SAFE DOSAGE

Question 1

A nurse is administering medications to four clients. The nurse should identify which of the following nursing actions as a part of the evaluation phase of the nursing process?

Answer 1

Collecting information about a client’s pain level following administration of a narcotic.

Question 2

A nurse is teaching a newly licensed nurse about crushing medications. The nurse should explain that which of the following medications can be crushed?

Answer 2

Sucralfate tablets

Question 3

A nurse is transcribing medication prescriptions for a group of clients. Which of the following is the appropriate way for the nurse to record medications that require the use of a decimal point?

Answer 3

0.6 mL

Question 4

A nurse is caring for a client who states that his provider told him he is at risk for anaphylaxis following administration of amoxicillin and that he does not understand what this means. Which of the following is an appropriate response by the nurse?

Answer 4

“Anaphylaxis is a severe hypersensitivity or allergic reaction that is life-threatening.”

Question 5

A nurse is preparing to administer a medication to a newly admitted client. The nurse should identify which of the following actions as a part of the assessment phase of the nursing process?

Answer 5

Asking the client about a history of medication allergies

Question 6

Legal responsibility of a nurse?

Answer 6

Reporting medication errors

Question 7

Document the administration of the medication immediately after which of the following actions?

Answer 7

Injecting the insulin

Question 8

Manifestation of an anaphylactic reaction to the medication?

Answer 8

Swollen Lips

Question 9

Newly licensed nurse to have a second nurse review the dosage of which of the following meds prior to administration?

Answer 9

Heparin

Question 10

time critical medications (SATA)

Answer 10

need to be given at precise time or within 30 minutes (0745, 0830)

Question 11

A nurse is preparing to administer an oral medication. Which of the following actions should the nurse take? (SATA)

Answer 11

• Provide client education about the
• Check the expiration date of the medication
• Verify the dosage of the medication
• Ask the client if they have any allergies

Question 12

A nurse is working in a MEd Surg unit is preparing to administer medications to a client. The nurse plans to use 2 forms of identification to verify that she has the right client. Which of the following actions can the nurse take to identify the client? (SATA)

Answer 12

• Compare the name on the client’s wristband with the name in the medication administration record (MAR).
• Ask the client to state his date of birth.
• Ask the client to state his name.
• Use the bar code scan to identify the client.

Question 13

standing prescription

Answer 13

Written for specific circumstances and/or for specific units

A: Acetaminophen 650 mg by mouth every 6 hr for temperature greater than 38.4° C (101.2° F)

Question 14

The nurse should contact the provider to clarify which of the following prescriptions?

Answer 14

Morphine 2.5 mg IV bolus PRN for incisional pain

Question 15

medication reconciliation

Answer 15

A procedure to maintain an accurate and up-to-date list of medications for all patients between all phases of health care delivery.

A: Vitamins, supplements, and over-the-counter (OTC) medications should be included in a medication reconciliation.

Question 16

High alert pain medication - planning stage

Answer 16

Verify the dosage calculation with another nurse.

Question 17

A nurse is caring for a client who received Lisinopril 30 min ago and is now reporting dizziness and headache. Which of the following actions should the nurse take first?

Answer 17

A. Obtain the client vital signs

Question 18

sever back pain at 1400. Prescriptions include oxycodone extended release 20 mg PO every 12 hr (last does at 0600) and oxycodeone immediate release 5 mg PO every 4 hr PRN (last dose rec’d at 2300 the day before).

Answer 18

Administer oxycodone immediate-release 5 mg PO now.

Question 19

A nurse is preparing to administer digoxin 225 mcg for a pediatric client who has a heart rate above 90/min. Which action(s) should the nurse take to ensure administration of the right dose? (SATA)

Answer 19

• Validate that the dosage is within the safe range.

- Confirm the medication amount is appropriate for the child

Question 20

Client received a double dose of a prescribed medication.

Answer 20

Assess the client for adverse effects.

