,
,
, 6. The LPN/VN is assessing a patient before giving a drug for blood pressure management. The
nurse notes the blood pressure to be 90/50 mm Hg. What is the nurse‘s best action?
a. Hold the drug and report the blood pressure to the RN.
b. Give the patient a full glass of water before giving the drug.
c. Come back in 30 minutes and recheck the blood pressure.
d. Have the patient perform pursed lip breathing before giving the drug.
ANS: A
The best action is to hold the drug and contact the RN. The patient may need an adjustment to
the dose of the blood pressure drug or switching to another drug. Giving water with the drug
is not contraindicated but does not recognize the patient‘s risk for hypotension. Pursed lip
breathing has no role in this situation.
DIF: Cognitive Level: Remembering REF: p. 4
7. The LPN is collecting objective data for inclusion in the nursing assessment. Which piece of
information indicates that the LPN has a clear understanding of objective assessment data?
a. A patient‘s rating of chest pain as 8 on a 1 to 10 scale.
b. Family members report that patient has been experiencing pain for 1 month.
c. Detailed history of the patient‘s current illness upon admission.
d. Compilation of past laboratory results and x-ray reports.
ANS: D
The patient‘s past laboratory and x-ray results are examples of objective data. A pain rating of
8/10, a family member‘s description of the patient‘s pain, and history of current illness are
examples of subjective data.
DIF: Cognitive Level: Remembering REF: p. 3
8. A patient recently began a taking blood pressure drug and presents for a follow-up
appointment. The office nurse reviews the patient‘s daily blood pressure recordings. Which
stage of the nursing process corresponds to this review?
a. Assessment
b. Planning
c. Diagnosis
d. Evaluation
ANS: D
The evaluation phase involves examining the results that occur when the plan is implemented.
Reviewing the patient‘s daily blood pressure recording examines the patient‘s response to the
drug. The assessment phase provides initial information about the patient, the problem, and
anything that may change the choice of treatment. The planning phase involves using patient
assessment data and diagnoses to set goals and write care plans. The diagnosis phase involves
decision-making about the patient‘s problems, including medical diagnoses made by the
healthcare provider and nursing diagnoses developed through the North American Nursing
Diagnosis Association (NANDA).
of data to uncover patterns, trends, and insights that can inform business decisions. The advent of big data – vast amounts of structured and unstructured data – has revolutionized many industries, including
healthcare, finance, marketing, and sports.Predictive Analytics: Uses historical data and statistical algorithms to forecast future trends. For example, businesses can use predictive analytics to anticipate
customer behavior.Data Visualization: The graphical representation of data to make complex information easier to understand. Tools like Tableau and Power BI are commonly used for data
visualization.Machine Learning and Artificial Intelligence (AI): A subset of data analytics where machines learn from data without being explicitly programmed. Machine learning algorithms are used to
predict outcomes, automate processes, and optimize decisions.Blockchain and CryptocurrenciesBlockchain technology provides a decentralized and secure way to store and transfer data. It is best known for
its use in cryptocurrency transactions but has applications in areas like supply chain management, healthcare, and voting systems.Blockchain for Business: Blockchain enables transparent and immutable
record-keeping, making it ideal for applications like tracking goods in a supply chain or securing digital identities.Cryptocurrency: Digital or virtual currencies that use cryptography for security. Bitcoin,
Ethereum, and other cryptocurrencies have become widely known as alternative forms of currency.IT Governance and ComplianceIT governance refers to the policies,
DIF: Cognitive Level: Remembering REF: p. 2
, 9. After receiving report, the LPN gives drugs to her assigned patients on the evening shift. With
which stage of the nursing process does this activity correspond?
a. Implementation
b. Assessment
c. Planning
d. Diagnosis
ANS: A
The implementation phase involves actively following the plan of care and accurately giving
ordered drug to the patients. The assessment phase involves obtaining initial information
about the patient, the problem, and anything that may change the choice of treatment. The
planning phase involves using patient assessment data and diagnoses to set goals and write
care plans. The diagnosis phase involves decision-making about the patient‘s problems,
including medical diagnoses made by the healthcare provider and nursing diagnoses
developed through the North American Nursing Diagnosis Association (NANDA).
DIF: Cognitive Level: Remembering REF: p. 5
10. You are reviewing a patient‘s new antihypertensive drug order. The order as written is unclear
as to the number of times per day the drug is to be given. What is your best action?
a. Call the healthcare provider to clarify the order.
b. Refer the question to the hospital pharmacy.
c. Give the drug according to the information in a drug handbook.
d. Hold the drug until the healthcare provider returns the following day.
ANS: A
Your responsibility as a nurse giving drugs is to apply knowledge about the specific drug and
drug orders. No part of the drug order should be unclear. Any questions related to the drug,
dose or appropriateness for the specific patient should be answered before the drug is given.
DIF: Cognitive Level: Understanding REF: p. 4
of data to uncover patterns, trends, and insights that can inform business decisions. The advent of big data – vast amounts of structured and unstructured data – has revolutionized many industries, including healthcare,
finance, marketing, and sports.Predictive Analytics: Uses historical data and statistical algorithms to forecast future trends. For example, businesses can use predictive analytics to anticipate customer behavior.Data
Visualization: The graphical representation of data to make complex information easier to understand. Tools like Tableau and Power BI are commonly used for data visualization.Machine Learning and Artificial
Intelligence (AI): A subset of data analytics where machines learn from data without being explicitly programmed. Machine learning algorithms are used to predict outcomes, automate processes, and optimize
decisions.Blockchain and CryptocurrenciesBlockchain technology provides a decentralized and secure way to store and transfer data. It is best known for its use in cryptocurrency transactions but has applications in
areas like supply chain management, healthcare, and voting systems.Blockchain for Business: Blockchain enables transparent and immutable record-keeping, making it ideal for applications like tracking goods in a
supply chain or securing digital identities.Cryptocurrency: Digital or virtual currencies that use cryptography for security. Bitcoin, Ethereum, and other cryptocurrencies have become widely known as alternative forms
of currency.IT Governance and ComplianceIT governance refers to the policies,
11. A patient is receiving an antibiotic for pneumonia. On the third day of the treatment regimen,
a rash appears on her chest, and she reports itching and shortness of breath. Which term
describes the effect that has occurred?
a. Therapeutic effect
b. Adverse effect
c. Side effect
d. Overdose effect
fields to provide even more in-depth exploration:________________________________________Business (Continued)Innovation and DisruptionInnovation is a key driver in business today. Companies that continuously
innovate are better positioned to maintain competitive advantage, create new market opportunities, and meet evolving customer demands. Disruptive innovation refers to new products or services that significantly alter or replac
existing markets or industries.Disruptive Innovation Examples: Think of how streaming services like Netflix disrupted traditional cable television or how e-commerce platforms like Amazon challenged brick-and-mortar retail
stores. These innovations often start in niche markets but grow to reshape entire industries.Product Development Lifecycle: Businesses continuously innovate by developing new products and services. The lifecycle typically
includes stages like idea generation, design and development, testing, market introduction, and post-launch evaluation.Mergers and Acquisitions (M&A)Mergers and acquisitions refer to the consolidation of companies or asset
often driven by the desire to expand market share, reduce competition, or achieve economies of scale. M&A activity can be complex, involving financial due diligence, negotiation, and integration processes.Strategic M&A:
Companies may acquire competitors to expand their market presence or diversify their product offerings. For example, the acquisition of Instagram by Facebook enabled Facebook to tap into the rapidly growing mobile photo-
sharing market.Hostile Takeovers: In some cases, a company may acquire another without the consent of its management, which can lead to conflicts and regulatory scrutiny.Business Analytics and Data-Driven Decision
MakingData-driven decision-making involves using data and analytical tools to guide business strategies and improve operations. With the rise of big data, businesses now have access to vast amounts of information that can be
used to make better decisions.Predictive Analytics: This form of analysis helps businesses forecast future trends based on historical data. For instance, retail companies use predictive analytics to forecast inventory needs, while
banks use it for credit risk assessment.Descriptive Analytics: Focuses on understanding historical performance by analyzing past data. For example, sales teams might use descriptive analytics to identify successful marketing
campaigns and product offerings.Prescriptive Analytics: Goes a step further by recommending specific actions based on the data. A typical example is recommending a price point or promotional strategy based on customer
behavior and market
ANS: B
An itchy rash with shortness of breath that develops in response to drug is an example of an
allergic reaction or adverse effect to the antibiotic. Therapeutic effects occur when an
, antibiotic fights infection without causing any adverse effects. Side effects of drugs are known
potential effects of the antibiotic that range from mild to moderate. An overdose occurs if a
patient receives too much of a drug.
