Chapter 09: Safety and Quality
McCuistion: Pharmacology: A
Patient-Centered Nursing Process
Approach, 11th Edition
(2) the right drug - ANS-
\(3)
the right dose - ANS-
\(4) the right route - ANS-
\(5) the right time, and (6) the right documentation. - ANS-
\3. A health care provider calls a nursing unit to leave a telephone order for an as needed
(PRN)
antipyretic medication for a child. The provider tells the nurse to "give PO acetaminophen for
a
fever greater than 101 F per protocol." What will the nurse do next?
a. Ask the provider to verify how many mg per kg per dose and how frequently to
give the medication.
b. Look up the protocol in the unit manual and write the drug order for the provider
to sign.
c. Provide the child's weight to the hospital pharmacist to write the order based on
the protocol.
d. Transcribe the verbal order to the order sheet as "give PO acetaminophen for a
fever greater than 101 F per protocol." - ANS-ANS: A
The components of a drug order include drug name, dose, route, frequency, and any
instructions
for dosing. A nurse receiving a telephone order should "read back" the order from the
provider
that includes this information. The provider, and not the nurse or the pharmacist, is
responsible
for writing the order with all components.
\A patient who is diagnosed with atrial fibrillation is to begin taking warfarin (Coumadin). The
patient refuses to take the medication because "it is rat poison." After the nurse provides
teaching, the patient still refuses. What action will the nurse take?
a. Hold the dose and document the patient's refusal.
b. Hold the dose, notify the provider of the situation, and document these actions.
c. Put the medication in the patient's food.
d. Tell the patient that the drug is necessary for treatment. - ANS-ANS: B
Patients have a right to refuse medications, but the provider should be notified if omitting the
medication can have serious effects. According to the principle of autonomy, it is unethical to
put a medication in a patient's food without their knowledge.
\having a hospital policy helps ensure safety. Single dose vials are more convenient and
help to reduce calculation errors, but multidose vials are
, often used - ANS-
\In order to ensure that a medication is given to the right patient, the nurse must perform
which
action?
a. Ask the patient to spell their last name.
b. Match the patient with a photo ID.
c. Swipe a bar code on the patient's ID bracelet.
d. Verify the patient using two identifiers. - ANS-ANS: D
The Joint Commission requires two forms of identification before medication administration.
Patients are asked to state their name and date of birth. Some, but not all, institutions use
photos
and bar codes to aid in identification.
\nurses unsure of calculations should check their work with another nurse. Nurses
frequently have to look up information on new drugs, and hospitals should offer reasonable
access to current information. - ANS-
\The community health nurse is preparing to administer a medication to a patient in the
patient's
home. The order reads "amoxicillin as directed BID PO." The nurse will perform which
action?
a. Administer the medication as ordered on the prescription label.
b. Ask the patient to take the medication as ordered.
c. Contact the provider to confirm the correct dose and instructions for the
medication.
d. Review the drug information to verify the correct dose. - ANS-ANS: C
The home nurse must have a complete order for giving medications, including the name of
the
medication, dose, route, and frequency, so the nurse should contact the provider to ascertain
the
dose. The prescription label may be outdated if the provider has changed the regimen.
\The nurse assumes care of a patient who had surgery that morning. The provider has
ordered
hydrocodone (Lortab) every 4 hours for mild to moderate pain and morphine sulfate for
moderate to severe pain. The nurse reviews the patient's record and notes the patient has
received two doses of hydrocodone 4 hours apart for a pain level of 7 to 8 on a scale of 1 to
10
and has reported a decrease in pain to a level of 6 to 7 after 30 minutes. It has been 4 hours
since
the last dose, and the patient reports a pain level of 7. What will the nurse do?
a. Administer the hydrocodone.
b. Administer morphine.
c. Ask the patient which drug to give.
d. Notify the provider of the patient's current pain level. - ANS-ANS: B
The previous nurse has documented a poor response to pain medication given for mild to
moderate pain. The nurse should administer the medication ordered for moderate to severe
pain.