Question 21

The prescription reads morphine 2 mg IV bolus at 1400. It means?

Answer 21

Single order

Question 22

Topiramate XR 100 mg PO daily. Capsule, tood hard to swallow. What does the nurse do?

Answer 22

Request extended-release sprinkles from the pharmacy.

Question 23

Docusate sodium 50 mg capsule PO twice daily. Client refuses

Answer 23

Withhold the medication.

Question 24

Client received double dose. What should the nurse do first?

Answer 24

Assess the client.

Question 25

The nurse is reviewing a client’s prescriptions. The nurse should contact the provider to clarify which of the following?

Answer 25

Acetaminophen 325 mg every 6 hr PRN for headache

Question 26

practice: a nurse in a urgent care facility is preparing to administer a stat dose of med to toddler who is accompanied by parent. The child is not wearing an identification band. How should the nurse identify the client?

Answer 26

ask the parent to identify the client by name

Question 27

practice: nursing is reviewing a new prescription by provider. The nurse should verify that which of the following components of prescription are present?

Answer 27

• date & time of prescription
• dosage of med
• route of administration
• generic name of med [to ensure pt. receives correct med]
• provider signature

explanation: the prescription does NOT include client diagnosis

Question 28

practice: a nurse receives a telephone prescription from a provider. The provider states, “administer three-tenths of a milligram of nitroglycerin orally to client”. How should nurse transcribe on MAR?

Answer 28

0.3 mg

Question 29

practice: a nurse is preparing to administer med to client. Which of the following should be used to identify?

Answer 29

• client telephone number
• client photograph
• client assigned ID number

explanation: place of birth and hospital room number are not appropriate identifiers.

Question 30

practice: a nurse is asked to administer a med to client bc coworker must help with an emergency. The coworker gives the nurse a syringe labeled furosemide 20 mg. The label also includes the clients name and hospital identification number. Which of the following response is appropriate?

Answer 30

“ill go help with the emergency situation while you administer the medication”

Question 31

practice: a nurse is administering meds to client. which of the following actions should nurse perform during planning phase?

Answer 31

• calculating the dose
• verify the dose

explanation: vital signs are checked & allergies are noted during assessment or data collection. The dose of the medication is calculated & verified during the planning stage. The purpose of the med is explained during implementation phase. The. client is observed for adverse effects of med during evaluation phase.

Question 32

practice: error prone abbreviation w/ correct way to write info on MAR

Answer 32

QD=once daily
HS=at bedtime
SC=subcutaneous
IU=unit [international]

Question 33

a charge nurse is teaching a newly licensed nursing about medication reconciliation. Which of the following info should the charge nurse include in the teaching?

Answer 33

Vitamins, supplements, and over the counter (OTC) medications should be included in a medication reconciliation

explanation: the nurse needs to include a list of all meds that the client takes, both prescribed and OTC. Medication reconciliation can identify potential interactions b/w meds and help avoid possible adverse effects

Question 34

a nurse is receiving a client’s prescriptions. The nurse should contact the provider to clarify which of the following prescriptions?

Answer 34

Acetaminophen 325 mg every 6 hr PRN for headache

explanation: this prescription contains name of med, dosage, frequency, and circumstance for administration, BUT NOT THE ROUTE

Question 35

A nurse discovers a medication error in which client received twice prescribed amount of med. which of the following actions should nurse take first?

Answer 35

assess the client

explanation: when using nursing process, the first action after discovering med error is to assess client status. This ensures that any adverse effects of med error are identified and that relevant interventions are implemented

Question 36

a nurse is transcribing a providers prescription for client. The prescription reads morphine 2 mg IV bolus at 1400. The nurse should recognize this as which of the following types of med orders?

Answer 36

Single order

explanation: a single (one time) order stipulates the administer the med one time either at specific time the provider indicates or as soon as possible

Question 37

a nurse manager is reviewing a client’s med record and discovers that the client received a double dose of prescribed med. Which of the following actions should nurse manager take first?