DIF: Cognitive Level: Understanding REF: p. 9
12. An LPN enters a patient‘s room to give a scheduled drug. Before administration, the patient
states, ―I can‘t take that drug; I‘m allergic to it.‖ What should the nurse do first?
a. Reassure the patient that the drug is needed and observations regarding possible
allergic symptoms will be made.
b. Review the patient record and encourage the patient to take the drug if no allergies
have been documented.
c. Assess the patient‘s allergic history and notify the healthcare provider to determine
a course of action.
d. Document patient refusal and leave a note on the patient chart for the healthcare
provider.
ANS: C
The patient has shared information that indicates the potential for the ordered drug to cause
adverse effects. Before giving the drug, the nurse should investigate further by obtaining a
more detailed drug history and notifying the healthcare provider who wrote the order.
Although the order may be accurately written, determining whether the drug‘s benefits
outweigh the risks is not an action within the legal scope of the nurse‘s practice. The nurse
should not offer false reassurance and as an advocate for patient safety, should investigate
further before giving the drug. The patient has raised concerns regarding the drug that should
promptly be brought to the provider‘s attention. A note on the chart leaves potential for
information to be missed.
DIF: Cognitive Level: Applying REF: p. 4
13. The LPN is preparing to give the initial dose of an antibiotic to a patient diagnosed with an
infection. The patient says, ―I broke out in a rash the last time I took that pill.‖ What action
should the LPN take next?
innovations often start in niche markets but grow to reshape entire industries.Product Development Lifecycle: Businesses cont inuously innovate by developing new products and services. The lifecycle
typically includes stages like idea generation, design and development, testing, market introduction, and post-launch evaluation.Mergers and Acquisitions (M&A)Mergers and acquisitions refer to the
consolidation of companies or assets, often driven by the desire to expand market share, reduce competition, or achieve economies of scale. M&A activity can be complex, involving financial due
diligence, negotiation, and integration processes.Strategic M&A: Companies may acquire competitors to expand their market presence or diversify their product offerings. For example, the acquisition of
Instagram by Facebook enabled Facebook to tap into the rapidly growing mobile photo-sharing market.Hostile Takeovers: In some cases, a company may acquire another without the consent of its
management, which can lead to conflicts and regulatory scrutiny.Business Analytics and Data-Driven Decision MakingData-driven decision-making involves using data and analytical tools to guide
business strategies and improve operations. With the rise of big data, businesses now have access to vast amounts of information that can be used to make better decisions.Predictive Analytics: This form
of analysis helps businesses forecast future trends based on historical data. For instance, retail companies use predictive analytics to forecast inventory needs, while banks use it for credit risk
assessment.Descriptive Analytics: Focuses on understanding historical performance by analyzing past data. For example, sales teams might use descriptive analytics to identify successful marketing
campaigns and product offerings.Prescriptive Analytics: Goes a step further by recommending specific actions based on the data. A typical example is recommending a price point or promotional
strategy based on customer behavior and market conditions.Human Resource Management (HRM) and Employee EngagementHuman resource management plays a vital role in managing and
developing the organization's most important asset—its people. HR functions extend beyond recruitment and include performance management, employee training, compensation, and workforce
planning.Employee Engagement: Ensuring employees are motivated and committed to their work is a key focus of HR. Engaged employees are more productive, committed, and less likely to leave the
organization.Workplace Culture: A positive workplace culture promotes teamwork, creativity, and innovation. It is shaped by leadership, communication, and the organizational environment, impacting
employee satisfaction and overall performance.Talent Management: Identifying and nurturing top talent is crucial for long-term success. Effective talent management ensures that employees' skills are
aligned with business needs, and there is a clear path for career progression.________________________________________Accounting (Continued)Managerial Accounting and Performance
a. Give the drug and check the patient in 30 minutes for a rash.
b. Document that the patient refused the drug per agency policy.
c. Leave the drug at the bedside while checking the chart for the patient‘s allergies.
d. Notify the registered nurse or healthcare provider.
ANS: D
This is a possible adverse reaction, and the RN or healthcare provider should be notified
immediately. You would never give the drug to see if it does cause a rash. Drug should never
be left at the bedside. The patient did not refuse the drug.
DIF: Cognitive Level: Applying REF: p. 9
, 14. Which priority assessment must you make before giving any patient a drug by mouth?
a. Quiz the patient about the action of each drug.
b. Make sure the patient can swallow.
c. Find out whether the patient prefers cold or room temperature liquids.
d. Ask the patient to repeat his or her name and birthdate.
ANS: B
Before the patient can take any drug by mouth, they must be able to swallow. Asking the
patient to repeat his name and birthdate may be part of using two identifiers but this is
important with all patients. Preferences are also important, but the priority is that the patient
be able to swallow the drug.
DIF: Cognitive Level: Understanding REF: p. 8
MULTIPLE RESPONSE
1. You are preparing to give the morning drugs to your assigned patients. Before giving each
drug, which steps are considered to be ―rights‖ of giving a drug? (Select all that apply.)
a. The right plan
b. The right time
c. The right dose
d. The right patient
e. The right to self-administer
f. The right drug
ANS: B, C, D, F
The nine rights associated with giving drugs are as follows: right patient, right drug, right
time, right dose, right route, right documentation, right reason, right response, and right to
refuse.
DIF: Cognitive Level: Remembering REF: p. 5
enhance patient outcomes and reduce healthcare costs.EHR Implementation: The use of electronic health records has become standard in healthcare settings, allowing for the efficient management of patient data,
improving communication, and reducing errors.Telehealth and Virtual Care: Telehealth enables healthcare providers to deliver services remotely, making it more accessible for patients in rural or underserved areas.
Nurses often conduct virtual assessments, follow-up consultations, and patient education.Public Health NursingPublic health nursing focuses on promoting and protecting the health of populations, rather than
individual patient care. Public health nurses work in community settings, schools, and public health agencies, addressing health disparities and promoting health education.Epidemiology: Public health nurses work
with epidemiologists to track disease outbreaks and implement preventive measures. They are crucial in preventing the spread of infectious diseases through immunizations, education, and outreach.Community Health
Initiatives: Public health nurses may run programs on maternal and child health, mental health awareness, smoking cessation, and more.________________________________________Information Technology
(Continued)Cloud Computing and Its ImpactCloud computing has revolutionized the way businesses store and access data. By shifting infrastructure to cloud-based platforms, organizations benefit from cost savings,
scalability, and flexibility.Hybrid Cloud: A hybrid cloud model combines both private and public clouds, allowing businesses to keep sensitive data on private servers while utilizing public clouds for less-sensitive
tasks.Cloud Security: As more businesses move to the cloud, ensuring the security of cloud-based data becomes a top priority. This includes encryption, access control, and multi-factor authentication.Cloud-based
Software-as-a-Service (SaaS): SaaS solutions like Salesforce, Dropbox, and Microsoft 365 allow businesses to access applications over the internet without installing them on local machines, simplifying IT
infrastructure.Artificial Intelligence and Automation in ITAI and automation are rapidly transforming IT operations, from enhancing software development to managing IT infrastructure.Robotic Process Automation
(RPA): RPA involves automating repetitive, rule-based tasks like data entry, invoice processing, and customer support. RPA tools help companies save time and reduce human error.AI in IT Operations (AIOps):
AIOps leverages AI to automate and optimize IT operations, such as monitoring system health, identifying anomalies, and resolving issues without human intervention.IT Support and Help Desk ManagementIT
support teams help users troubleshoot technical issues, maintain systems, and implement IT solutions. A well-organized help desk ensures that users’ problems are addressed quickly and efficiently.Ticketing Systems:
IT help desks often use ticketing systems to track and manage user requests. These systems allow IT teams to prioritize, resolve, and follow up on issues.Remote IT Support: With the rise of remote work, IT support
teams have expanded their role to offer remote assistance, solving issues through online communication tools and screen sharing.Cybersecurity Threats and Best PracticesCybersecurity is an ever-evolving field that
must constantly adapt to new threats, such as hacking, data breaches, and ransomware attacks.Phishing Attacks: These are fraudulent attempts to obtain sensitive information, often through email or malicious websites.
