Karch’s Focus on Nursing
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
A nurse is preparing to administer a medication that is classified
as a Schedule II controlled substance. The nurse is reviewing the
prescription and notes that the provider has written for a 90-
day supply of the medication with three refills. What is the
nurse's best action?
,A. Administer the medication as prescribed, as the provider has
full authority to prescribe controlled substances.
B. Contact the provider to clarify the prescription, as it is
written in violation of federal regulations.
C. Consult the pharmacist to determine if the prescription can
be legally filled.
D. Ask the patient if they have used this medication before to
assess for tolerance.
Correct Answer: B
Rationale: Federal law strictly regulates the prescribing of
controlled substances. Schedule II medications have the highest
level of restriction among prescribed drugs and cannot be
refilled. A new, written prescription (with very limited
exceptions for emergency oral orders) is required for each fill. A
prescription for a 90-day supply with refills is not legally valid.
Why the Other Options Are Incorrect
A. The provider does not have full authority to prescribe any
amount of any controlled substance. Their authority is strictly
limited by federal and state laws. Administering the medication
as written would be a medication error and a violation of the
law.
C. It is the nurse's responsibility to verify the prescription's
validity. While a pharmacist could provide consultation, the
nurse is legally obligated to question a prescription that appears
,to be fraudulent or illegal. The primary action is to clarify with
the prescriber.
D. While patient education is a component of safe medication
administration, it does not address the primary legal and safety
issue of an invalid prescription. The priority is to ensure the
prescription is valid before administration.
Learning Objective: Apply federal and legal regulations
regarding controlled substance prescribing to ensure safe
medication administration.
Bloom's Taxonomy: Apply
Difficulty: Moderate
NCLEX Client Needs Category: Safe and Effective Care
Environment: Management of Care
NCJMM Clinical Judgment Skill: Recognize Cues
Question 2
A patient is prescribed a new medication for hypertension. The
patient has a history of severe allergic reactions, including
anaphylaxis, to penicillin. The nurse is reviewing the new
prescription and notices the drug is a cephalosporin. Which
nursing action is most important?
A. Administer the medication with an antihistamine to prevent
a reaction.
B. Hold the medication and contact the provider to discuss a
, potential cross-sensitivity.
C. Educate the patient on the signs of an allergic reaction and
administer the drug.
D. Administer a small test dose to check for a reaction before
giving the full dose.
Correct Answer: B
Rationale: There is a known risk of cross-sensitivity between
penicillins and cephalosporins due to a similar beta-lactam ring
structure. While the cross-reactivity rate is lower than
previously thought, it remains a significant concern, especially
in patients with a history of severe, immediate hypersensitivity
reactions to penicillin. The most appropriate action is to hold
the medication and consult the prescriber to determine if an
alternative antibiotic is needed or if a desensitization protocol is
warranted .
Why the Other Options Are Incorrect
A. Administering an antihistamine prophylactically is not a
standard practice to prevent anaphylaxis and does not address
the potential for a severe, life-threatening reaction. It could also
mask early signs of a reaction.
C. While patient education is always important, administering
the drug without first addressing the known allergy places the
patient at significant risk. The benefit of the drug would not
outweigh the potential for a severe adverse reaction.
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
A nurse is preparing to administer a medication that is classified
as a Schedule II controlled substance. The nurse is reviewing the
prescription and notes that the provider has written for a 90-
day supply of the medication with three refills. What is the
nurse's best action?
,A. Administer the medication as prescribed, as the provider has
full authority to prescribe controlled substances.
B. Contact the provider to clarify the prescription, as it is
written in violation of federal regulations.
C. Consult the pharmacist to determine if the prescription can
be legally filled.
D. Ask the patient if they have used this medication before to
assess for tolerance.
Correct Answer: B
Rationale: Federal law strictly regulates the prescribing of
controlled substances. Schedule II medications have the highest
level of restriction among prescribed drugs and cannot be
refilled. A new, written prescription (with very limited
exceptions for emergency oral orders) is required for each fill. A
prescription for a 90-day supply with refills is not legally valid.
Why the Other Options Are Incorrect
A. The provider does not have full authority to prescribe any
amount of any controlled substance. Their authority is strictly
limited by federal and state laws. Administering the medication
as written would be a medication error and a violation of the
law.
C. It is the nurse's responsibility to verify the prescription's
validity. While a pharmacist could provide consultation, the
nurse is legally obligated to question a prescription that appears
,to be fraudulent or illegal. The primary action is to clarify with
the prescriber.
D. While patient education is a component of safe medication
administration, it does not address the primary legal and safety
issue of an invalid prescription. The priority is to ensure the
prescription is valid before administration.
Learning Objective: Apply federal and legal regulations
regarding controlled substance prescribing to ensure safe
medication administration.
Bloom's Taxonomy: Apply
Difficulty: Moderate
NCLEX Client Needs Category: Safe and Effective Care
Environment: Management of Care
NCJMM Clinical Judgment Skill: Recognize Cues
Question 2
A patient is prescribed a new medication for hypertension. The
patient has a history of severe allergic reactions, including
anaphylaxis, to penicillin. The nurse is reviewing the new
prescription and notices the drug is a cephalosporin. Which
nursing action is most important?
A. Administer the medication with an antihistamine to prevent
a reaction.
B. Hold the medication and contact the provider to discuss a
, potential cross-sensitivity.
C. Educate the patient on the signs of an allergic reaction and
administer the drug.
D. Administer a small test dose to check for a reaction before
giving the full dose.
Correct Answer: B
Rationale: There is a known risk of cross-sensitivity between
penicillins and cephalosporins due to a similar beta-lactam ring
structure. While the cross-reactivity rate is lower than
previously thought, it remains a significant concern, especially
in patients with a history of severe, immediate hypersensitivity
reactions to penicillin. The most appropriate action is to hold
the medication and consult the prescriber to determine if an
alternative antibiotic is needed or if a desensitization protocol is
warranted .
Why the Other Options Are Incorrect
A. Administering an antihistamine prophylactically is not a
standard practice to prevent anaphylaxis and does not address
the potential for a severe, life-threatening reaction. It could also
mask early signs of a reaction.
C. While patient education is always important, administering
the drug without first addressing the known allergy places the
patient at significant risk. The benefit of the drug would not
outweigh the potential for a severe adverse reaction.
