Nurs 552 Exam #3 Review |115 questions and answers.

b (From Kozier & Erb.Rationale: If there is any doubt, the medication administration process should be interrupted until the question is clarified. Listen to the client. Find out any other information the client may have about that certain medication. For example, does he know the dosage of the medication taken at home? Do not administer the medication (option 1). Inform the client that you will check the chart first. Review the chart to make sure there is no discrepancy between the physician's order and the MAR. Review the physician's progress notes because the medication may have been increased or reduced as part of the treatment plan (option 3). Check with the pharmacist because sometimes a pill may be a different color or shape based on the pharmaceutical company. Do not leave medications at the bedside. Medications should never be left unattended (option 4). Inform the client of your findings. The client will appreciate that you took the time to make sure that he received the correct medication. While it takes time to check out the client's statement, you will be glad that you avoided a potential medication error.) A client tells the nurse, "this pill is a different color than the one that I usually take at home." Which is the best response by the nurse? a. go ahead and take your med b. I will recheck your med order c. maybe the doc ordered a different med d. I'll leave the pill here while I check with the doc b (pull the ear down and back) Proper administration of an otic med to a 2 yr old client includes which of the following: a. pull the ear straight back b. pull the ear down and back c. pull the ear up and back d. pull the ear straight upward ace (From Kozier & Erb. Rationale: Five milliliters is too large an amount to inject into one site. The nurse needs to divide the amount into two 2.5-mL injections. A 3-mL syringe could be used (option 1). The length of the needle will depend on the muscle development of the client. The nurse needs to assess the client. The presumption, based on the information provided, is that this client's muscle mass is within normal limits. The needle length would need to be 1 1/2 inches because the medication is ordered to be given "deep IM" (option 5). This also suggests that the medication should be given in the preferred site for IM injections—the ventrogluteal site—because it provides the greatest thickness of gluteal muscle. The gauge of the needle for an IM injection into the ventrogluteal muscle can range between #20 and #23 (option 3). The nurse needs to assess the viscosity of the medication. Smaller gauges (e.g., #23) produce less tissue trauma; however, viscous solutions may require a larger gauge (e.g., #20-#21).) The primary care provider prescribed 5 mL of a medication to be given deep intramuscular for a 40-year-old female who is 5′7″ tall and weighs 135 pounds. Which is the most appropriate equipment for the nurse to use? Select all that apply. a. Two 3-mL syringes b. One 5-mL syringe c. A #20-#23 gauge needle d. A 1-inch needle e. A 1 1/2-inch needle abce (from NURS 552 lecture) A nurse calls a night-float physician for a patient complaining of chest pain. The physician states, "She can have some morphine, every 2 hours, as needed, thanks, bye." The physician hands up. Select all that apply which are viable actions or statements. a. Not an appropriate order: need dose and route b. Need to do read back; need to document if physician hangs up before read back is completed c. Call the physician back, can call supervisor or charge nurse d. Give the medication as ordered. e. Explain the situation to charge nurse and refuse to give the medication. bi (from NURS 552 lecture drug ingredients and signature of person administering: all others are essential parts of the 7 parts of medication orders) Which of the following is NOT an essential part of a medication order, select all that apply. a Full name of pt b Drug Ingredients c Date and time order is written d Name of the drug e Dose (How much and how often) f Frequency g Route (oral, topical, etc.) h Signature of person writing i Signature of person administering aefcdgb (from 552 lecture) List the correct process of medication administration. a. Gather meds and supplies b. Record c. Inform client d. Scan drug e. Identify client (3 identifiers) f. Scan bracelet g. Administer drug ab (from NURS 552 lecture: pt has low respiration and BP) A nurse is caring for a post-op patient with the following VS: HR 65 BP 105/60 RR 7 Temp 97.1. The patient winces and guards his incision. The nurse has an order to administer 4mg of morphine IVP prn every hour for pain. What should the nurse consider before administering the medication? Select all that appy. a. low respiration rate b. low blood pressure c. low temperature d. winces and guards incision. a, b (fluconazole (Diflucan) & Metronidazole (Flagyl)) Your patient has a fungal infection. You'd most likely be administer which medication. Select all that apply: a. fluconazole (Diflucan) b. Metronidazole (Flagyl) c. trimethoprim-sulfamethoxazole d. minocycline types of Beta-lactam drugs Ampicillin amoxicillin