Employees must be educated on how to identify phishing attempts to avoid data breaches.Ransomware: Malicious software that locks users out of their systems and demands payment for access to be restored.
Organizations must have strong backup and disaster recovery systems to mitigate the effects of ransomware attacks.Zero Trust Security: A security model that assumes no one, whether inside or outside the
organization, should be trusted by default. It emphasizes strong identity verification, network segmentation, and continuous monitoring.________________________________________These extended explanations
offer a more in-depth look at the evolving trends, challenges, and opportunities in Business, Accounting, Nursing, and Information Technology (IT). As industries develop, these fields will continue to be fundamental
drivers of innovation and progress, impacting every aspect of our daily lives.Absolutely! Here’s
2. A licensed practical/vocational nurse has a specific set of roles and responsibilities. Which
responsibilities are within the scope of an LPN/LVN? (Select all that apply.)
a. Writing medical orders
b. Assessment of admission vitals to report to the admitting RN
c. Conducting a comprehensive admission assessment
d. Independent initiation of comprehensive plan of care
e. Management of patient care under RN supervision
, ANS: B, E
Assisting the RN in gathering specific data such as vital signs is within the scope of
LPN/LVN practice. The LPN/LVN works directly with the patient and manages care and
assists the RN in data collection and care plan development. The LPN/LVN does not have the
legal authority to write medical orders or carry out the admission assessment. LPNs/LVNs are
more dependent in the planning and evaluation phase of the nursing process. An LPN/LVN
can collect data to assist the RN with care plan development but is unable to initiate a
comprehensive plan of care independently.
DIF: Cognitive Level: Remembering REF: p. 3
3. The LPN is collecting subjective data for inclusion in the nursing assessment. What
information indicates that the LPN has a clear understanding of the nature of subjective
assessment data? (Select all that apply.)
a. Pulse rate
b. ECG brought in by the patient
c. Chief complaint of chest pain in the patient‘s own words
d. Auscultation of lung sounds
e. The patient‘s statement of current over the counter and prescription drugs
f. The patient‘s laboratory test results
ANS: C, E
Subjective data include information given by the patient or family, like concerns or symptoms
felt by the patient, and their statement of mediations. The pulse rate, recent ECG, laboratory
test results, and lung auscultation obtained through physical examination are examples of
objective data.
DIF: Cognitive Level: Remembering REF: p. 3
treat employees, customers, suppliers, and the environment with respect. Ethical issues could include transparency, fair trade practices, environmental responsibility, and workplace discrimination.Regulatory
Compliance: Businesses must adhere to a wide range of regulations and laws designed to protect employees, consumers, and the environment. Failure to comply with regulations like the Foreign Corrupt Practices Act
(FCPA) or the Sarbanes-Oxley Act (SOX) can lead to heavy fines and damage to the company’s reputation.Supply Chain Management (SCM)Supply chain management involves overseeing the movement of goods
and services from suppliers to customers. A well-managed supply chain improves operational efficiency and customer satisfaction, while a poorly managed one can lead to inefficiencies and higher costs.Global
Supply Chains: With globalization, companies are sourcing materials and products from across the world. Supply chain management now involves coordinating with suppliers, manufacturers, and distributors across
multiple countries.Just-in-Time (JIT) Manufacturing: JIT is a strategy where companies minimize inventory by receiving goods and materials only when they are needed in the production process. While it reduces
storage costs, it requires precise forecasting and strong supplier relationships.Supply Chain Resilience: The COVID-19 pandemic revealed the vulnerability of global supply chains. Companies are now focusing on
creating more resilient supply chains that can withstand disruptions from natural disasters, political instability, or pandemics by diversifying suppliers, implementing contingency plans, and improving
visibility.________________________________________Accounting (Continued)Financial Statement AnalysisFinancial statement analysis helps stakeholders assess a company’s financial performance and health.
This analysis is essential for investors, creditors, and managers in making informed decisions about the business.Horizontal and Vertical Analysis: Horizontal analysis compares financial data over time, typically from
year to year, to identify trends and growth patterns. Vertical analysis, on the other hand, expresses each item in a financial statement as a percentage of a base amount (e.g., total sales or total assets) to analyze the
relationship between different financial elements.Ratio Analysis: Financial ratios are used to evaluate a company's performance, profitability, liquidity, and solvency. Key ratios include the current ratio (liquidity), the
return on assets (ROA), and the debt-to-equity ratio (solvency). These ratios help assess whether a company is financially healthy or facing challenges.Internal and External Financial ReportingCompanies need to
ensure that their financial reporting is accurate and transparent. Internal financial reporting provides management with the information needed to make operational decisions, while external reporting is used to
communicate with investors, regulators, and other stakeholders.Internal Financial Reporting: Internal reports include financial forecasts, budget analysis, variance reports, and cost-benefit analyses. These reports are
essential for management to make informed decisions regarding operations and strategy.External Financial Reporting: External reports include financial statements like income statements, balance sheets, and cash
flow statements, which are shared with external stakeholders such as investors, auditors, and government regulators. Companies must adhere to generally accepted accounting principles (GAAP) or IFRS to ensure
transparency.Environmental, Social, and Governance (ESG) ReportingESG reporting is becoming more important as companies and investors focus on sustainability and corporate responsibility. It involves tracking a
company’s impact on the environment, society, and its governance practices.Environmental Impact: This aspect of ESG focuses on a company’s efforts to reduce its carbon footprint, manage waste, and use sustainable
resources. Companies may disclose their greenhouse gas emissions, water usage, and recycling efforts.Social Responsibility: The social component of ESG includes factors like labor practices, community
engagement, and customer satisfaction. For example, companies that provide safe working conditions, pay fair wages, and support local communities often score higher on social responsibility metrics.Governance
Practices: Governance focuses on how a company is managed and whether it adheres to ethical and legal standards. Issues like executive compensation, board diversity, and transparency in decision-making fall under
governance practices.________________________________________Nursing (Continued)Nursing Specialties
4. A 72 year-old female patient has just been admitted to a rehabilitation center for extended
physical therapy following a stroke. You are obtaining the patient‘s drug history. Which
information should you collect? (Select all that apply.)
a. Drugs currently being taken
b. Over-the-counter drugs being taken
c. Referrals to specialists
d. Diseases or conditions requiring drugs
e. Use of herbal supplements
f. Past medical history
, g. Alcohol use
h. Drug allergies
ANS: A, B, D, E, G, H
Important information to gather from a patient‘s drug history are the current prescription
drugs, OTC drugs, the conditions that denote the patient‘s need for a drug, alcohol use, drug
allergies, and the use of nutritional or herbal supplements. The remaining choices are items in
the history of present or past illnesses, and not concerned with drugs.
