week 11 sherpath Flashcards
In which situation related to medication administration is the use of the teach-back method essential?
Patient refuses a medication.
New medication is prescribed.
Dosage of a medication is changed.
More than one medication is taken at the same time.
Patient refuses a medication.
To confirm the right drug, medication labels are checked against the medication administration record (MAR) at least how many times before the medication is administered to the patient? Record your answer as a whole number.
Use numbers only.
3 times
At which times does the nurse check for the “right drug”?
Select all that apply.
When removing the drug from the dispensing unit
When preparing the medication
Just before entering the patient’s room
At the bedside immediately before administration
On completion of documentation that the medication was given
When removing the drug from the dispensing unit
When preparing the medication
At the bedside immediately before administration
Match the prescription abbreviation with its meaning.
Before meals
Milliliter
Four times per day
Sublingual
Answer choices
PRN
SL
mg
qid
Ac
ML
Before meals
ac
Milliliter
mL
Four times per day
qid
Sublingual
SL
Which medication prescription requires clarification with the health care provider?
Cefadroxil 500 mg PO bid
Tobramycin 60 mg IM q8h
Diazepam 6 mg IM STAT
Heparin 7500 units subcutaneously
Heparin 7500 units subcutaneously
What is the meaning of “qid” in a medication prescription?
Every day
Every other day
Four times per day
Every day as needed
Four times per day
The metric system has a basic unit of __ .
10
Which information are needed to set up a dimensional analysis equation for calculating a medication dosage?
Select all that apply.
Dose to be given
Available concentration
Frequency of administration
Unit conversion
Time of last dose given
Dose to be given
Available concentration
Unit conversion
Which step in dimensional analysis is done first?
Set up the equation.
Identify the unit of measure needed for the answer.
Calculate the numbers to get the answer.
Simplify the units.
Identify the unit of measure needed for the answer.
Which factors related to medication errors are considered systems factors?
Select all that apply.
Stress
Communication of prescriptions
Dispensing
Miscalculation of dosage
Product labeling, packaging, and nomenclature
Communication of prescriptions
Product labeling, packaging, and nomenclature
At which times would the nurse perform medication reconciliation?
Select all that apply.
At least once every 72 hours
When a patient is discharged home
Whenever a new medication is prescribed
When a patient is admitted to the hospital
Whenever the dosage of a medication is changed
When a patient is discharged home
When a patient is admitted to the hospital
Which factor best explains the need for medication reconciliation as a routine part of medication error prevention?
Cultural diversity
Population mobility
Prevalence of polypharmacy
Increase in health care options
Prevalence of polypharmacy
Which actions are taken when a patient refuses a medication?
Select all that apply.
Notify the health care provider.
Contact a family member.
Inquire why the patient is refusing.
Explain the consequences of refusal with teach-back.
Provide at least two opportunities for the patient to reconsider.
Document the circumstances of the situation and the actions taken.
Notify the health care provider.
Inquire why the patient is refusing.
Explain the consequences of refusal with teach-back.
Document the circumstances of the situation and the actions taken.
As a general rule, which information should be given to a patient when a drug is being administered?
Select all that apply.
Name of the drug
Why the drug has been prescribed
Risk for adverse reactions
How long the drug will be taken
Expected side effects
Whether the drug is having the expected therapeutic effect
Name of the drug
Why the drug has been prescribed
Expected side effects
The nurse looks up an unfamiliar medication when preparing to administer it. The reference indicates the medication is on the Institute for Safe Medication Practices (ISMP) high-alert list. Which action would the nurse take?
Have a second nurse verify the dosage.
Reconfirm the prescription with the health care provider.
Schedule laboratory blood work for 1 hour after administration.
Double-check with the patient that there is no known allergy to the medication.
Have a second nurse verify the dosage.
The nurse would contact the health care provider for clarification for which medication prescription?
Ciprofloxacin 0.5 g PO bid
Diltiazem 60 mg PO bid
Lisinopril 5 mg PO qd
Doxepin hydrochloride 30 mg PO at bedtime
Lisinopril 5 mg PO qd
To which aspect does the abbreviation STAT refer when used in a prescription for a medication?
Drug dosage
Drug formulation
Route of administration
Frequency/time of administration
Frequency/time of administration
Which medication would the nurse plan to give without first clarifying the prescription with the health care provider?
Toprol XL 100 mg PO QD
Naltrexone hydrochloride 50 mg PO daily
Pantoprazole SOD DR 40 mg by mouth
Benzonatate 200 mg PO tid PRN
Naltrexone hydrochloride 50 mg PO daily
Medication prescription: cimetidine 0.4 g PO, q6h
Available: 400-mg tablets
How many tablets should be given to the patient?
