A patient newly diagnosed with diabetes is to be discharged from the
hospital. Which action should be taken first during medication education?
A. Asking the patient to demonstrate how to measure and administer
insulin
B. Discussing methods of storing insulin and discarding syringes
C. Giving information about how diet and exercise affect insulin
requirements
D. Teaching the patient about the long-term consequences of poor diabetes
control
ANS: A
Because insulin must be given correctly to controlsymptoms and because an
overdose can be fatal,
,it is most important for the patient to know how to administer it. Asking for a
demonstration of
technique is the best way to determine whether the patient has understood the
teaching. When a
patient isreceiving a lot of new information, the information presented first isthe
most likely to be
remembered. The other teaching points are important as well, but they are not as
critical and can
be taught later.DIF: Cognitive Level: ApplicationREF: p. 11TOP: Nursing
Process: Planning
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential
The drug manual states that older adult patients are at increased risk for
hepatic side effects. Which action is most important when prescribing this
medication to an 80-year-old patient?
a. Obtain pretreatment laboratory work.
b. Ensure that the drug is given in the correct dose at the correct time to
minimize the risk of adverse effects.
c. Discontinue the order; the drug is contraindicated for this patient.
d. Give the medication intravenously so that the drug does not pass
through the liver.
ANS: A
The drug manual indicates that this drug should be given with caution to elderly
patients. Getting information about liver function before giving the drug
establishes baseline data that can be compared with post-treatment data to
determine whether the drug is affecting the liver. Giving the correct dose at the
correct interval helps to minimize risk, but without baseline information, the
effects cannot be determined. The drug is not contraindicated.
,DIF: Cognitive Level: AnalysisREF: p. 12TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Reduction of Risk Potential
A patient recently diagnosed with HIV is prescribed several medications to
treat the condition. Which factors could impact the patient's adherence to
the treatment regimen?Select all that apply.
a. The patient is uninsured
b. The patient works three part-time jobs
c. The medication regimen includes six different pills
d. Patient has an eighth-grade reading comprehension level
e. Medication regimen requires medication be taken at regular 4-hour
intervals.
ANS: A,B,C,E
Lack of insurance coverage can inhibit the patient from purchasing the
medications, limiting his access to treatment. Having three part-time jobs
indicates that the patient has a busy schedule, which contributes to forgetfulness
and poor adherence. The more complex the medication regimen, the more
difficult it is to maintain patient adherence. Although a patient with an eighth-
grade reading comprehension level may have difficulty understanding
professional medical language, medication teaching can be adjusted to meet the
patient's learning needs.
DIF: Cognitive Level:
ComprehensionREF: pp. 13-14TOP: Nursing Process: Evaluation MSC:
NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential
, A patient diagnosed with bipolar disorder is prescribed daily lithium.
Which action is most important to determine if the therapeutic level is
maintained?
a. Obtain preadministration blood work.
b. Administer medication at regular intervals.
c. Ensure periodic laboratory testing is completed.
d. Assess the patient for adverse effects.
ANS: C
Therapeutic serum levels are determined through periodic laboratory testing.
Preadministration blood work may be necessary to determine the patient's
physical condition but will not determine therapeutic levels. Scheduling
medication administration at regular intervals will help to ensure medication is
absorbed and metabolized predictably, but will not determine therapeutic blood
levels. Assessing the patient for physical signs of adverse effects does not
determine if a therapeutic level has been obtained.
DIF: Cognitive Level: ApplicationREF: p. 12TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential
The nurse administers naloxone [Narcan] to a patient who has received a
toxic dose of morphine sulfate. The nurse understands that the naloxone is
effective because of which action?
a. Countering the effects of morphine sulfate by agonist actions
b. Increasing the excretion of morphine sulfate by altering serum pH
c. Preventing activation of opioid receptors through antagonist actions
d. Regulating the sensitivity of opioid receptors by neurochemical
alterations
hospital. Which action should be taken first during medication education?