DIF: Cognitive Level: Understanding REF: p. 3
access to care, and policy changes that affect the healthcare system. For instance, nurses may advocate for better staffing ratios, improved patient safety protocols, or policies that address health disparities in
underserved communities.Healthcare Reform: Nurses actively participate in efforts to reform healthcare systems. This includes advocating for universal healthcare, expanded insurance coverage, and policies that
improve health outcomes, such as mental health parity and access to preventive care.End-of-Life Care and Palliative NursingPalliative care focuses on improving the quality of life for patients facing serious illness or
end-of-life challenges. Nurses in palliative and hospice care play an essential role in providing physical, emotional, and spiritual support for patients and their families.Symptom Management: Nurses in palliative care
work closely with patients to manage symptoms such as pain, nausea, and shortness of breath. They often collaborate with physicians, social workers, and chaplains to provide holistic care.Advance Directives and
Ethical Considerations: Nurses help patients and families navigate decisions about end-of-life care, including advance directives, do-not-resuscitate (DNR) orders, and other ethical considerations related to life-
sustaining treatment.________________________________________Information Technology (Continued)Digital Transformation and IT IntegrationAs businesses continue to adapt to the digital age, integrating IT
systems and technologies is critical to ensuring efficient operations and staying competitive.Enterprise Integration: Many businesses now employ enterprise resource planning (ERP) systems to integrate key functions
like finance, HR, supply chain management, and customer relations. ERPs help ensure smooth data flow across departments and increase operational efficiency.System Interoperability: Interoperability refers to the
ability of different IT systems to communicate and exchange data seamlessly. In industries like healthcare, financial services, and government, system interoperability is critical for improving service delivery, reducing
redundancy, and enhancing decision-making.Cybersecurity in the Age of Digital TransformationAs businesses increase their digital presence, the risk of cyber threats continues to rise. Cybersecurity is a priority for
organizations seeking to protect their data, networks, and users from malicious attacks.Data Encryption: Data encryption is a critical security measure that ensures sensitive information is unreadable by unauthorized
individuals. This is especially important when handling personal, financial, or medical data.Zero-Day Vulnerabilities: These are flaws in software that are unknown to the vendor and thus unpatched, leaving systems
vulnerable to cyberattacks. Cybersecurity experts work to identify and mitigate these vulnerabilities as quickly as possible.Incident Response: When a security breach occurs, an incident response plan is crucial to
minimize damage. This includes identifying the threat, containing the breach, assessing the impact, and communicating with affected stakeholders.The Future of IT with Quantum
Chapter 02: Legal, Regulatory, and Ethical Aspects of Drug Administration
Visovsky: Introduction to Clinical Pharmacology, 11th Edition
MULTIPLE CHOICE
1. You have obtained a liquid narcotic for a patient in pain from the unit‘s locked cabinet.
However, the dose was accidentally spilled before giving it to the patient. What is the best
action to take at this point?
a. Ask another nurse to cosign the inventory record describing the situation.
b. Immediately obtain another dose from the narcotic control system.
c. Document the occurrence in the drug record.
d. Clean up the spill and notify the supervisor.
ANS: A
Accounting for controlled substances is a legal requirement. If the drug is accidentally
dropped, contaminated, or spilled two nurses must sign the inventory report and describe the
situation.
DIF: Cognitive Level: Remembering REF: p. 16
2. As you arrive to work, a nurse from the previous shift tells you that she has completed the
narcotic count for your shift. What action should be taken?
a. There is no need for any additional action as this is the standard procedure.
b. Accept the keys to the narcotic cabinet and recount the drugs yourself.
c. Recount the narcotics again with a nurse from the previous shift.
d. Recount the drugs yourself at the end of your shift.
ANS: C
At the end of each shift, the contents of the locked cabinet are counted together by one nurse
from each shift in order to verify the narcotics count. If not done properly, the nurse risks
being held accountable for any shortages or discrepancies, and may be found guilty of
falsifying the narcotic count records.
DIF: Cognitive Level: Applying REF: p. 16
, 3. A one-time order for a controlled substance drug has been written for a patient you are caring
for. However, the drug ordered is available only in a larger dose than is needed. What should
you do with the remaining drug?
a. Give the full dose that is available.
b. Flush the remaining drug in the toilet of the patient‘s bathroom.
c. Save the remaining drug in case the patient needs it again.
d. Have another nurse to witness wasting of the leftover drug, and document
according to policy.
access to care, and policy changes that affect the healthcare system. For instance, nurses may advocate for better staffing ratios, improved patient safety protocols, or policies that address
health disparities in underserved communities.Healthcare Reform: Nurses actively participate in efforts to reform healthcare systems. This includes advocating for universal healthcare,
expanded insurance coverage, and policies that improve health outcomes, such as mental health parity and access to preventive care.End-of-Life Care and Palliative NursingPalliative care
focuses on improving the quality of life for patients facing serious illness or end-of-life challenges. Nurses in palliative and hospice care play an essential role in providing physical,
emotional, and spiritual support for patients and their families.Symptom Management: Nurses in palliative care work closely with patients to manage symptoms such as pain, nausea, and
shortness of breath. They often collaborate with physicians, social workers, and chaplains to provide holistic care.Advance Directives and Ethical Considerations: Nurses help patients and
families navigate decisions about end-of-life care, including advance directives, do-not-resuscitate (DNR) orders, and other ethical considerations related to life-sustaining
treatment.________________________________________Information Technology (Continued)Digital Transformation and IT IntegrationAs businesses continue to adapt to the digital age,
integrating IT systems and technologies is critical to ensuring efficient operations and staying competitive.Enterprise Integration: Many businesses now employ enterprise resource planning
(ERP) systems to integrate key functions like finance, HR, supply chain management, and customer relations. ERPs help ensure smooth data flow across departments and increase
operational efficiency.System Interoperability: Interoperability refers to the ability of different IT systems to communicate and exchange data seamlessly. In industries like healthcare,
financial services, and government, system interoperability is critical for improving service delivery, reducing redundancy, and enhancing decision-making.Cybersecurity in the Age of
Digital TransformationAs businesses increase their digital presence, the risk of cyber threats continues to rise. Cybersecurity is a priority for organizations seeking to protect their data,
networks, and users from malicious attacks.Data Encryption: Data encryption is a critical security measure that ensures sensitive information is unreadable by unauthorized individuals. This
is especially important when handling personal, financial, or medical data.Zero-Day Vulnerabilities: These are flaws in software that are unknown to the vendor and thus unpatched, leaving
systems vulnerable to cyberattacks. Cybersecurity experts work to identify and mitigate these vulnerabilities as quickly as possible.Incident Response: When a security breach occurs, an
incident response plan is crucial to minimize damage. This includes identifying the threat, containing the breach, assessing the impact, and communicating with affected stakeholders.The
Future of IT with Quantum
ANS: C
If the ordered dose is smaller than the dose provided (so that some drug must be discarded),
two nurses witness the wasting of the drug, and sign the controlled substance inventory report
according to institution policy.
DIF: Cognitive Level: Understanding REF: p. 16
4. An elderly patient in an assisted living home requests an over-the-counter cough preparation
for a mild cough she is experiencing. What is your best response?
a. ―I do not have any of this drug for you at this time, but can give you a dose from
another patient‘s supply.‖
b. ―I will bring it to you right away, but I must keep it with your other prescription
drugs.‖
c. ―I will need to contact your healthcare provider for an order before I can give this
drug to you.‖
d. ―You may have this, but your family will need to bring it in for you.‖
ANS: C
Over-the-counter (OTC) drugs do not require a prescription for purchase, but a healthcare
provider‘s order is required before it can be given by the LPN/LVN in an institutional setting.
OTC drugs may interact with a patient‘s prescribed drugs, especially in the elderly.
