Rasmussen NUR2474 Questions and
Complete Solutions Graded A+
6 rights of med administration - Answer: i. Patient
ii. Drug
iii. Dose
iv. Time
v. Route
vi. Documentation
Extra rights to med admin - Answer: i. Assessment
ii. Evaluation
iii. Patient to education iv. Patient to refuse care
Biggest medication error is misinterpreting prescriptions - Answer: i. Do not assume if something is
unclear about an order. Clarify with prescriber.
ii. TORB and VORB
(Telephone order read back) (Verbal order read back).
Pre- medication administration assessment and interventions - Answer: 1. If patient is complaining of
pain 10/10, intervene (prn meds, standing orders, call physician for new orders) then assess.
2. Collection of baseline data to evaluate therapeutic effects and adverse effects.
3. Identification of high-risk patients.
4. Assessment of the patient's capacity for self-care.
5. Allergies?
a) Collect history. What happens during an allergic reaction?
b) If patient is having an allergic reaction: primary intervention is to STOP THE MEDICATION THAT IS
CAUSING THE REACTION.
,6. If patient refuses drug, determine why. INVESTIGATE.
Post- medication administration assessment and interventions - Answer: 1. Therapeutic response 2.
Adverse reaction and interaction
3. Adherence to treatment
4. Satisfaction with treatment
Patient teaching for medication therapy in general (safety, and compliance) - Answer: i. Safety
1. If medication causing certain side effects, consult physician.
ii. Compliance
1. It is important not to stop or change a medication without consulting the physician.
2. Take medications as prescribed and for the reason they are prescribed.
Side effects vs adverse effects vs allergies - Answer: a. Side effects.
i. Nausea, vomiting, expected and unavoidable reactions, drug effects produced at therapeutic level.
b. Adverse effects.
i. Noxious, unintended, and undesired effect that occurs at normal drug doses, harmful at therapeutic
level.
c. Allergies.
i. Redness, itching, hives, swelling; A condition in which the immune system reacts abnormally to a
foreign substance.
a. Side effects. - Answer: i. Nausea, vomiting, expected and unavoidable reactions, drug effects produced
at therapeutic level.
b. Adverse effects. - Answer: i. Noxious, unintended, and undesired effect that occurs at normal drug
doses, harmful at therapeutic level.
c. Allergies. - Answer: i. Redness, itching, hives, swelling; A condition in which the immune system reacts
abnormally to a foreign substance.
,Intended effect - Answer: i. Maintenance of vital signs within expected limits.
ii. Decrease in the risk of seizures.
iii. Decrease in the intensity of withdrawal manifestations.
iv. Substitution therapy during alcohol withdrawal.
Teratogenic effect - Answer: i. Drug-induced birth defect.
ii. Birth defects are not limited to distortions of gross anatomy; they also include neurobehavioral and
metabolic anomalies.
Paradoxical effect - Answer: i. Opposite the intended drug effect.
ii. Common example:
1. Insomnia and excitement that may occur when some children and older adults are given
benzodiazepines for sedation.
Tolerance - Answer: i. Pharmacodynamic tolerance
1. Reduced responsiveness to a medication that clients take over time.
ii. Metabolic tolerance 1. Metabolism of medication increases over time and the effectiveness of the
medication declines.
iii. Cross-tolerance
1. Become tolerant to a medication that is chemically similar to another medication they became
tolerant of.
i. Pharmacodynamic tolerance - Answer: 1. Reduced responsiveness to a medication that clients take
over time.
ii. Metabolic tolerance - Answer: 1. Metabolism of medication increases over time and the effectiveness
of the medication declines.
iii. Cross-tolerance - Answer: 1. Become tolerant to a medication that is chemically similar to another
medication they became tolerant of.
, Half-life of medications - Answer: a. Defined as the time required for the amount of drug in the body to
decrease by 50%.
b. Percentage versus amount.
c. Determines the dosing interval.
Half-life of Modafinil (CNS suppressant; narcolepsy) - Answer: About 15 hours.
Half-life of Phenytoin (Seizures) - Answer: 8-60 hours
1. lower doses: 8 hours. 2. higher doses: 60 hours.
Half-life of Fluvoxamine (SSRI) - Answer: About 15 hours.
Half-life of Citalopram (SSRI) - Answer: About 35 hours.
Half-life of Duloxetine (SNRI) - Answer: 12 hours.
Donepezil (Aricept) - Answer: Therapy in patients with Alzheimer's disease.
Alzheimer's Disease - Answer: i. uncurable, cannot be delayed/slowed, or reversed. However cognitive
decline can be slowed down with meds. Cholinesterase inhibitors may cause fainting due to hypotension
and bradycardia.
Donepezil - Answer: i. Indicated for mild, moderate or severe AD.
ii. Affects ACh levels.
iii. Take acetaminophen (Tylenol) instead of NSAIDs (aspirin or ibuprofen).
iv. Inhibition/prevention to breakdown Acetylcholine (ACh).
Donepenzil (common side effects) - Answer: v. Common side effects
1. Nausea/vomiting
2. GI discomfort (diarrhea)