NR 224: Fundamentals of Nursing Practice Skills Advanced Exam Preparation and Study Companion: Comprehensive Review Modules, Complete Test Bank, Updated Practice Tests, and Final Readiness Assessment

A nurse is preparing to administer a medication but cannot clearly read the prescriber’s handwritten order. The prescriber is known to be busy and may become irritated when contacted. What should the nurse do? A. Ask another nurse to interpret the order B. Administer the most likely medication and document the uncertainty C. Contact the prescriber and request clarification D. Delay the medication until the next scheduled dose Correct Answer: C. Contact the prescriber and request clarification Rationale: An unclear medication order must be clarified with the authorized prescriber before administration. Patient safety takes priority over concerns about inconveniencing the prescriber. Guessing the medication or delaying it without attempting clarification is unsafe. Question 2 A patient is prescribed 2 tablespoons of milk of magnesia. How many millilitres should the nurse administer? A. 10 mL B. 15 mL C. 20 mL D. 30 mL Correct Answer: D. 30 mL Rationale: One tablespoon equals 15 mL. Therefore, 2 tablespoons × 15 mL = 30 mL. Question 3 A nurse is administering prescribed ear drops to an 8-year-old child. Which technique is appropriate? A. Pull the auricle downward and backward B. Pull the auricle upward and backward C. Pull the auricle directly outward D. Press firmly on the external auditory canal Correct Answer: B. Pull the auricle upward and backward Rationale: For children older than approximately 3 years and for adults, the auricle is pulled upward and backward to straighten the ear canal. Younger children generally require the auricle to be pulled downward and backward. Question 4 A patient is prescribed cephalexin 500 mg orally. The available tablets contain 250 mg each. How many tablets should the nurse administer? A. 0.5 tablet B. 1 tablet C. 2 tablets D. 4 tablets Question 5 While preparing medications for a 4-year-old child, the nurse explains the medications to the child’s mother. The mother states, “My child has never taken that medication before.” What should the nurse do first? A. Reassure the mother that the medication is safe B. Administer the medication because it appears on the record C. Withhold the medication and verify the order D. Ask the mother to discuss the concern with the physician later Correct Answer: C. Withhold the medication and verify the order Rationale: A caregiver’s concern may identify a prescribing, transcription, or patientidentification error. The nurse should pause administration and verify the medication order before proceeding. Question 6 A patient is being discharged from the hospital with several new medications and a referral for home care. Which action should be the discharge nurse’s priority? A. Ask the family to search online for medication information B. Ensure the home care agency receives the medication and teaching needs C. Tell the patient to contact the hospital if problems occur D. Provide only a printed medication list Correct Answer: B. Ensure the home care agency receives the medication and teaching needs Rationale: Safe transition of care requires effective communication with the home care agency regarding medications, monitoring requirements, and teaching needs. A printed medication list alone may not adequately address follow-up or learning needs. Question 7 A nursing student brings an antibiotic to a patient. The patient asks, “What is this medication, and why am I taking it?” Which response is most appropriate? A. “The physician ordered it, so you need to take it.” B. “It is an antibiotic that treats the infection identified by your care team.” C. “I am not permitted to discuss medications with patients.” D. “Take it now, and the physician will explain it later.” Correct Answer: B. “It is an antibiotic that treats the infection identified by your care team.” Rationale: Patients have the right to understand the name, purpose, and expected effects of their medications. Providing clear information promotes informed participation and safe medication use. Question 8 A patient states that he cannot swallow a prescribed sustained-release capsule. Which action should the nurse take? A. Crush the capsule and mix it with food B. Open the capsule and dissolve it in water C. Ask the prescriber to order an alternative formulation D. Instruct the patient to chew the capsule thoroughly Correct Answer: C. Ask the prescriber to order an alternative formulation Rationale: Sustained-release medications generally should not be crushed, opened, or chewed because doing so may release the medication too rapidly and increase the risk of adverse effects. An alternative formulation or route should be prescribed. Question 9 A patient refuses a scheduled medication and tells the nurse to take it away. What should the nurse do first? A. Document the refusal and leave immediately B. Ask the patient to explain the reason for refusing C. Tell the patient that refusal is not permitted D. Hide the medication in the patient’s food Correct Answer: B. Ask the patient to explain the reason for refusing Rationale: Patients have the right to refuse medication. The nurse should first determine the reason for refusal, which may involve side effects, misunderstanding, beliefs, or previous experiences. This allows the nurse to provide education and address concerns. Question 10 A nurse receives an order for a loop diuretic to reduce a patient’s blood pressure. What determines the route by which the medication should be administered? A. The patient’s preferred route B. The nurse’s clinical preference C. The manufacturer’s most common route D. The prescriber’s medication order Correct Answer: D. The prescriber’s medication order Rationale: The medication route is an essential component of a complete prescription. The nurse should follow the prescribed route unless clarification or a revised order is obtained.