DIF: Cognitive Level: Applying REF: p. 17
5. Which of the following orders is an example of a single drug order?
,
, 6. The LPN/VN is assessing a patient before giving a drug for blood pressure management. The
nurse notes the blood pressure to be 90/50 mm Hg. What is the nurse‘s best action?
a. Hold the drug and report the blood pressure to the RN.
b. Give the patient a full glass of water before giving the drug.
c. Come back in 30 minutes and recheck the blood pressure.
d. Have the patient perform pursed lip breathing before giving the drug.
ANS: A
The best action is to hold the drug and contact the RN. The patient may need an adjustment to
the dose of the blood pressure drug or switching to another drug. Giving water with the drug
is not contraindicated but does not recognize the patient‘s risk for hypotension. Pursed lip
breathing has no role in this situation.
DIF: Cognitive Level: Remembering REF: p. 4
7. The LPN is collecting objective data for inclusion in the nursing assessment. Which piece of
information indicates that the LPN has a clear understanding of objective assessment data?
a. A patient‘s rating of chest pain as 8 on a 1 to 10 scale.
b. Family members report that patient has been experiencing pain for 1 month.
c. Detailed history of the patient‘s current illness upon admission.
d. Compilation of past laboratory results and x-ray reports.
ANS: D
The patient‘s past laboratory and x-ray results are examples of objective data. A pain rating of
8/10, a family member‘s description of the patient‘s pain, and history of current illness are
examples of subjective data.
DIF: Cognitive Level: Remembering REF: p. 3
8. A patient recently began a taking blood pressure drug and presents for a follow-up
appointment. The office nurse reviews the patient‘s daily blood pressure recordings. Which
stage of the nursing process corresponds to this review?
a. Assessment
b. Planning
c. Diagnosis
d. Evaluation
ANS: D
The evaluation phase involves examining the results that occur when the plan is implemented.
Reviewing the patient‘s daily blood pressure recording examines the patient‘s response to the
drug. The assessment phase provides initial information about the patient, the problem, and
anything that may change the choice of treatment. The planning phase involves using patient
assessment data and diagnoses to set goals and write care plans. The diagnosis phase involves
decision-making about the patient‘s problems, including medical diagnoses made by the
healthcare provider and nursing diagnoses developed through the North American Nursing
Diagnosis Association (NANDA).
of data to uncover patterns, trends, and insights that can inform business decisions. The advent of big data – vast amounts of structured and unstructured data – has revolutionized many industries, including
healthcare, finance, marketing, and sports.Predictive Analytics: Uses historical data and statistical algorithms to forecast future trends. For example, businesses can use predictive analytics to anticipate
customer behavior.Data Visualization: The graphical representation of data to make complex information easier to understand. Tools like Tableau and Power BI are commonly used for data
visualization.Machine Learning and Artificial Intelligence (AI): A subset of data analytics where machines learn from data without being explicitly programmed. Machine learning algorithms are used to
predict outcomes, automate processes, and optimize decisions.Blockchain and CryptocurrenciesBlockchain technology provides a decentralized and secure way to store and transfer data. It is best known for
its use in cryptocurrency transactions but has applications in areas like supply chain management, healthcare, and voting systems.Blockchain for Business: Blockchain enables transparent and immutable
record-keeping, making it ideal for applications like tracking goods in a supply chain or securing digital identities.Cryptocurrency: Digital or virtual currencies that use cryptography for security. Bitcoin,
Ethereum, and other cryptocurrencies have become widely known as alternative forms of currency.IT Governance and ComplianceIT governance refers to the policies,
DIF: Cognitive Level: Remembering REF: p. 2
, 9. After receiving report, the LPN gives drugs to her assigned patients on the evening shift. With
which stage of the nursing process does this activity correspond?
a. Implementation
b. Assessment
c. Planning
d. Diagnosis
ANS: A
The implementation phase involves actively following the plan of care and accurately giving
ordered drug to the patients. The assessment phase involves obtaining initial information
about the patient, the problem, and anything that may change the choice of treatment. The
planning phase involves using patient assessment data and diagnoses to set goals and write
care plans. The diagnosis phase involves decision-making about the patient‘s problems,
including medical diagnoses made by the healthcare provider and nursing diagnoses
developed through the North American Nursing Diagnosis Association (NANDA).
DIF: Cognitive Level: Remembering REF: p. 5
10. You are reviewing a patient‘s new antihypertensive drug order. The order as written is unclear
as to the number of times per day the drug is to be given. What is your best action?
a. Call the healthcare provider to clarify the order.
b. Refer the question to the hospital pharmacy.
c. Give the drug according to the information in a drug handbook.
d. Hold the drug until the healthcare provider returns the following day.
ANS: A
Your responsibility as a nurse giving drugs is to apply knowledge about the specific drug and
drug orders. No part of the drug order should be unclear. Any questions related to the drug,
dose or appropriateness for the specific patient should be answered before the drug is given.
DIF: Cognitive Level: Understanding REF: p. 4
of data to uncover patterns, trends, and insights that can inform business decisions. The advent of big data – vast amounts of structured and unstructured data – has revolutionized many industries, including healthcare,
finance, marketing, and sports.Predictive Analytics: Uses historical data and statistical algorithms to forecast future trends. For example, businesses can use predictive analytics to anticipate customer behavior.Data
Visualization: The graphical representation of data to make complex information easier to understand. Tools like Tableau and Power BI are commonly used for data visualization.Machine Learning and Artificial
Intelligence (AI): A subset of data analytics where machines learn from data without being explicitly programmed. Machine learning algorithms are used to predict outcomes, automate processes, and optimize
decisions.Blockchain and CryptocurrenciesBlockchain technology provides a decentralized and secure way to store and transfer data. It is best known for its use in cryptocurrency transactions but has applications in
areas like supply chain management, healthcare, and voting systems.Blockchain for Business: Blockchain enables transparent and immutable record-keeping, making it ideal for applications like tracking goods in a
supply chain or securing digital identities.Cryptocurrency: Digital or virtual currencies that use cryptography for security. Bitcoin, Ethereum, and other cryptocurrencies have become widely known as alternative forms
of currency.IT Governance and ComplianceIT governance refers to the policies,
11. A patient is receiving an antibiotic for pneumonia. On the third day of the treatment regimen,
a rash appears on her chest, and she reports itching and shortness of breath. Which term
describes the effect that has occurred?
a. Therapeutic effect
b. Adverse effect
c. Side effect
d. Overdose effect
fields to provide even more in-depth exploration:________________________________________Business (Continued)Innovation and DisruptionInnovation is a key driver in business today. Companies that continuously
innovate are better positioned to maintain competitive advantage, create new market opportunities, and meet evolving customer demands. Disruptive innovation refers to new products or services that significantly alter or replac
existing markets or industries.Disruptive Innovation Examples: Think of how streaming services like Netflix disrupted traditional cable television or how e-commerce platforms like Amazon challenged brick-and-mortar retail
stores. These innovations often start in niche markets but grow to reshape entire industries.Product Development Lifecycle: Businesses continuously innovate by developing new products and services. The lifecycle typically
includes stages like idea generation, design and development, testing, market introduction, and post-launch evaluation.Mergers and Acquisitions (M&A)Mergers and acquisitions refer to the consolidation of companies or asset
often driven by the desire to expand market share, reduce competition, or achieve economies of scale. M&A activity can be complex, involving financial due diligence, negotiation, and integration processes.Strategic M&A:
Companies may acquire competitors to expand their market presence or diversify their product offerings. For example, the acquisition of Instagram by Facebook enabled Facebook to tap into the rapidly growing mobile photo-
sharing market.Hostile Takeovers: In some cases, a company may acquire another without the consent of its management, which can lead to conflicts and regulatory scrutiny.Business Analytics and Data-Driven Decision
MakingData-driven decision-making involves using data and analytical tools to guide business strategies and improve operations. With the rise of big data, businesses now have access to vast amounts of information that can be
used to make better decisions.Predictive Analytics: This form of analysis helps businesses forecast future trends based on historical data. For instance, retail companies use predictive analytics to forecast inventory needs, while
banks use it for credit risk assessment.Descriptive Analytics: Focuses on understanding historical performance by analyzing past data. For example, sales teams might use descriptive analytics to identify successful marketing
campaigns and product offerings.Prescriptive Analytics: Goes a step further by recommending specific actions based on the data. A typical example is recommending a price point or promotional strategy based on customer
behavior and market
ANS: B
An itchy rash with shortness of breath that develops in response to drug is an example of an
allergic reaction or adverse effect to the antibiotic. Therapeutic effects occur when an
, antibiotic fights infection without causing any adverse effects. Side effects of drugs are known
potential effects of the antibiotic that range from mild to moderate. An overdose occurs if a
patient receives too much of a drug.
