Chapter 28 - Medications

Chapter 28 - Medications Medication Administration Scenarios and Answers 1. Administering Medication via Nasogastric Tube - Question: What guideline should the nurse follow when administering a drug via this route? - A) Flush the tube with water between each drug administered. ️ - B) Position the client supine prior to administering the drug. - C) Administer the medication at a cold temperature. - D) If connected to suction, do not reconnect to suction for five minutes after drug administration. - Feedback: Correct. Flushing the tube with water between each drug helps ensure that all medication is delivered and prevents clogging. Positioning the patient with the head of the bed elevated and administering medication at room temperature enhance comfort and safety. --- 2. Client Allergies and Medication Orders - Question: How should the nurse respond to an order for an antibiotic when the client has a penicillin allergy? - A) Withhold the medication until the potential drug allergy has been addressed by the care team. ️ - B) Administer the medication and increase the frequency of assessments in the hours that follow. - C) Substitute an antibiotic with similar action, but from a different drug family. - D) Discuss the severity, signs, and symptoms of the drug allergy with the client. - Feedback: Correct. Client safety is the priority; the nurse must ensure that the allergy risk is addressed before administering any related medications. --- 3. Parenteral Route Administration - Question: Which client receives a drug that requires a parenteral route? - A) A woman who has been ordered intravenous antibiotics. ️ - B) A woman who takes a diuretic pill each morning. - C) A man with emphysema who uses nebulized bronchodilators. - D) A man who has an antifungal ointment applied to his skin rash daily. - Feedback: Correct. The parenteral route includes intravenous and injection methods, while the other options describe oral, pulmonary, or topical routes. --- 4. Trough Level Specimen Scheduling - Question: When would the nurse schedule the trough level specimen? - A) Before administering the first dose. - B) Immediately after the first dose. - C) 30 minutes before the next dose. ️ - D) 24 hours after the last dose. - Feedback: Correct. The trough level is best measured just before the next dose to determine the lowest drug concentration. --- 5. Understanding Therapeutic Range - Question: What is the term for the concentration of insulin in the blood serum that produces the desired effect without causing toxicity? - A) Peak level. - B) Trough level. - C) Half-life. - D) Therapeutic range. ️ - Feedback: Correct. The therapeutic range ensures the drug is effective without reaching toxic levels. --- 6. Adverse Effects of Narcotics - Question: A client taking an oral narcotic for pain relief reports constipation. What is this response called? - A) Therapeutic effect. - B) Adverse effect. ️ - C) Toxic effect. - D) Idiosyncratic effect. - Feedback: Correct. Constipation is a common and predictable adverse effect of narcotics, which can usually be managed. --- A nurse is conducting an interview for a health history. In addition to asking the client about medications being taken, what else should be asked to assess the risk for drug interactions? A) The effects of prescribed medications B) Type and amount of foods eaten C) Daily amount of intake and output D) Use of herbal supplements ️Ans: D Feedback: Herbal remedies can interact with prescribed medications. When asking a client if he or she is taking any medications, the nurse should specifically ask if herbal supplements are also being used. A nurse is converting the dosage of a medication to a different unit in the metric system. The medication label specifies the drug as being 0.5 g per tablet. The order is for 500 mg. How many tablets will the nurse give? A) 1 B) 2 C) 5 D) 10 ️Ans: A Feedback: To convert in the metric system from a smaller unit to a larger unit, move the decimal point three places to the right. As 0.5 g = 500 mg, the nurse would administer one tablet. A physician has ordered that a medication be given "stat" for a client who is having an anaphylactic drug reaction. At what time would the nurse administer the medication? A) At the next scheduled medication time B) Immediately after the order is noted C) Not until verifying it with the client D) Whenever the client asks for it ️Ans: B Feedback: A stat order is a single order, and it is carried out immediately. This is a legal order. The nurse would not wait until the next scheduled medication time or verify the order with the client. With a p.r.n. order, the client receives medication when it is requested or required. What does the nurse do to verify an order for a medication listed on a medication administration record (MAR)? A) Compare it with the original physician's order.