1 tablet(s)
Medication prescription: digoxin 0.25 mg IV stat
Available: digoxin 0.5 mg/2 mL
How many milliliters should be given to the patient?
Use numbers only.
1 mL
Medication prescription: hydrochlorothiazide 25 mg PO daily
Available: 50-mg tablets
How many tablets should be given to the patient? (Record your answer as a decimal and include a leading zero, if applicable.)
0.5 tablet(s)
Patient reluctance to share information is a major obstacle to which process?
Medication reconciliation
Assessment of allergic reactions
Identification of medication side effects
Determination of patient education needs
Medication reconciliation
Match each right of medication administration to the factor that puts it at risk for being violated.
Look-alike and soundalike medications
Need to crush a tablet
Narrow window of administration
Smudged patient name on wristband
Answer choices
Right dose
Right route
Right drug
Right patient
Right time
Look-alike and soundalike medications
Right drug
Need to crush a tablet
Right dose
Narrow window of administration
Right time
Smudged patient name on wristband
Right patient
Which questions are answered by the medication reconciliation process?
Select all that apply.
Are all prescribed medications available in generic forms?
Does the patient’s insurance cover all prescribed medications?
Are any of the prescribed medications duplicates of each other?
Does the patient currently need every medication that is prescribed?
Are there any medications that the patient needs that are not prescribed?
Do any of the prescribed medications interact with one another, requiring an adjustment in dosage or a change in the medications themselves?
Are any of the prescribed medications duplicates of each other?
Does the patient currently need every medication that is prescribed?
Are there any medications that the patient needs that are not prescribed?
Do any of the prescribed medications interact with one another, requiring an adjustment in dosage or a change in the medications themselves?
Which statements describe a medication history and its function?
Select all that apply.
Helps identify areas where patient education is needed
Focuses on both current and recently used medications
Can guide decisions on future medications if accurate and complete
Gathers data about herbal preparations but not dietary supplements
Asks questions related to patient adherence to the prescribed medication regimen.
Helps identify areas where patient education is needed
Focuses on both current and recently used medications
Can guide decisions on future medications if accurate and complete
Asks questions related to patient adherence to the prescribed medication regimen.
Which statement best describes ongoing assessments related to medication administration?
Ongoing assessments are primarily used as part of the patient’s annual physical examination in the outpatient setting.
The main purpose of ongoing assessments is to document changes in the patient’s medication history.
Ongoing assessments should be done every week to ensure the therapeutic effect of the medication is maintained.
The main purposes of ongoing assessments are to evaluate the effectiveness of a medication and to identify any adverse effects.
The main purposes of ongoing assessments are to evaluate the effectiveness of a medication and to identify any adverse effects.
Match the category of medication with the point-of-administration assessment that it requires.
Pulse
Blood pressure
Temperature
Respiratory rate
Answer choices
Antipyretic
Opioid analgesic
Antihypertensive
Anticoagulant
Cardiac glycoside
Pulse
Cardiac glycoside
Blood pressure
Antihypertensive
Temperature
Antipyretic
Respiratory rate
Opioid analgesic
Assessment of dexterity and mobility statuses could cue to which problem related to medication administration?
Lack of sufficient fatty tissue for a subcutaneous injection
Ability to open medication containers
Risk for a rectal tear with rectal administration
Need for extended- or time-release medications
Ability to open medication containers
Which factor would the nurse recognize as a cue indicating that a patient must be checked for bleeding after an intramuscular injection?
Slender, nonathletic build
Allergy to aspirin
Current anticoagulant therapy
Elevated serum creatinine levels
Current anticoagulant therapy
For which reason would the nurse ask a patient about food allergies as part of the medication history?
Can cue to the need for enteric-coated tablets
Can cue to the risk for an allergic reaction to the medication
Can cue to the necessity of avoiding oral medication administration
Can cue to the importance of monitoring levels of medication in the blood
Can cue to the risk for an allergic reaction to the medication
Which focused assessment would the nurse perform when caring for a patient with a prescription for a medication administered by transdermal patch?
Assess the patient’s level of consciousness.
Inspect the patient’s skin for cracks and lesions.
Ensure the patient has patent intravenous access.
Check to make sure the patient has adequate muscle mass.
Inspect the patient’s skin for cracks and lesions.
The nurse is caring for a patient who has digoxin prescribed for chronic heart failure. Which assessment data is needed before administering the digoxin?
Blood pressure
Radial pulse
Apical pulse
Oxygen saturation
Apical pulse
Which questions would the nurse ask a patient when obtaining the patient’s medication history?