sephalosporins carbapenems b (fillers often have lactose; Af Am and Hisp. clients have a higher prevelence of intolerance) Which of the following are considerations when administering generic drugs to Hispanic and African American clients? a. paralysis and issues breathing b. intolerance to lactose fillers c. require 1/2 as much as white men d. all of the above d (Alaskan Eskimos, though the a, b, c are also at increased risk) Succinylcholine creates the greatest risk to what population for muscle paralysis after surgey? a. Asians b. American Indians c. Jewish d. Alaskan Eskimos a (risk of hemorrhage) If the individual has the CYP2CP gene they are at risk for what if given Coumadin (warfarin)? a. risk of hemorrhage b. risk of clotting c. both a & b d. risk of tachycardia b (risk of clotting) If the individual has the VKORC1 Gene they are at risk for what if given Coumadin (warfarin)? a. risk of hemorrhage b. risk of clotting c. both a & b d. risk of tachycardia C (tardive dyskinesia) An African American client was given an anti-psychotic medication; one of the major side effects of is the risk of what? a. Homan's sign b. Deep Vein Thrombosis c. Tardive Dyskensia d. Hemorrhage b (Thiazide diuretics, specifically Hydrochlorothiazide) An African American client's blood pressure is consistently 160/90 on a regular basis and has not been controlled with diet, exercise, or stress relieving activities. His HCP is most likely to prescribe which of the following antihypertensive? a. Succinylcholine b. Thiazide diuretics c. B Blockers d. ACE inhibitors b (Chinese) Which population generally requires less propranolol (1/2 as much as white men)? a. African Americans b. Chinese c. Eastern European d. American Eskimo ad (Hispanic Americans and African Americans) What population is most likely to have liver cirrhosis as a result of prolonged alcohol consumption? Select all that apply. a. Hispanic Americans b. American Indians c. European Caucasian d. African Americans e. Whites a (Asians and American Indians) What population (s) is most likely to have heat palpations and flushing as a result of alcohol consumption? a. Asians and American Indians b. Asians and Caucasians c. African Americans d. Hispanic Americans d (women) What population is likely to develop hypothyroidism and tardive dyskensia with anti-psychotics? a. Asians b. Men c. African Americans d. Women a (lower) Adverse affects of anti-psychotics generally occur at __________ doses for Hispanics compared to most populations. a. lower b. prescribed c. normal d. higher a (more) Caffeine is typically ________ effective in Asians than Caucasians. a. more b. less c. equally d. none of the above b (12-24 hrs) The greatest risk for respiratory failure or depression for an opiod-naive person is within the first ______ of administration. a. 24-28 hrs b. 12-24 hrs c. 36 hrs 5. 6-12 hrs ab (a patient suffering from dementia and a small child or toddler) What patient population might be a poor candidate for a PCA pump? Select all that apply. a. a patient suffering from dementia b. a small child or toddler c. a middle aged, menopausal post surgical woman d. someone with a skin rash c (it is important to note that b. 1.0 mL is the max that can be injected into the upper arm on the deltoid two inches below the acromion process) What is the maximum amount of fluid that can be injected into the Ventrogluteal intramuscular site? a. 2.0 mL b. 1.0 mL c. 3.0 mL 5. 1.5 mL d (NURS 552 Quiz 5) A nurse holds a bottle with the label next to the palm of the hand when pouring a liquid medication. What is the rationale for this action? a. To warm the solution to body temperature b. Ensure accuracy of the measurement of the dose c. Conceal the label from the curiosity of others d. Prevent soiling of the label by spilled liquid c (NURS 552 Quiz 5) A nurse gives an intradermal injection and a bleb does not form. What should the nurse do? a. Document the medication as given b. Notify the healthcare provider c. Give the injection a second time a (NURS 552 Quiz 5) A nurse plans to administer a 3 ml intramuscular (IM) injection. Which muscle can it not be given in? a. Deltoid b. Vastus lateralis c. Ventrogluteal d (15 degrees NURS 552 Quiz 5) At what angle should the nurse insert the needle when giving an intradermal injection? a. 90 degrees b. 30 degrees c. 45 degrees d. 15 degrees d (NURS 552 lecture/Kozier & Erb) At what angle should the nurse insert the needle when giving an intramuscular injection? a. 15 degrees b. 30 degrees c. 45 degrees d. 90 degrees cd (Kozier & Erb, pg 795) At what angle (s) should the nurse insert the needle when giving a subcutaneous injection? Select all that apply. a. 15 degrees b. 30 degrees c. 45 degrees d. 90 degrees c (Under the tongue Nurs 552 quiz 5) Where should a sublingual medication be placed? a. On the skin b. Inside the cheek c. Under the tongue d. On the lower eyelid a (At the patient's bedside NURS 552 quiz) When should the nurse remove the medication from its unit dose package? a. At the patient's bedside b. Outside the door to the patient's room c. In the medication room d. At the medication cart False (the dorsogluteal site is in close proximity