Hydrocodone has not been effective and should not be given. The nurse bases the drug
selection
McCuistion: Pharmacology: A
Patient-Centered Nursing Process
Approach, 11th Edition
(2) the right drug - ANS-
\(3)
the right dose - ANS-
\(4) the right route - ANS-
\(5) the right time, and (6) the right documentation. - ANS-
\3. A health care provider calls a nursing unit to leave a telephone order for an as needed
(PRN)
antipyretic medication for a child. The provider tells the nurse to "give PO acetaminophen for
a
fever greater than 101 F per protocol." What will the nurse do next?
a. Ask the provider to verify how many mg per kg per dose and how frequently to
give the medication.
b. Look up the protocol in the unit manual and write the drug order for the provider
to sign.
c. Provide the child's weight to the hospital pharmacist to write the order based on
the protocol.
d. Transcribe the verbal order to the order sheet as "give PO acetaminophen for a
fever greater than 101 F per protocol." - ANS-ANS: A
The components of a drug order include drug name, dose, route, frequency, and any
instructions
for dosing. A nurse receiving a telephone order should "read back" the order from the
provider
that includes this information. The provider, and not the nurse or the pharmacist, is
responsible
for writing the order with all components.
\A patient who is diagnosed with atrial fibrillation is to begin taking warfarin (Coumadin). The
patient refuses to take the medication because "it is rat poison." After the nurse provides
teaching, the patient still refuses. What action will the nurse take?
a. Hold the dose and document the patient's refusal.
b. Hold the dose, notify the provider of the situation, and document these actions.
c. Put the medication in the patient's food.
d. Tell the patient that the drug is necessary for treatment. - ANS-ANS: B
Patients have a right to refuse medications, but the provider should be notified if omitting the
medication can have serious effects. According to the principle of autonomy, it is unethical to
put a medication in a patient's food without their knowledge.
\having a hospital policy helps ensure safety. Single dose vials are more convenient and
help to reduce calculation errors, but multidose vials are
, often used - ANS-
\In order to ensure that a medication is given to the right patient, the nurse must perform
which
action?
a. Ask the patient to spell their last name.
b. Match the patient with a photo ID.
c. Swipe a bar code on the patient's ID bracelet.
d. Verify the patient using two identifiers. - ANS-ANS: D
The Joint Commission requires two forms of identification before medication administration.
Patients are asked to state their name and date of birth. Some, but not all, institutions use
photos
and bar codes to aid in identification.
\nurses unsure of calculations should check their work with another nurse. Nurses
frequently have to look up information on new drugs, and hospitals should offer reasonable
access to current information. - ANS-
\The community health nurse is preparing to administer a medication to a patient in the
patient's
home. The order reads "amoxicillin as directed BID PO." The nurse will perform which
action?
a. Administer the medication as ordered on the prescription label.
b. Ask the patient to take the medication as ordered.
c. Contact the provider to confirm the correct dose and instructions for the
medication.
d. Review the drug information to verify the correct dose. - ANS-ANS: C
The home nurse must have a complete order for giving medications, including the name of
the
medication, dose, route, and frequency, so the nurse should contact the provider to ascertain
the
dose. The prescription label may be outdated if the provider has changed the regimen.
\The nurse assumes care of a patient who had surgery that morning. The provider has
ordered
hydrocodone (Lortab) every 4 hours for mild to moderate pain and morphine sulfate for
moderate to severe pain. The nurse reviews the patient's record and notes the patient has
received two doses of hydrocodone 4 hours apart for a pain level of 7 to 8 on a scale of 1 to
10
and has reported a decrease in pain to a level of 6 to 7 after 30 minutes. It has been 4 hours
since
the last dose, and the patient reports a pain level of 7. What will the nurse do?
a. Administer the hydrocodone.
b. Administer morphine.
c. Ask the patient which drug to give.
d. Notify the provider of the patient's current pain level. - ANS-ANS: B
The previous nurse has documented a poor response to pain medication given for mild to
moderate pain. The nurse should administer the medication ordered for moderate to severe
pain.
Hydrocodone has not been effective and should not be given. The nurse bases the drug
selection