Answer 37

assess the client of adverse effects

explanation: when using nursing process, first step is assessing. By checking the client for adverse effects, the nurse can provide prompt treatment to minimize harm to the client

Question 38

a nurse is preparing to administer a time-critical med to a client at 0800. Which of the following times are appropriate for the nurse to administer the medication?

Answer 38

• 0745 and 0830

explanation: within 30 minutes (before or after) designated time of 0800

Question 39

*a nurse is preparing to administer digoxin 225 mcg for a pediatric client who has heart rate over 90/min. Which of the following actions should the nurse take to ensure administration of the right dose?

Answer 39

• validate that the dosage is within safe range
• confirm the medication amount is appropriate for child

explanation:

• validate safe range by using child weight & med reference text that indicates appropriate dosage parameters. Closely adhere to 6 rights of med administration
• right dosage - 6 rights of med administration

Question 40

a nurse of medical unit is assisting with orientation of new RN. The nurse should remind the new RN to have a 2nd nurse review the dosage of which of the following meds prior to administration?

Answer 40

heparin

explanation: nurse should have a 2nd nurse check dosage of high-alert med, such as heparin, b/c serious client harm can occur if dosage is excessive. High-alert med classes include CNS drugs, chemotherapeutic agents, and anticoagulants

Question 41

*a charge nurse is reviewing the types of prescriptions with a new RN. Which of the following prescriptions should the nurse include as an example of standing prescription?

Answer 41

acetaminophen 60 mg by mouth every 6 hr for temperature greater than 38.4C (101.2F)

explanation: a standing prescription is protocol-based and contains directions for administration based upon specific situations, such as development of fever

Question 42

*a nurse is providing teaching regarding med administration to a group of new RNs. which of the following is a legal responsibility of a nurse?

Answer 42

reporting medication errors

explanation: a nurse is legally responsible for reporting medication errors according to facility policy

Question 43

a nurse is preparing to administer insulin subcutaneously to a client. The nurse document the administration of. the med immediately after which of the following actions

Answer 43

injecting the insult

explanation: the nurse should document interventions, such as med administration, immediately after they occur. the nurse. should not delay documentation b/c this could lead to errors, such as omission of the doc or administration of 2nd dosage of med to client by another nurse. THE NURSE SHOULD NEVER DOCUMENT AN ACTION PRIOR TO IMPLEMENTATION

Question 44

*A nurse is teaching a new RN about crushing meds. The nurse should explain that which of the following meds can be crushed?

Answer 44

Sucralfate tablets

explanation: the nurse should explain that certain meds, such as those that are scored, can be safely crushed and mixed w/ food or water for a client who has difficulty swallowing. The nurse should check w/ pharmacist before crushing a med to make certain that it can be safely crushed

Question 45

A nurse is transcribing med prescription for a group of clients. Which of the following is appropriate way for nurse to record meds that require use of decimal point?

Answer 45

0.4 ml

Question 46

*a nurse is preparing to administer an oral medication. Which of the following actions should the nurse take?

Answer 46

• Provide client education about the medication (regarding name & purpose of each med)
• Check the expiration date (should review package info before med administration)
• Verify the dosage of med (should review package info before med administration)
• Ask the client if they have any allergies

Question 47

A nurse is preparing to administer a medication to a newly admitted client. The nurse should identify which of the following actions as part of the assessment phase of the nursing process?

Answer 47

asking the client about a history of medication allergies

explanation: the nurse should identify that data collection is part of the assessment phase. The nurse should collect data regarding the client’s prior adverse reactions to medications, lab data, use of other meds, and pertinent vital signs as part of the assessment phase to ensure safe med administration

Question 48

A nurse is caring for a client who states that his provider told him he is at risk for anaphylaxis following administration of amoxicillin and that he does not understand what this means. Which of the following is an appropriate response by the nurse ?