to the sciatic nerve and bone, it is not the preferred site) True or False. In adults, the dorsogluteal site is preferred over the ventro gluteal site when giving intramuscular injections. a (Pull the skin laterally away from the injection site before inserting the needle; NURS 552 quiz) Which action should be implemented by the nurse when a medication is delivered by the Z-track method? a. Pull the skin laterally away from the injection site before inserting the needle b. Administer the injection in the muscle on the anterolateral aspect of the thigh c. Insert the needle in a separate spot for each dose on a Z-shaped grid on the abdomen d. Use a special syringe designed for Z-track injection b (Vastus lateralis) What is the preferred site for intra-muscular (IM) injection in children? a. Dorsal gluteal b. Vastus lateralis c. Ventrogluteal d. Deltoid d (an intrathecal injection is injected into the spinal cord; it is not intravenous) Intravenous medications are administered through several methods except for: A. Bolus B. PCA C. Piggyback D. Intrathecal E. Electronic Pumps a (Sim's on left side with upper leg flexed at knee) Best patient position when administering a rectal suppository a. Sim's on left side with upper leg flexed at knee b. Sim's on right side with lower leg slightly bended c. Supine with slightly bent knees d. Prone at 180 degrees a (An empty stomach) For an oral medication to reach the blood stream faster, drugs should be taken with.... a. An empty stomach b. A full stomach c. A catalyst d. A PCA Pump b (antagonistic) Naloxone is an antidote for Morphine. Based on drug interactions, Naloxone is then considered as what? a. Agonistic b. Antagonistic c. Idiosyncratic d. Synergistic c (dosage) Amount of drug prescribed for a patient by a physician in a given amount of time or at a given frequency. a. Route b. Number of Tablets c. Dosage d. Prescription a (synergistic) With regards to pain, taking both Advil and Motril simultaneously could be considered to have what kind of effect? a. Synergistic b. Idiosyncratic c. Antagonistic d. Toxic a. (Cumulative) When one drug has a long duration and another drug has a long half life, these two drugs will have a longer time for excretion when taken at the same. They could build up in the body which could lead to a toxic or lethal effect. What is this effect referred to? a. Cumulative b. Agonistic c. Idiosyncratic d. Antagonistic a (NURS 552 lecture: agonist) A ___________ is a type of drug produces the same response as endogenous substance when occupying site a. agonist b. antagonist c. therapeutic d. pharmacological b (NURS 552 lecture: antagonist) A ____________ is a type of drug that inhibits cell function through occupying receptor site a. agonist b. antagonist c. therapeutic d. pharmacological c (Drug tolerance) Mr. Jones has been taking a proton pump inhibitor for more than 3 years because of his chronic GERD. Every year, when his prescription is refilled, his dosage is increased. His response to this proton pump inhibitor could be considered what? a. Drug dependence b. Drug use c. Drug tolerance d. Drug dosage ab (Kozier & Erb pg 756) Which of the following are considerations for how the GI system would affect medications in a patient? Select all that apply. a. Rate of absorption b. Amount of absorption c. Speed of metabolism d. Rate of distribution e. Rate of excretion c (liquid; pg. 756 Kozier & Erb) Which would be absorbed the fastest: pill, capsule, or liquid? a. pill b. capsule c. liquid b (It will decrease absorption pg. 756 Kozier & Erb) A client is experiencing diarrhea. How could this affect absorption of an oral drug? a. It will not affect the rate of absorption b. It will decrease absorption c. In will increase absorption abc (answers abc are all possible depending on the drug; the last answer is incorrect pg. 756 Kozier & Erb) How does the presence of food in the stomach possibly affect the rate of absorption? Select all that apply. a. slow absorption b. speed up absorption c. no affect on absorption d. no drugs should be taken with food c (slows it down, Kozier & Erb pg 756) How is distribution of the oral medication affected if a client has less than normal cardiac output (e.g., low BP, prolonged capillary refill)? a. no impact because the drug is not given via IV b. speeds it up c. slows it down a (pg 756 Kozier & Erb) Most _________________________ takes place in the liver. Any decrease in the ability of the liver to metabolize medication could lead to an accumulation of the active drug in the bloodstream. This could put the client at risk for toxic effects and adverse reactions. a. biotransformation b. reabsorption c. distribution d. excretion abc (NURS 552 lecture, Kozier & Erb 756) What are risk factors that can affect liver function? Select all that apply. a. Alcohol use b. age c. diabetes d. gender e. muscle mass a (nurs 552 lecture, Kozier & Erb 756) A client is suspected of having decreased liver function. What information would be the most essential for the nurse to know about the oral medication that is to be given? a. where the medication is metabolized b. how old the client is c. kidney function d. bloop pressure