Safely Preparing and Giving Drugs

Understanding Pharmacology Essentials for Medication Safety

Nursing
29
Questions
0
True/False
23
Choices
6
Essay
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Questions

Q1
Free

What is the best way for the nurse to make sure that the right patient is receiving a prescribed drug when the patient is alert and oriented?

Multiple Choice
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A) Ask the patient to state his or her name.
B) Check the patients wrist band.
C) Look at the patients chart.
D) Have the patient state his or her name and birth date.
Answer:
D) Have the patient state his or her name and birth date.

Explanation:
To make sure that the right patient receives any drug that has been prescribed, The Joint Commission (TJC) recommends checking two unique patient identifiers (name and birth date) before medication administration. An alert and oriented patient can be asked directly.
Q2
Free

When is it acceptable for the nurse to take a verbal order from the prescriber before giving a drug to a patient?

Multiple Choice
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A) During the night shift when the prescriber is not at the hospital
B) In an emergency situation such as a cardiac arrest
C) When a patient is experiencing severe pain
D) At any time it is necessary
Answer:
B) In an emergency situation such as a cardiac arrest

Explanation:
A prescribers drug order should be in written form and include all the minimal information required by the U.S. government. Verbal orders should only be accepted in emergency situations. As soon as the emergency is resolved, verbal orders must be written and signed. For safety, when a nurse contacts a prescriber or follows a verbal order, the nurse should be sure to write the order, read it back, and ask for confirmation that what was written is correct.
Q3
Free

The nurse is giving morning medications to a patient who refuses to take an oral dose of docusate (Colace). What is the nurses best response?

Multiple Choice
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A) Your prescriber ordered that you must take this drug twice a day.
B) Docusate will soften your bowel movements so that you do not strain.
C) This drug will help prevent constipation while you are on bed rest.
D) Can you tell me why you do not want to take the docusate?
Answer:
D) Can you tell me why you do not want to take the docusate?

Explanation:
A patient has the right to refuse to take any drug. Although it is important that the patient understand why the drug has been prescribed and the consequences of refusing to take it, the nurse should investigate why the patient prefers not to take a drug. For example, if a patient is having diarrhea and understands the action of docusate, refusing the drug is not only the patients right, but is also the right action to take.
Q4

What is the most important role of the nurse in preventing drug errors?

Multiple Choice
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A) Always checking the patients diagnosis before giving a drug
B) Always following the six rights of drug administration
C) Being the one defense for detecting and preventing drug errors
D) Being most likely to detect a drug error that has occurred
Answer:

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Q5

The prescriber orders atenolol (Tenormin) 25 mg to be given orally once a day to control a patients high blood pressure. The nurse takes the patients vital signs and finds that the blood pressure is 128/80 mm Hg and the heart rate is 60 beats per minute. What does the nurse do first before giving this drug?

Multiple Choice
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A) Check the order for prescriber limitations on when the drug should be given.
B) Notify the prescriber and ask if the drug should be given.
C) Reassess the blood pressure and heart rate in 30 minutes.
D) Give the drug exactly as prescribed.
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Q6

A patient is prescribed omeprazole (Prilosec) 60 mg once a day orally. The patient is having difficulty with swallowing and has a feeding tube in place. What is the nurses best action?

Multiple Choice
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A) Open the capsule and mix the contents with water, then give the drug through the feeding tube.
B) Raise the head of the bed 90 degrees and mix the capsule in applesauce for easier swallowing.
C) Contact the prescriber and pharmacist about using another drug or another form of the drug.
D) Hold the tube feeding for at least 30 minutes before giving the drug.
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Q7

For which route of parenteral drug administration does the nurse use a 3/8-inch 25-gauge needle?

Multiple Choice
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A) Intracardiac
B) Subcutaneous
C) Intramuscular
D) Intravenous
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Q8

A patient with severe postoperative pain is ordered to receive morphine 2 mg intravenously. The patient asks the nurse if the drug could be taken by mouth instead. What is the nurses best response?

