Pharmacology Clear And Simple A Guide to Drug 2nd Edition By Watkins – Test Bank
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Sample
Test
Chapter 3. Patient Safety in Medication Administration
Multiple Choice
Identify the choice that best completes the statement or answers
the question.
____ 1. The student nurse is
preparing to provide medications to a client scheduled to receive lisinopril
(Zestril) 10 mg PO daily and ofloxacin (Floxin) 2 drops o.s. three times daily.
Which of the following actions by the student is best?
|
A. |
Provide the lisinopril by
mouth and the ofloxacin into the right ear. |
|
B. |
Provide the lisinopril into
the right ear and the ofloxacin into the right eye. |
|
C. |
Provide the lisinopril into
the left ear and the ofloxacin orally. |
|
D. |
Provide the lisinopril
orally and the ofloxacin into the left eye. |
____ 2. When providing medications
from floor stock to a client on the Alzheimer’s unit of a long-term-care
facility, the nurse demonstrates the principle of right drug by which of the
following?
|
A. |
Checks the label before
taking the medication out of the cabinet, checks the label before pouring the
medication, checks the label before placing the bottle back in the cabinet |
|
B. |
Checks the label before
taking the medication out of the cabinet, checks the label before
pouring the medication, checks the label before leaving the medication room |
|
C. |
Checks the label after
removing the bottle from the cabinet, checks the label after pouring the dose
of medication, checks the label before closing the cabinet door |
|
D. |
Checks the label while
removing the bottle from the cabinet, checks the label after pouring the dose
of medication, checks the label while replacing the bottle in the cabinet |
____ 3. The nurse is preparing to
discharge a client originally admitted for community-acquired pneumonia who has
a discharge prescription for cefditoren (Spectracef). Which of the following
instructions would the nurse include in the discharge teaching?
|
A. |
“Be sure to take the
medication until your cough is gone.” |
|
B. |
“It is important that you
take the medication with meals.” |
|
C. |
“Taking the medication at
set time intervals will help blood levels stay constant.” |
|
D. |
“Keeping the medication on
the counter top will help you remember to take it.” |
____ 4. While working in an urgent
care center, the nurse assists in the care of a client with allergic rhinitis
who has been given a prescription for beclomethasone nasal spray (Beconase), 2
sprays in each nostril 2 to 4 times daily. The nurse would provide further
instruction to which of the following client statements?
|
A. |
“This will help my nose to
not run so constantly.” |
|
B. |
“I should spray this in
each nostril whenever my nose starts to drip.” |
|
C. |
“I can use this before I go
to work, midday, and again at bedtime.” |
|
D. |
“This medication is a mild
steroid and will reduce swelling and irritation of my nasal
passages.” |
____ 5. The nurse is conducting a
home visit for a 43-year-old client. The client, who has three children under
the age of 12, is 3 days post-mastectomy. The nurse would be most concerned by
which of the following?
|
A. |
The client has a calendar
for appointments and a list with physician contact information by the phone. |
|
B. |
The client keeps her
medications in a daily pill box that sits on the kitchen windowsill. |
|
C. |
The client reports that it
was too uncomfortable to wear the temporary prosthesis she had been given. |
|
D. |
The children are
participating in a support group for family members of people with cancer. |
____ 6. The nurse is providing
medications to a client with a gastrostomy tube. Diclofenac (Cambia) has been
ordered. Prior to administration, the nurse should take which of the following
actions?
|
A. |
Ensure that the medication
comes as a liquid preparation. |
|
B. |
Obtain a 3-mL syringe and
needle with a safety device. |
|
C. |
Document the medication
provision. |
|
D. |
Ask the client to state her
name and room number. |
____ 7. A nurse on the pediatric
unit is preparing to pass medications for a 10-year-old client with
exacerbation of asthma. Amphetamine (Adderall) and fluticasone (Advair) are
scheduled. The nurse must be aware of which of the following?
|
A. |
Adderall and Advair should
not be given at the same time. |
|
B. |
Adderall is used to reduce
bronchospasms. |
|
C. |
Advair must be given with
food. |
|
D. |
Adderall and Advair each
have look-alike/sound-alike medications. |
____ 8. A nurse working in the GI
clinic is performing pre-op phone calls. The nurse calls a client who is scheduled
for a colonoscopy to inform the client of the following orders, “Begin clear
liquid diet 24 hours prior to the exam; take magnesium citrate (Citroma) 1
bottle PO 12 hours prior to the exam and another 8 hours prior to the exam;
remain NPO for 6 hours prior to the study.” The test is scheduled the next day
at 2 p.m. The nurse would instruct the patient to:
|
A. |
“Only have liquids to drink
at this point until the test. Use the enema prep at 2 a.m. and then again at
6 a.m. You can’t have anything to eat or drink after waking in the morning.” |
|
B. |
“Start a clear liquid diet
today at 2 p.m. Drink a bottle of prep at 2 a.m. and another at 6 a.m., and
then don’t eat or drink anything after 8 a.m.” |
|
C. |
“Don’t eat anything solid
starting with lunch today. Give yourself an enema with the prep at 6 a.m. and
again at noon, and don’t have anything to eat or drink after 8 a.m.” |
|
D. |
“Start a clear liquid diet
with dinner today. Drink the prep 12 hours and 8 hours before your test at 2
p.m. tomorrow, and be sure not to eat anything solid after you get up in the
morning.” |
____ 9. While working in a
surgical clinic, the nurse notes orders that read, “.25 mg digoxin (Lanoxin) IV
now.” Which action by the nurse is best?