DIF: Cognitive Level: Understanding REF: p. 9
12. An LPN enters a patient‘s room to give a scheduled drug. Before administration, the patient
states, ―I can‘t take that drug; I‘m allergic to it.‖ What should the nurse do first?
a. Reassure the patient that the drug is needed and observations regarding possible
allergic symptoms will be made.
b. Review the patient record and encourage the patient to take the drug if no allergies
have been documented.
c. Assess the patient‘s allergic history and notify the healthcare provider to determine
a course of action.
d. Document patient refusal and leave a note on the patient chart for the healthcare
provider.
ANS: C
The patient has shared information that indicates the potential for the ordered drug to cause
adverse effects. Before giving the drug, the nurse should investigate further by obtaining a
more detailed drug history and notifying the healthcare provider who wrote the order.
Although the order may be accurately written, determining whether the drug‘s benefits
outweigh the risks is not an action within the legal scope of the nurse‘s practice. The nurse
should not offer false reassurance and as an advocate for patient safety, should investigate
further before giving the drug. The patient has raised concerns regarding the drug that should
promptly be brought to the provider‘s attention. A note on the chart leaves potential for
information to be missed.
DIF: Cognitive Level: Applying REF: p. 4
13. The LPN is preparing to give the initial dose of an antibiotic to a patient diagnosed with an
infection. The patient says, ―I broke out in a rash the last time I took that pill.‖ What action
should the LPN take next?
innovations often start in niche markets but grow to reshape entire industries.Product Development Lifecycle: Businesses cont inuously innovate by developing new products and services. The lifecycle
typically includes stages like idea generation, design and development, testing, market introduction, and post-launch evaluation.Mergers and Acquisitions (M&A)Mergers and acquisitions refer to the
consolidation of companies or assets, often driven by the desire to expand market share, reduce competition, or achieve economies of scale. M&A activity can be complex, involving financial due
diligence, negotiation, and integration processes.Strategic M&A: Companies may acquire competitors to expand their market presence or diversify their product offerings. For example, the acquisition of
Instagram by Facebook enabled Facebook to tap into the rapidly growing mobile photo-sharing market.Hostile Takeovers: In some cases, a company may acquire another without the consent of its
management, which can lead to conflicts and regulatory scrutiny.Business Analytics and Data-Driven Decision MakingData-driven decision-making involves using data and analytical tools to guide
business strategies and improve operations. With the rise of big data, businesses now have access to vast amounts of information that can be used to make better decisions.Predictive Analytics: This form
of analysis helps businesses forecast future trends based on historical data. For instance, retail companies use predictive analytics to forecast inventory needs, while banks use it for credit risk
assessment.Descriptive Analytics: Focuses on understanding historical performance by analyzing past data. For example, sales teams might use descriptive analytics to identify successful marketing
campaigns and product offerings.Prescriptive Analytics: Goes a step further by recommending specific actions based on the data. A typical example is recommending a price point or promotional
strategy based on customer behavior and market conditions.Human Resource Management (HRM) and Employee EngagementHuman resource management plays a vital role in managing and
developing the organization's most important asset—its people. HR functions extend beyond recruitment and include performance management, employee training, compensation, and workforce
planning.Employee Engagement: Ensuring employees are motivated and committed to their work is a key focus of HR. Engaged employees are more productive, committed, and less likely to leave the
organization.Workplace Culture: A positive workplace culture promotes teamwork, creativity, and innovation. It is shaped by leadership, communication, and the organizational environment, impacting
employee satisfaction and overall performance.Talent Management: Identifying and nurturing top talent is crucial for long-term success. Effective talent management ensures that employees' skills are
aligned with business needs, and there is a clear path for career progression.________________________________________Accounting (Continued)Managerial Accounting and Performance
a. Give the drug and check the patient in 30 minutes for a rash.
b. Document that the patient refused the drug per agency policy.
c. Leave the drug at the bedside while checking the chart for the patient‘s allergies.
d. Notify the registered nurse or healthcare provider.
ANS: D
This is a possible adverse reaction, and the RN or healthcare provider should be notified
immediately. You would never give the drug to see if it does cause a rash. Drug should never
be left at the bedside. The patient did not refuse the drug.
DIF: Cognitive Level: Applying REF: p. 9
, 14. Which priority assessment must you make before giving any patient a drug by mouth?
a. Quiz the patient about the action of each drug.
b. Make sure the patient can swallow.
c. Find out whether the patient prefers cold or room temperature liquids.
d. Ask the patient to repeat his or her name and birthdate.
ANS: B
Before the patient can take any drug by mouth, they must be able to swallow. Asking the
patient to repeat his name and birthdate may be part of using two identifiers but this is
important with all patients. Preferences are also important, but the priority is that the patient
be able to swallow the drug.
DIF: Cognitive Level: Understanding REF: p. 8
MULTIPLE RESPONSE
1. You are preparing to give the morning drugs to your assigned patients. Before giving each
drug, which steps are considered to be ―rights‖ of giving a drug? (Select all that apply.)
a. The right plan
b. The right time
c. The right dose
d. The right patient
e. The right to self-administer
f. The right drug
ANS: B, C, D, F
The nine rights associated with giving drugs are as follows: right patient, right drug, right
time, right dose, right route, right documentation, right reason, right response, and right to
refuse.
DIF: Cognitive Level: Remembering REF: p. 5
enhance patient outcomes and reduce healthcare costs.EHR Implementation: The use of electronic health records has become standard in healthcare settings, allowing for the efficient management of patient data,
improving communication, and reducing errors.Telehealth and Virtual Care: Telehealth enables healthcare providers to deliver services remotely, making it more accessible for patients in rural or underserved areas.
Nurses often conduct virtual assessments, follow-up consultations, and patient education.Public Health NursingPublic health nursing focuses on promoting and protecting the health of populations, rather than
individual patient care. Public health nurses work in community settings, schools, and public health agencies, addressing health disparities and promoting health education.Epidemiology: Public health nurses work
with epidemiologists to track disease outbreaks and implement preventive measures. They are crucial in preventing the spread of infectious diseases through immunizations, education, and outreach.Community Health
Initiatives: Public health nurses may run programs on maternal and child health, mental health awareness, smoking cessation, and more.________________________________________Information Technology
(Continued)Cloud Computing and Its ImpactCloud computing has revolutionized the way businesses store and access data. By shifting infrastructure to cloud-based platforms, organizations benefit from cost savings,
scalability, and flexibility.Hybrid Cloud: A hybrid cloud model combines both private and public clouds, allowing businesses to keep sensitive data on private servers while utilizing public clouds for less-sensitive
tasks.Cloud Security: As more businesses move to the cloud, ensuring the security of cloud-based data becomes a top priority. This includes encryption, access control, and multi-factor authentication.Cloud-based
Software-as-a-Service (SaaS): SaaS solutions like Salesforce, Dropbox, and Microsoft 365 allow businesses to access applications over the internet without installing them on local machines, simplifying IT
infrastructure.Artificial Intelligence and Automation in ITAI and automation are rapidly transforming IT operations, from enhancing software development to managing IT infrastructure.Robotic Process Automation
(RPA): RPA involves automating repetitive, rule-based tasks like data entry, invoice processing, and customer support. RPA tools help companies save time and reduce human error.AI in IT Operations (AIOps):
AIOps leverages AI to automate and optimize IT operations, such as monitoring system health, identifying anomalies, and resolving issues without human intervention.IT Support and Help Desk ManagementIT
support teams help users troubleshoot technical issues, maintain systems, and implement IT solutions. A well-organized help desk ensures that users’ problems are addressed quickly and efficiently.Ticketing Systems:
IT help desks often use ticketing systems to track and manage user requests. These systems allow IT teams to prioritize, resolve, and follow up on issues.Remote IT Support: With the rise of remote work, IT support
teams have expanded their role to offer remote assistance, solving issues through online communication tools and screen sharing.Cybersecurity Threats and Best PracticesCybersecurity is an ever-evolving field that
must constantly adapt to new threats, such as hacking, data breaches, and ransomware attacks.Phishing Attacks: These are fraudulent attempts to obtain sensitive information, often through email or malicious websites.