Multiple Choice
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A) Giving the drug intravenously will give you faster pain relief.
B) I will call your prescriber and ask if the order can be changed.
C) Your surgeon wants you to receive the drug intravenously.
D) We can substitute the intravenous drug with an oral drug.
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Q9

A patient is to receive nitroglycerin ointment, 1 inch STAT, for elevated blood pressure. What must the nurse do before giving this drug?

Multiple Choice
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A) Shave the hair off the patients chest.
B) Place the patient on a heart monitor.
C) Put on a pair of disposable gloves.
D) Measure the dose directly on the patients skin.
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Q10

A sublingual drug is administered by placing the drug in what part of the body?

Multiple Choice
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A) Between the cheek and the upper jaw
B) Under the tongue
C) In the nose
D) In the eyes
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Q11

What administration technique does the nurse use to give a 2-year-old child ear drops?

Multiple Choice
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A) Pull the earlobe down and back.
B) Pull the earlobe up and out.
C) Keep the earlobe straight.
D) Hang the patients head over the side of the bed.
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Q12

What must the nurse be sure to tell the patient after a vaginal drug is administered?

Multiple Choice
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A) This drug should be refrigerated.
B) You may take this drug at home while sitting on the toilet.
C) Be sure to empty your bladder after receiving this drug.
D) Remain lying down for 10 to 15 minutes after taking this drug.
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Q13

When giving a drug to a patient who is awake but confused, what is the best way for the nurse to identify the patient?

Multiple Choice
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A) Check the room and bed number that the patient occupies.
B) Ask the patient to state his or her name and birth date.
C) Check the name on the patients wristband.
D) Ask the patient if he or she is Mr. or Ms. [name].
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Q14

The prescriber orders a new drug over the telephone for a nursing home patient who has symptoms of a urinary tract infection. The order is for Gantanol, 2 g now and then 1 g every 12 hours for the next 10 days. What further information is most important for the nurse to obtain from the prescriber?

Multiple Choice
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A) How many refills are needed?
B) Do you want the drug given orally or intravenously?
C) Which brand of drug should be given, or is this a generic drug?
D) Does this drug need to be given with a meal or on an empty stomach?
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Q15

The physician orders all of the following drugs for a patient who had surgery 2 days ago. Which drug order does the nurse administer first?

Multiple Choice
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A) Alphamine (cyanocobalamin) 100 mcg intramuscularly once
B) Benadryl (diphenhydramine) 25 mg orally every 8 hours
C) Compazine (prochlorperazine) 10 mg orally STAT
D) Dalmane (flurazepam) 30 mg orally at night PRN
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Q16

The nurse asks the patient to state his name and birth date, and the patient responds correctly. The nurse then gives the patient the prescribed drug tablet. The patient says I havent ever taken a green pill before. What is the nurses best response?

Multiple Choice
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A) Go ahead and take the drug. The same medications from different drug companies may have a different color.
B) Go ahead and take the drug. It is likely that your health care provider has prescribed a new drug for you.
C) Dont take this drug right now. It is probably not the one prescribed for you.
D) Dont take this drug right now. Let me recheck everything to be sure.
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Q17

Which question is most important for the nurse to ask a patient before administering a new drug?

Multiple Choice
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A) Are you allergic to any drugs?
B) Do you know what this drug is for?
C) When was the last time you ate or drank?
D) What other drugs have you taken in the last 24 hours?
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Q18

When the nurse brings in the next dose of a drug that a patient first received 6 hours ago, the patient reports a pounding heart rate ever since taking the last dose. What is the nurses best first action?

Multiple Choice
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A) Document the report as the only action.
B) Check the patients vital signs for changes.
C) Hold the dose and notify the prescriber immediately.
D) Reassure the patient that this is an expected response to the drug.
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Q19

A 1-year-old child is prescribed a transdermal drug patch for pain control. To which site does the nurse apply the patch?

