurse take?

-Repeat the least important information to the client
-Have the client perform a return demonstration of the procedure
-Provide the client with educational materials written at an 8th-grade reading level
-Dim the lights in the client’s room before beginning the teaching

Answer 78

-Have the client perform a return demonstration of the procedure

The nurse should have the client perform a return demonstration of the procedure to determine the client’s understanding.

Question 79

A nurse is assisting with teaching a client who has a new prescription for a nitroglycerin patch. Which of the following actions should the nurse take? (Select all that apply.)

-Ask the client what they know about the nitroglycerin patch
-Find out whether the client is able to pay for the medication
-Determine the client’s ability to apply the patch
-Check the client’s reading comprehension level
-Use medical terminology to instruct the client about the patch

Answer 79

-Ask the client what they know about the nitroglycerin patch
-Determine the client’s ability to apply the patch
-Check the client’s reading comprehension level

Question 80

A nurse is collecting data on a client who is receiving vancomycin IV. The nurse observes the client has a rash on their neck, chest, and back. Which of the following actions should the nurse take first?

-Notify the client’s provider
-Stop the infusion of the vancomycin
-Administer diphenhydramine to the client
-Document the incident in the client’s chart

Answer 80

-Stop the infusion of the vancomycin

The greatest risk to the client is injury from an acute allergic reaction. Therefore, the first action the nurse should take is to stop the infusion of the vancomycin to reduce the risk of further injury.

Question 81

A nurse is preparing to administer a medication to a client who has an enteral feeding tube. Which of the following actions should the nurse take?

-Mix the medication with the client’s feeding infusion
-Flush the feeding tube with 10 mL of water prior to administration of the medication
-Administer the medication to the client in a liquid form
-Place the client in a supine position prior to administering the medication

Answer 81

-Administer the medication to the client in a liquid form

The nurse should administer the medication in a liquid form to reduce the risk of clogging the feeding tube. The nurse should consult with the pharmacist to determine which medications are available as a liquid and which can be crushed and mixed with water prior to administration.

Question 82

A nurse is reinforcing teaching with a client who has a new prescription for an antibiotic to treat a urinary tract infection. Which of the following statements should the nurse make?

-You can expect to experience a rash while taking this medication
-Natural supplements do not interact with antibiotics
-This medication is used to treat a viral infection
-Finish the entire course of the prescription

Answer 82

-Finish the entire course of the prescription

The nurse should instruct the client to complete the entire course of the antibiotic prescription, even if they are feeling better, to eradicate the infection.

Question 83

A nurse is assisting with teaching a newly licensed nurse about administering a transdermal nitroglycerin patch to a client. Which of the following instructions should the nurse include?

-Place a new transdermal patch over the same site as an old patch
-Apply no more than two transdermal patches at a time
-Expect the transdermal medication to absorb rapidly
-Wear clean gloves to apply the transdermal medication

Answer 83

-Wear clean gloves to apply the transdermal medication

The nurse should wear clean gloves to apply the transdermal patch to protect the nurse from accidentally absorbing the medication

Question 84

A nurse is reviewing measurement systems to perform dosage calculations with a newly licensed nurse. Which of the following instructions should the nurse include?

-To convert g to mg, move the decimal 3 places to the right
-Liters is a unit of measurement for distance
-The metric system uses fractions rather than decimals
-Grains is used as a measurement of weight in the metric system

Answer 84

-To convert g to mg, move the decimal point 3 places to the right

Calculation in the metric system moves the decimal either to the left or to the right. When converting from smaller to larger, move the decimal to the correct number of places to the left. When converting from larger to smaller, move the decimal the correct places to the right.

Question 85

A nurse is preparing to administer medications to a client who is not wearing an identification bracelet. Which of the following actions should the nurse take before administering the medications?

-Verify the client’s identity using their diagnosis
-Use one identifier to confirm the client’s identity
-Use the client’s room number to identify the client
-Have the client confirm their name and date of birth

Answer 85

-Have the client confirm their name and date of birth

The client’s identity must be verified using two unique identifiers prior to medication administration to ensure the correct medication is being given to the right client. The nurse should confirm the client’s identity and replace the client’s identification band.

Question 86

A nurse is preparing to administer clindamycin 0.3 g IM to a client. Available is clindamycin 150 mg/mL. How many mL should the nurse administer?

Answer 86

2 mL

Question 87

A nurse is preparing to administer phenytoin suspension 300 mg PO, twice per day. The amount available is phenytoin suspension 125 mg/5 mL. How many mL should the nurse administer per dose?

Answer 87

12 mL

Question 88

A nurse has received a prescription to administer a medication STAT to a client. Which of the following actions should the nurse take?

-Administer the medication whenever the client reports specific manifestations, such as pain
-Administer the medication at specific times until directed by health care provider
-Administer the medication at regular intervals of 4 hr
-Administer the medication within 30 min of the health care provider prescribing the medication

Answer 88

-Administer the medication within 30 min of the health care provider prescribing the medication

STAT medication prescriptions should be given immediately and usually one at a time. STAT prescriptions should be administered within 30 min of the health care provider prescribing the medication.

Question 89

A nurse is preparing to administer insulin to a client. Which of the following actions should the nurse take first?

-Document the insulin administration
-Assist with teaching the client about the insulin
-Have a second nurse confirm the insulin dose
-Monitor the client for adverse effects of the insulin

Answer 89

The first action the nurse should take is to have a second nurse confirm the insulin dose to reduce the risk for a medication error. All forms of insulin are considered high alert medications that require a second nurse to confirm the dosage prior to medication administration

Question 90

A nurse is preparing to administer medications to a preschooler. Which of the following information should the nurse keep in mind when administering medications to this client?

-The dosage is calculated by height
-The preschooler is unable to take capsules
-Preschoolers receive the same amount of medication as adults
-The deltoid muscle can be used to administer intramuscular injections
-The deltoid muscle can be used to administer intramuscular injections

Answer 90

The deltoid muscle can be used to administer intramuscular injections in preschoolers as well as in adults.