Answers |
Introduction to Pharmacology |
NCLEX Next Gen (NGN) Exam-Style MCQs with
Rationales | ATI Pharmacology Review |
Nursing Exam Prep
Question 1
Clinical Scenario
A 72-year-old woman is admitted with community-acquired
pneumonia. Her medical history includes hypertension,
osteoarthritis, and chronic kidney disease stage 3. During
medication reconciliation, the nurse notes prescriptions from
multiple healthcare providers, several over-the-counter (OTC)
medications, and an herbal supplement. The client states, "I
take everything exactly as I remember because they're all
important."
Question Stem
Which nursing action is the highest priority before
administering the client's scheduled medications?
,A. Ask the client to identify the purpose of each medication.
B. Verify all prescription, OTC, and herbal medications during
medication reconciliation.
C. Administer the prescribed medications first to avoid delaying
therapy.
D. Request that family members bring medication bottles after
discharge.
Correct Answer
Correct Answer: B. Verify all prescription, OTC, and herbal
medications during medication reconciliation.
Detailed Rationale
Medication reconciliation is a critical patient safety process
performed during transitions of care to identify discrepancies,
duplicate therapies, omissions, drug interactions, allergies, and
inappropriate medications. Older adults frequently receive
medications from multiple providers and often use OTC
products and herbal supplements that may significantly alter
drug effectiveness or increase adverse effects. Completing an
accurate medication reconciliation before administering
medications reduces the risk of medication errors and adverse
drug events.
,Option A is beneficial but does not ensure that the medication
list is complete or accurate. Knowing why the patient takes
medications cannot replace formal reconciliation.
Option C is incorrect because administering medications before
confirming their accuracy increases the risk of preventable
harm, particularly in patients with polypharmacy and chronic
kidney disease, where dosage adjustments may be necessary.
Option D may provide additional information later but does not
address the immediate need to verify medications before
administration.
Nurses play an essential role in comparing the patient's home
medication list with newly prescribed therapies, clarifying
discrepancies with the provider, documenting allergies, and
assessing for duplicate or interacting medications before
administration.
Learning Objectives
After completing this question, the learner should be able to:
• Describe the purpose of medication reconciliation.
• Prioritize nursing actions that reduce medication errors.
• Recognize the importance of assessing OTC and herbal
medication use.
, • Apply medication safety principles during transitions of
care.
Medication Safety Focus: Medication Reconciliation
Question 2
Clinical Scenario
A nurse prepares to administer an oral dose of digoxin to a 78-
year-old client with heart failure. Assessment findings include:
• Apical pulse: 54 beats/min
• Blood pressure: 118/70 mm Hg
• Potassium: 4.2 mEq/L
• The client reports no dizziness or chest pain.
Question Stem
What is the nurse's best action?
A. Administer the medication as prescribed.
B. Hold the medication and notify the healthcare provider.
C. Administer half of the prescribed dose.
D. Reassess the pulse after the medication is administered.
Correct Answer