Employees must be educated on how to identify phishing attempts to avoid data breaches.Ransomware: Malicious software that locks users out of their systems and demands payment for access to be restored.
Organizations must have strong backup and disaster recovery systems to mitigate the effects of ransomware attacks.Zero Trust Security: A security model that assumes no one, whether inside or outside the
organization, should be trusted by default. It emphasizes strong identity verification, network segmentation, and continuous monitoring.________________________________________These extended explanations
offer a more in-depth look at the evolving trends, challenges, and opportunities in Business, Accounting, Nursing, and Information Technology (IT). As industries develop, these fields will continue to be fundamental
drivers of innovation and progress, impacting every aspect of our daily lives.Absolutely! Here’s
2. A licensed practical/vocational nurse has a specific set of roles and responsibilities. Which
responsibilities are within the scope of an LPN/LVN? (Select all that apply.)
a. Writing medical orders
b. Assessment of admission vitals to report to the admitting RN
c. Conducting a comprehensive admission assessment
d. Independent initiation of comprehensive plan of care
e. Management of patient care under RN supervision
, ANS: B, E
Assisting the RN in gathering specific data such as vital signs is within the scope of
LPN/LVN practice. The LPN/LVN works directly with the patient and manages care and
assists the RN in data collection and care plan development. The LPN/LVN does not have the
legal authority to write medical orders or carry out the admission assessment. LPNs/LVNs are
more dependent in the planning and evaluation phase of the nursing process. An LPN/LVN
can collect data to assist the RN with care plan development but is unable to initiate a
comprehensive plan of care independently.
DIF: Cognitive Level: Remembering REF: p. 3
3. The LPN is collecting subjective data for inclusion in the nursing assessment. What
information indicates that the LPN has a clear understanding of the nature of subjective
assessment data? (Select all that apply.)
a. Pulse rate
b. ECG brought in by the patient
c. Chief complaint of chest pain in the patient‘s own words
d. Auscultation of lung sounds
e. The patient‘s statement of current over the counter and prescription drugs
f. The patient‘s laboratory test results
ANS: C, E
Subjective data include information given by the patient or family, like concerns or symptoms
felt by the patient, and their statement of mediations. The pulse rate, recent ECG, laboratory
test results, and lung auscultation obtained through physical examination are examples of
objective data.
DIF: Cognitive Level: Remembering REF: p. 3
treat employees, customers, suppliers, and the environment with respect. Ethical issues could include transparency, fair trade practices, environmental responsibility, and workplace discrimination.Regulatory
Compliance: Businesses must adhere to a wide range of regulations and laws designed to protect employees, consumers, and the environment. Failure to comply with regulations like the Foreign Corrupt Practices Act
(FCPA) or the Sarbanes-Oxley Act (SOX) can lead to heavy fines and damage to the company’s reputation.Supply Chain Management (SCM)Supply chain management involves overseeing the movement of goods
and services from suppliers to customers. A well-managed supply chain improves operational efficiency and customer satisfaction, while a poorly managed one can lead to inefficiencies and higher costs.Global
Supply Chains: With globalization, companies are sourcing materials and products from across the world. Supply chain management now involves coordinating with suppliers, manufacturers, and distributors across
multiple countries.Just-in-Time (JIT) Manufacturing: JIT is a strategy where companies minimize inventory by receiving goods and materials only when they are needed in the production process. While it reduces
storage costs, it requires precise forecasting and strong supplier relationships.Supply Chain Resilience: The COVID-19 pandemic revealed the vulnerability of global supply chains. Companies are now focusing on
creating more resilient supply chains that can withstand disruptions from natural disasters, political instability, or pandemics by diversifying suppliers, implementing contingency plans, and improving
visibility.________________________________________Accounting (Continued)Financial Statement AnalysisFinancial statement analysis helps stakeholders assess a company’s financial performance and health.
This analysis is essential for investors, creditors, and managers in making informed decisions about the business.Horizontal and Vertical Analysis: Horizontal analysis compares financial data over time, typically from
year to year, to identify trends and growth patterns. Vertical analysis, on the other hand, expresses each item in a financial statement as a percentage of a base amount (e.g., total sales or total assets) to analyze the
relationship between different financial elements.Ratio Analysis: Financial ratios are used to evaluate a company's performance, profitability, liquidity, and solvency. Key ratios include the current ratio (liquidity), the
return on assets (ROA), and the debt-to-equity ratio (solvency). These ratios help assess whether a company is financially healthy or facing challenges.Internal and External Financial ReportingCompanies need to
ensure that their financial reporting is accurate and transparent. Internal financial reporting provides management with the information needed to make operational decisions, while external reporting is used to
communicate with investors, regulators, and other stakeholders.Internal Financial Reporting: Internal reports include financial forecasts, budget analysis, variance reports, and cost-benefit analyses. These reports are
essential for management to make informed decisions regarding operations and strategy.External Financial Reporting: External reports include financial statements like income statements, balance sheets, and cash
flow statements, which are shared with external stakeholders such as investors, auditors, and government regulators. Companies must adhere to generally accepted accounting principles (GAAP) or IFRS to ensure
transparency.Environmental, Social, and Governance (ESG) ReportingESG reporting is becoming more important as companies and investors focus on sustainability and corporate responsibility. It involves tracking a
company’s impact on the environment, society, and its governance practices.Environmental Impact: This aspect of ESG focuses on a company’s efforts to reduce its carbon footprint, manage waste, and use sustainable
resources. Companies may disclose their greenhouse gas emissions, water usage, and recycling efforts.Social Responsibility: The social component of ESG includes factors like labor practices, community
engagement, and customer satisfaction. For example, companies that provide safe working conditions, pay fair wages, and support local communities often score higher on social responsibility metrics.Governance
Practices: Governance focuses on how a company is managed and whether it adheres to ethical and legal standards. Issues like executive compensation, board diversity, and transparency in decision-making fall under
governance practices.________________________________________Nursing (Continued)Nursing Specialties
4. A 72 year-old female patient has just been admitted to a rehabilitation center for extended
physical therapy following a stroke. You are obtaining the patient‘s drug history. Which
information should you collect? (Select all that apply.)
a. Drugs currently being taken
b. Over-the-counter drugs being taken
c. Referrals to specialists
d. Diseases or conditions requiring drugs
e. Use of herbal supplements
f. Past medical history
, g. Alcohol use
h. Drug allergies
ANS: A, B, D, E, G, H
Important information to gather from a patient‘s drug history are the current prescription
drugs, OTC drugs, the conditions that denote the patient‘s need for a drug, alcohol use, drug
allergies, and the use of nutritional or herbal supplements. The remaining choices are items in
the history of present or past illnesses, and not concerned with drugs.