|
A. |
Give .25 mg of digoxin
intravenously. |
|
B. |
Give 25 mg of digoxin as an
injection into the skin. |
|
C. |
Contact the physician for
clarification of the order. |
|
D. |
Give .25 mL of digoxin as
an intramuscular injection. |
____ 10. A client being seen in the outpatient
clinic has been given a new prescription for tetracycline (Doxycycline) orally
each day. The client reported current medications include a multivitamin with
calcium, St. John’s Wort, and omeprazole (Prilosec). The nurse would provide
additional teaching for which client statement?
|
A. |
“I should try to take the
medication at roughly the same time each day.” |
|
B. |
“I can take this medication
with my other morning meds.” |
|
C. |
“I should take this
medication at least an hour before or 2 hours after I eat.” |
|
D. |
“Drinking extra water is
important when taking this medication.” |
____ 11. The nurse receives a phone call from
an elderly woman who states that her husband has recently started taking
atorvastatin (Lipitor) and is complaining of having sore muscles. Which response
by the nurse is best?
|
A. |
“Does your husband smoke
cigarettes?” |
|
B. |
“What type of exercise is
your husband doing?” |
|
C. |
“Does your husband have a
history of heart disease?” |
|
D. |
“Your husband should be
seen in the clinic today for some tests.” |
____ 12. A nurse from the adult medical unit
is pulled to the geriatric unit. The nurse notes many of the common medications
provided are in lower doses than typically prescribed. What action by the nurse
is the highest priority?
|
A. |
Notify the charge nurse
that clients may have received inappropriate medication dosages. |
|
B. |
Call the nursing supervisor
to investigate the nurse’s concerns. |
|
C. |
Don’t worry about the
discrepancy since this is not the nurse’s unit. |
|
D. |
Evaluate the lab values of
each client to determine liver and kidney function. |
____ 13. While working on a geriatric unit,
the nurse would be most concerned by which of these findings?
|
A. |
An 81-year-old client is
scheduled to take 12 pills at 9 a.m. |
|
B. |
A 72-year-old client given
a sleeping pill the night before seems confused. |
|
C. |
A 69-year-old client with a
deep vein thrombosis has an order for an anticoagulant. |
|
D. |
A 74-year-old client with
diabetes has a fasting glucose result of 88 g/dL. |
____ 14. The nurse notes that an elderly
client admitted with metastatic cancer has a low serum protein level. Which
action by the nurse is best?
|
A. |
No action is required
because the patient is terminal. |
|
B. |
Increase the frequency of
vital sign monitoring. |
|
C. |
Determine the most recent
complete blood count (CBC) results. |
|
D. |
Increase awareness and
assessment of potential medication side effects. |
____ 15. Shortly after providing a new
sleeping pill to a client on the medical unit, the nurse answers the client’s
call light. Which of the following findings would indicate to the nurse that
the client is experiencing an anaphylactic reaction to the medication?
|
A. |
The client’s respiratory
rate is 28 and slightly labored. |
|
B. |
The client complains of
continued wakefulness and agitation. |
|
C. |
The client states that she
feels nauseated and has a headache. |
|
D. |
The client reports feeling
hot and has a rash across her chest. |
____ 16. A nurse working at the poison control
center receives a call from a young woman babysitting for a 4-year-old child
who reportedly swallowed some of the parent’s medication. Which statement by
the nurse is best?
|
A. |
“I’m calling emergency
personnel for you now.” |
|
B. |
“What do the pills look
like?” |
|
C. |
“Have the child drink a
glass of milk.” |
|
D. |
“What is the name of the
pills?” |
____ 17. The nurse is preparing to provide
medications to a client in a double room. The client’s roommate has multiple
visitors present. Which of the following actions would the nurse take first?
|
A. |
Identify the action and
side effect of each medication as it is provided. |
|
B. |
Pull the client’s bedside
curtain and talk in subdued tones. |
|
C. |
Ask the client to state his
name and birth date to verify identity. |
|
D. |
Determine what questions
the client has about his medications. |
Multiple Response
Identify one or more choices that best complete the statement or
answer the question.