Multiple Choice
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A) On the lower arm where changing the patch is easier
B) On the back between the shoulders so the child cannot reach it
C) On the upper chest so that any skin irritation can be seen quickly
D) On the leg between the knee and the thigh for fastest drug absorption
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Q20

Which action is most important when the nurse prepares to administer an oral drug to a patient of any age?

Multiple Choice
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A) Asking the patient whether he or she prefers a tablet or a capsule
B) Determining when the patient last ate or drank
C) Assessing whether the patient has nausea
D) Checking the patients ability to swallow
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Q21

Which condition requires that the nurse withhold a drug dose for a patient with a feeding tube?

Multiple Choice
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A) The drug is in the form of a capsule.
B) The drug volume is greater than 20 mL.
C) Carbon dioxide is detected from the feeding tube.
D) The patient is unconscious and unable to swallow.
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Q22

Which technique is used with intramuscular drug injections but not with intradermal drug injections?

Multiple Choice
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A) Ensuring the site selected is appropriate for injection
B) Cleansing the selected site before inserting the needle
C) Aspirating the syringe before injecting the drug solution
D) Checking for allergic or sensitivity reactions to the injection
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Q23

The nurse prepares to administer an intravenous (IV) push drug, but the skin around the patients IV site is swollen and red. The patient states that the area hurts, and no blood return is obtained when the nurse aspirates the IV setup. What is the nurses best action?

Multiple Choice
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A) Restart IV administration of the drug.
B) Discontinue IV administration and notify the prescriber.
C) Dilute the drug more before injecting it into the current IV site.
D) Reassure the patient that this is an expected reaction and offer the prescribed pain medication.
Answer:

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Q24

[Multiple Response] Safe drug administration requires that the person giving a drug be knowledgeable about which drug features? (Select all that apply.)
a. Purpose
b. Actions
c. Brand name
d. Side effects
e. Abnormal reactions
f. Follow-up care

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Q25

[Multiple Response] What are the six rights of drug administration? (Select all that apply.)
a. Right patient
b. Right diagnosis
c. Right drug
d. Right dose
e. Right route
f. Right time g. Right documentation h. Right to refuse

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Q26

[Multiple Response] A patient is to receive an acetaminophen (Tylenol) suppository for an elevated temperature of 102.8 F. What actions must the nurse take? (Select all that apply.)
a. Ask if the patient is having any diarrhea.
b. Lubricate the blunt end of the suppository.
c. Put on a pair of sterile gloves.
d. Place the patient in the Sims position.
e. Ask the patient to take a deep breath and bear down.
f. Push the suppository into the rectum about 1 inch.

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Q27

[Multiple Response] When compared with the subcutaneous route, what are the advantages of giving drugs intramuscularly (IM)? (Select all that apply.)
a. IM injections require a smaller, shorter needle.
b. IM drugs are absorbed faster than subcutaneous drugs.
c. IM injections can be much larger that subcutaneous injections.
d. IM injections do not require the rotation of injection sites.
e. IM injections are less painful than subcutaneous injections.

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Q28

[Multiple Response] When compared with the subcutaneous route, what are the advantages of giving drugs intramuscularly (IM)? (Select all that apply.)
a. IM injections require a smaller, shorter needle.
b. IM drugs are absorbed faster than subcutaneous drugs.
c. IM injections can be much larger that subcutaneous injections.
d. IM injections do not require the rotation of injection sites.
e. IM injections are less painful than subcutaneous injections.

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Q29

[Sequencing] Place in correct order the steps to be taken when giving an oral drug.
A. Check the written order.
B. Document that the drug was given.
C. Observe the patient take the drug.
D. Offer the patient a cup of water.
E. Scan the drug wrapper.
F. Scan the patients wrist band.
G. Wash your hands.

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