DIF: Cognitive Level: Understanding REF: p. 3
access to care, and policy changes that affect the healthcare system. For instance, nurses may advocate for better staffing ratios, improved patient safety protocols, or policies that address health disparities in
underserved communities.Healthcare Reform: Nurses actively participate in efforts to reform healthcare systems. This includes advocating for universal healthcare, expanded insurance coverage, and policies that
improve health outcomes, such as mental health parity and access to preventive care.End-of-Life Care and Palliative NursingPalliative care focuses on improving the quality of life for patients facing serious illness or
end-of-life challenges. Nurses in palliative and hospice care play an essential role in providing physical, emotional, and spiritual support for patients and their families.Symptom Management: Nurses in palliative care
work closely with patients to manage symptoms such as pain, nausea, and shortness of breath. They often collaborate with physicians, social workers, and chaplains to provide holistic care.Advance Directives and
Ethical Considerations: Nurses help patients and families navigate decisions about end-of-life care, including advance directives, do-not-resuscitate (DNR) orders, and other ethical considerations related to life-
sustaining treatment.________________________________________Information Technology (Continued)Digital Transformation and IT IntegrationAs businesses continue to adapt to the digital age, integrating IT
systems and technologies is critical to ensuring efficient operations and staying competitive.Enterprise Integration: Many businesses now employ enterprise resource planning (ERP) systems to integrate key functions
like finance, HR, supply chain management, and customer relations. ERPs help ensure smooth data flow across departments and increase operational efficiency.System Interoperability: Interoperability refers to the
ability of different IT systems to communicate and exchange data seamlessly. In industries like healthcare, financial services, and government, system interoperability is critical for improving service delivery, reducing
redundancy, and enhancing decision-making.Cybersecurity in the Age of Digital TransformationAs businesses increase their digital presence, the risk of cyber threats continues to rise. Cybersecurity is a priority for
organizations seeking to protect their data, networks, and users from malicious attacks.Data Encryption: Data encryption is a critical security measure that ensures sensitive information is unreadable by unauthorized
individuals. This is especially important when handling personal, financial, or medical data.Zero-Day Vulnerabilities: These are flaws in software that are unknown to the vendor and thus unpatched, leaving systems
vulnerable to cyberattacks. Cybersecurity experts work to identify and mitigate these vulnerabilities as quickly as possible.Incident Response: When a security breach occurs, an incident response plan is crucial to
minimize damage. This includes identifying the threat, containing the breach, assessing the impact, and communicating with affected stakeholders.The Future of IT with Quantum
Chapter 02: Legal, Regulatory, and Ethical Aspects of Drug Administration
Visovsky: Introduction to Clinical Pharmacology, 11th Edition
MULTIPLE CHOICE
1. You have obtained a liquid narcotic for a patient in pain from the unit‘s locked cabinet.
However, the dose was accidentally spilled before giving it to the patient. What is the best
action to take at this point?
a. Ask another nurse to cosign the inventory record describing the situation.
b. Immediately obtain another dose from the narcotic control system.
c. Document the occurrence in the drug record.
d. Clean up the spill and notify the supervisor.
ANS: A
Accounting for controlled substances is a legal requirement. If the drug is accidentally
dropped, contaminated, or spilled two nurses must sign the inventory report and describe the
situation.
DIF: Cognitive Level: Remembering REF: p. 16
2. As you arrive to work, a nurse from the previous shift tells you that she has completed the
narcotic count for your shift. What action should be taken?
a. There is no need for any additional action as this is the standard procedure.
b. Accept the keys to the narcotic cabinet and recount the drugs yourself.
c. Recount the narcotics again with a nurse from the previous shift.
d. Recount the drugs yourself at the end of your shift.
ANS: C
At the end of each shift, the contents of the locked cabinet are counted together by one nurse
from each shift in order to verify the narcotics count. If not done properly, the nurse risks
being held accountable for any shortages or discrepancies, and may be found guilty of
falsifying the narcotic count records.
DIF: Cognitive Level: Applying REF: p. 16
, 3. A one-time order for a controlled substance drug has been written for a patient you are caring
for. However, the drug ordered is available only in a larger dose than is needed. What should
you do with the remaining drug?
a. Give the full dose that is available.
b. Flush the remaining drug in the toilet of the patient‘s bathroom.
c. Save the remaining drug in case the patient needs it again.
d. Have another nurse to witness wasting of the leftover drug, and document
according to policy.
access to care, and policy changes that affect the healthcare system. For instance, nurses may advocate for better staffing ratios, improved patient safety protocols, or policies that address
health disparities in underserved communities.Healthcare Reform: Nurses actively participate in efforts to reform healthcare systems. This includes advocating for universal healthcare,
expanded insurance coverage, and policies that improve health outcomes, such as mental health parity and access to preventive care.End-of-Life Care and Palliative NursingPalliative care
focuses on improving the quality of life for patients facing serious illness or end-of-life challenges. Nurses in palliative and hospice care play an essential role in providing physical,
emotional, and spiritual support for patients and their families.Symptom Management: Nurses in palliative care work closely with patients to manage symptoms such as pain, nausea, and
shortness of breath. They often collaborate with physicians, social workers, and chaplains to provide holistic care.Advance Directives and Ethical Considerations: Nurses help patients and
families navigate decisions about end-of-life care, including advance directives, do-not-resuscitate (DNR) orders, and other ethical considerations related to life-sustaining
treatment.________________________________________Information Technology (Continued)Digital Transformation and IT IntegrationAs businesses continue to adapt to the digital age,
integrating IT systems and technologies is critical to ensuring efficient operations and staying competitive.Enterprise Integration: Many businesses now employ enterprise resource planning
(ERP) systems to integrate key functions like finance, HR, supply chain management, and customer relations. ERPs help ensure smooth data flow across departments and increase
operational efficiency.System Interoperability: Interoperability refers to the ability of different IT systems to communicate and exchange data seamlessly. In industries like healthcare,
financial services, and government, system interoperability is critical for improving service delivery, reducing redundancy, and enhancing decision-making.Cybersecurity in the Age of
Digital TransformationAs businesses increase their digital presence, the risk of cyber threats continues to rise. Cybersecurity is a priority for organizations seeking to protect their data,
networks, and users from malicious attacks.Data Encryption: Data encryption is a critical security measure that ensures sensitive information is unreadable by unauthorized individuals. This
is especially important when handling personal, financial, or medical data.Zero-Day Vulnerabilities: These are flaws in software that are unknown to the vendor and thus unpatched, leaving
systems vulnerable to cyberattacks. Cybersecurity experts work to identify and mitigate these vulnerabilities as quickly as possible.Incident Response: When a security breach occurs, an
incident response plan is crucial to minimize damage. This includes identifying the threat, containing the breach, assessing the impact, and communicating with affected stakeholders.The
Future of IT with Quantum
ANS: C
If the ordered dose is smaller than the dose provided (so that some drug must be discarded),
two nurses witness the wasting of the drug, and sign the controlled substance inventory report
according to institution policy.
DIF: Cognitive Level: Understanding REF: p. 16
4. An elderly patient in an assisted living home requests an over-the-counter cough preparation
for a mild cough she is experiencing. What is your best response?
a. ―I do not have any of this drug for you at this time, but can give you a dose from
another patient‘s supply.‖
b. ―I will bring it to you right away, but I must keep it with your other prescription
drugs.‖
c. ―I will need to contact your healthcare provider for an order before I can give this
drug to you.‖
d. ―You may have this, but your family will need to bring it in for you.‖
ANS: C
Over-the-counter (OTC) drugs do not require a prescription for purchase, but a healthcare
provider‘s order is required before it can be given by the LPN/LVN in an institutional setting.
OTC drugs may interact with a patient‘s prescribed drugs, especially in the elderly.
DIF: Cognitive Level: Applying REF: p. 17
5. Which of the following orders is an example of a single drug order?