A. Asking the patient to demonstrate how to measure and administer
insulin
B. Discussing methods of storing insulin and discarding syringes
C. Giving information about how diet and exercise affect insulin
requirements
D. Teaching the patient about the long-term consequences of poor diabetes
control
ANS: A
Because insulin must be given correctly to controlsymptoms and because an
overdose can be fatal,
,it is most important for the patient to know how to administer it. Asking for a
demonstration of
technique is the best way to determine whether the patient has understood the
teaching. When a
patient isreceiving a lot of new information, the information presented first isthe
most likely to be
remembered. The other teaching points are important as well, but they are not as
critical and can
be taught later.DIF: Cognitive Level: ApplicationREF: p. 11TOP: Nursing
Process: Planning
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential
The drug manual states that older adult patients are at increased risk for
hepatic side effects. Which action is most important when prescribing this
medication to an 80-year-old patient?
a. Obtain pretreatment laboratory work.
b. Ensure that the drug is given in the correct dose at the correct time to
minimize the risk of adverse effects.
c. Discontinue the order; the drug is contraindicated for this patient.
d. Give the medication intravenously so that the drug does not pass
through the liver.
ANS: A
The drug manual indicates that this drug should be given with caution to elderly
patients. Getting information about liver function before giving the drug
establishes baseline data that can be compared with post-treatment data to
determine whether the drug is affecting the liver. Giving the correct dose at the
correct interval helps to minimize risk, but without baseline information, the
effects cannot be determined. The drug is not contraindicated.
,DIF: Cognitive Level: AnalysisREF: p. 12TOP: Nursing Process:
Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity:
Reduction of Risk Potential
A patient recently diagnosed with HIV is prescribed several medications to
treat the condition. Which factors could impact the patient's adherence to
the treatment regimen?Select all that apply.
a. The patient is uninsured
b. The patient works three part-time jobs
c. The medication regimen includes six different pills
d. Patient has an eighth-grade reading comprehension level
e. Medication regimen requires medication be taken at regular 4-hour
intervals.
ANS: A,B,C,E
Lack of insurance coverage can inhibit the patient from purchasing the
medications, limiting his access to treatment. Having three part-time jobs
indicates that the patient has a busy schedule, which contributes to forgetfulness
and poor adherence. The more complex the medication regimen, the more
difficult it is to maintain patient adherence. Although a patient with an eighth-
grade reading comprehension level may have difficulty understanding
professional medical language, medication teaching can be adjusted to meet the
patient's learning needs.
DIF: Cognitive Level:
ComprehensionREF: pp. 13-14TOP: Nursing Process: Evaluation MSC:
NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential
, A patient diagnosed with bipolar disorder is prescribed daily lithium.
Which action is most important to determine if the therapeutic level is
maintained?
a. Obtain preadministration blood work.
b. Administer medication at regular intervals.
c. Ensure periodic laboratory testing is completed.
d. Assess the patient for adverse effects.
ANS: C
Therapeutic serum levels are determined through periodic laboratory testing.
Preadministration blood work may be necessary to determine the patient's
physical condition but will not determine therapeutic levels. Scheduling
medication administration at regular intervals will help to ensure medication is
absorbed and metabolized predictably, but will not determine therapeutic blood
levels. Assessing the patient for physical signs of adverse effects does not
determine if a therapeutic level has been obtained.
DIF: Cognitive Level: ApplicationREF: p. 12TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk
Potential
The nurse administers naloxone [Narcan] to a patient who has received a
toxic dose of morphine sulfate. The nurse understands that the naloxone is
effective because of which action?
a. Countering the effects of morphine sulfate by agonist actions
b. Increasing the excretion of morphine sulfate by altering serum pH
c. Preventing activation of opioid receptors through antagonist actions
d. Regulating the sensitivity of opioid receptors by neurochemical
alterations