Answer 48

“Anaphylaxis is a severe hypersensitivity or allergic reaction that is life threatening”

explanation: anaphylaxis is a severe allergic reaction that can result in severe bronchoconstriction w/ laryngeal edema and precipitous drop in BP

Question 49

A nurse is administering meds to 4 clients. The nurse should identify which of the following nursing actions as part of the evaluation phase of the nurse process?

Answer 49

Collecting info about a client’s pain level following administration of a narcotic

explanation: the nurse should identify that collecting info from client regarding a medications therapeutic response is part of the evaluation phase of the nursing process. The. nurse should include in the evaluation phase the client’s therapeutic response, adverse effects, and client’s adherence to the med therapy

Question 50

*A nurse working in a med-surg unit is preparing to administer meds to a client. The nurse plans to use two forms of identification to verify that she has the right client. Which of the following actions can the nurse take the identify the client?

Answer 50

• Compare the name on the client’s wristband with the name in the MAR (med administrator record)
• Ask the client to state his date of birth
• Ask the client to state his name [full name]
• Use the bar code scan to identify the client

Question 51

A nurse is assessing a client following administration of an antibiotic. The nurse should identify that which of the following findings is a manifestation of an anaphylactic reaction to medication?

Answer 51

swollen lips

explanation: the nurse should identify that swollen lips is a manifestation of anaphylactic reaction. Other manifestations include stridor, dyspnea, wheezing, urticaria [hives], and pruritus. The nurse should notify the rapid response team, elevate the clients head of the bed, apply high-flow oxygen, and prepare to administer epinephrine

Question 52

A nurse is reviewing a client’s prescriptions. The nurse should contact the provider to clarify which of the following prescriptions?

Answer 52

Morphine 2.5 mg IV bolus PRN for incisional pain

*explanation: the prescription requires clarification because it is missing the FREQUENCY of medication administration

Question 53

A nurse is caring for a client who received lisinopril 30 min ago and is now reporting dizziness and headache. Which of the following actions should the nurse take first?

Answer 53

Obtain the client’s vital signs

explanation: the first action the nurse should take when using the nursing process is to ASSESS the client. Therefore, the first action the nurse should take is to obtain the client’s vital signs

Question 54

A nurse is preparing to administer medication to a client who has a prescription for docusate sodium 50 mg capsule PO twice daily. This client refuses to take the med because of nausea. Which of the following actions should the nurse take?

Answer 54

Withhold the medication

explanation: the nurse should withhold the med due the client’s nausea and notify the provider. If nausea persists, the nurse should contact the provider to prescribe an antiemetic

Question 55

a nurse is preparing to administer a high-alert pain med to a client. which of the following actions should the nurse perform during the planning stage of medication administration?

Answer 55

Verify the dosage calculation with another nurse

explanation: to ensure client safety and prevent harm, the nurse should always have another nurse verify dosage calculations prior to administering a high alert med. This occurs during the PLANNING stage of med administration

Question 56

A nurse is caring for a client for reports severe back pain at 1400. The client’s prescriptions include oxycodone extended-release 20 mg PO every 12 hrs (last dose received at 0600) and oxycodone immediate-release 5 mg PO every 4 hr PRN (last dose received at 2300 the day before). Which of the following actions should the nurse take?

Answer 56

Administer oxycodone immediate-release 5 mg PO now

explanation: it has been 15 hrs since the previous dose of oxycodone immediate-release, and the medication is prescribed every 4 hr as needed, so the nurse should prepare to administer a dose now to treat the clients pain

Question 57

A nurse is caring for a client who is to receive topiramate XR 100 mg PO daily. The client tells the nurse that the capsule is too hard to swallow. Which of the following actions should the nurse take?

Answer 57

request extended release sprinkles from the pharmacy

explanation: the nurse can administer topiramate XR in sprinkle form, if available. This is not changing the route of the medication. The sprinkle capsule can be opened and mixed with food for ease of swallowing while still remaining extended release