Select all that apply.
“What is your alcohol intake?”
“What are your current laboratory test values?”
“Have you recently stopped taking any medications?”
“What prescribed medications are you currently taking?”
“Do you have any preferences or habits related to your cultural background that influence the medications you take?”
“What is your alcohol intake?”
“Have you recently stopped taking any medications?”
“What prescribed medications are you currently taking?”
“Do you have any preferences or habits related to your cultural background that influence the medications you take?”
Which factor is cued by gathering information about a patient’s prior exposure to a medication that is being prescribed?
Risk for kidney impairment
Likelihood of side and adverse effects
Probability of a medication interaction
Ability to follow prescribed directions for taking the medication
Likelihood of side and adverse effects
Which factors would the nurse recognize as cues that oral administration might not be appropriate for a patient?
Select all that apply.
Patient must lie flat.
Patient has ill-fitting dentures.
Patient has difficulty swallowing.
Patient reports feeling nauseated.
Patient has postnasal drip and a sore throat.
Patient questions the taste of the medication, saying “Are you sure it doesn’t taste bad?”
Patient must lie flat.
Patient has difficulty swallowing.
Patient reports feeling nauseated.
Which factors would the nurse recognize as cues indicating that a patient is at increased risk for an adverse reaction to a medication?
Select all that apply.
Age of 71 years
History of kidney disease
Admitted for a knee replacement
Taking the medication for the first time
Allergic to watermelon, cucumber, and peanuts
Age of 71 years
History of kidney disease
Allergic to watermelon, cucumber, and peanuts
Which hypothesis is the nurse addressing when the patient is assessed for urticaria, itching, and rash after administration of a medication?
Risk for allergic reaction
Risk for Cross-Infection
Risk for Adverse Medication Interaction
Risk for impaired tissue integrity
Risk for allergic reaction
Which descriptors would the nurse use in summarizing changes in a patient’s condition after a medication interaction?
Critical, stable, good
Satisfactory, unsatisfactory
Life-threatening, urgent, immediate concern
Improving, declining, unchanged
Improving, declining, unchanged
Which hypothesis is the nurse addressing by using aseptic technique as an intervention?
Risk for Cross-Infection
Risk for allergic reaction
Risk for Adverse Medication Interaction
Risk for Injury
Risk for Cross-Infection
Which types of medication cannot be administered to patients who have difficulty swallowing and require medications to be crushed?
Select all that apply.
Capsules
Scored tablets
Sublingual tablets
Time-release tablets
Enteric-coated tablets
Time-release tablets
Enteric-coated tablets
Which direction would be given to a patient with a prescription for a swish-and-swallow medication?
“Do not rinse your mouth after taking the swish-and-swallow medication.”
“Tilt your head front to back while the medicine is in your mouth.”
“Keep the medication away from your cheeks; bubble it in the back of your throat, almost like gargling.”
“Take the swish-and-swallow medication before you swallow any other medications.”
“Do not rinse your mouth after taking the swish-and-swallow medication.”
When using a dropper to give liquid medication to an infant, where should the medication be deposited in the mouth?
Middle of tongue
Alongside the tongue
Behind the gum under the tongue
Between the gum and the lower lip
Alongside the tongue
When more than one medication must be instilled in the eye, the nurse waits a minimum of how many minutes between instillations?
3 minutes
For which purpose does the nurse push on the tragus after instilling an otic medication?
Relieve pain.
Straighten the ear canal.
Prevent loss of medication.
Reduce tinnitus.
Prevent loss of medication.
Which instruction would the nurse give a patient when a nasal medication is being administered?
“Breathe in.”
“Breathe out.”
“Breathe normally.”
“Hold your breath.”
“Breathe in.”
Which comment made by a patient wearing a transdermal patch requires further investigation by the nurse?
“I feel like a checkerboard with these patches being rotated around.”
“This patch itches and burns. I have to keep rubbing it to make it feel better.”
“I never realized I had so much hair on my chest and back until I tried to find hairless places to put a patch.”
“It seems that every one of these patches comes loose before it is time to remove it, and I have to tape around the sides with hypoallergenic tape to hold it in place.”
“This patch itches and burns. I have to keep rubbing it to make it feel better.”
The mother of a 2-year-old patient asks the nurse how far a rectal suppository prescribed for her child should be inserted. Which response by the nurse is accurate?
¼ inch
½ inch
1 inch
1½ inches
½ inch
Which patient position is preferred for insertion of a vaginal suppository?
Left side-lying position with upper knee flexed (Sims position)
Right side-lying position
Dorsal recumbent position
Prone with legs apart
Dorsal recumbent position