____ 1. While providing
medications in the clinical lab, a student would perform actions related to
safe administration that include which of the following? (Select all that
apply.)
|
A. |
Right medication |
|
B. |
Right dose |
|
C. |
Right time |
|
D. |
Right room |
|
E. |
Right patient |
|
F. |
Right route |
____ 2. While supervising a
student nurse providing morning medications to clients in the long-term-care
facility, the nurse would intervene if the student was observed performing
which of the following actions? (Select all that apply.)
|
A. |
The student checks the
patient’s arm band to verify identity. |
|
B. |
The student verifies the
medication order. |
|
C. |
The student scans the
medication with the computer scanner. |
|
D. |
The student checks the
medication’s expiration date. |
|
E. |
The student prepares a
medication scheduled for 1800. |
|
F. |
The student asks the client
to state his first name prior to giving the medication. |
____ 3. A female nursing student
is 18 weeks pregnant while attending her pharmacology class. Which of the
following facts related to fetal effects of medications will the student
recognize as true? (Select all that apply.)
|
A. |
Category A drugs are known
to have minimal risk to the fetus. |
|
B. |
Category C drugs are known
to cause severe risk to the fetus in human trials. |
|
C. |
Drugs that are classified
as teratogenic are not able to cross the placental barrier. |
|
D. |
Category X drugs have not
been studied in pregnant women. |
|
E. |
Category B drugs have
slight risk to the fetus; both animal and human studies have been done. |
____ 4. A nurse is working with a
group of male veterans participating in a smoking-cessation program. The nurse
recognizes that which of the following statements related to medications in
these clients is true? (Select all that apply.)
|
A. |
An increased number of
medications will have teratogenic effects in this population. |
|
B. |
Medications are likely to
be absorbed and distributed more rapidly. |
|
C. |
This population has a
decreased lipase secretion. |
|
D. |
These clients may need
larger doses of liver-metabolized drugs. |
|
E. |
Drugs will be metabolized
more slowly by this population. |
____ 5. A nurse working in the
emergency room is preparing for the admission of a 34-year-old client with a
drug overdose. Which of the following equipment and/or orders will the nurse
anticipate?
|
A. |
Telemetry monitoring |
|
B. |
Blood transfusion |
|
C. |
Activated charcoal |
|
D. |
Dialysis machine |
|
E. |
Nasogastric tube and 60-mL
syringe for lavage |
|
F. |
Contrast for magnetic
resonance imaging (MRI) testing |
____ 6. A nurse working on the
orthopedic unit is providing discharge instructions for a client with a
fractured femur. When explaining the client’s narcotic pain medication, the
nurse would include which statement? (Select all that apply.)
|
A. |
“This medication may make
you sleepy, so you can’t drive while taking it.” |
|
B. |
“Narcotics can cause
constipation, so be sure to drink extra fluid and eat a high-fiber diet.” |
|
C. |
“Many patients who take
this feel dizzy or light-headed, so you must be careful of falls, especially
at night.” |
|
D. |
“Only take the number of
pills prescribed per day. Taking more can be dangerous.” |
|
E. |
“You can take this
medication as many times as needed for pain control.” |
____ 7. An RN is working to
support clinical trials in clients with cancer. Which of the following would be
an anticipated part of this role? (Select all that apply.)
|
A. |
Educating the clients about
the treatment, side effects, and alternative therapies |
|
B. |
Ensuring that informed
consent to participate is obtained |
|
C. |
Documenting client and
family understanding related to the trial |
|
D. |
Providing payment to the
client for participation in the trial |
|
E. |
Ordering medications from
the pharmacy based on clients’ height and weight |
Matching
Place the following steps of medication administration for an
ordered medication in the correct order.
|
A. |
Ask the client to state
his/her name and birth date. |
|
B. |
Open the medication
packaging. |
|
C. |
Verify the medication and
dose. |
|
D. |
Scan the medication with
the computer scanner. |
____ 1. First
____ 2. Second
____ 3. Third
____ 4. Fourth
Chapter 3. Patient Safety in Medication Administration
Answer Section
MULTIPLE CHOICE
1. ANS:
D
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: Medication
Administration KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Table 3.2 (p. 29): PO is by mouth (orally) and
o.s. is left eye.
2. ANS:
A
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: Medication
Administration KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Check the
label before you take the bottle from the shelf, check the label before you
pour the drug out, check the label before you put the bottle back on the shelf.
3. ANS:
C
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification:
Antibiotics
KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Some
medications, such as antibiotics need to be given a standard number of hours
apart around the clock to maintain a consistent blood level. Most antibiotics
work best when taken on an empty stomach (p. 31). Store medications safely
locked away.
4. ANS:
B
PTS:
1
DIF: Easy
TOP: Therapeutic Classification: Inhaled Steroids
KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Emphasize that
patients need to adhere to the exact prescription and avoid self-medication.
5. ANS:
B
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: NA
KEY:
Analysis MSC: NCLEX
Category: Pharmacological Therapies
NOT: See Fast Tip 3.1 (p. 27): Store medications safely no
matter what age others are in the household. Discomfort at the surgical
incision site should be investigated to ensure that no infection is present,
but tenderness 3 days after surgery is still expected and may interfere with
prosthetic use.
6. ANS:
A
PTS: 1
DIF: Moderate
TOP: Therapeutic Classification: Anti-inflammatory
agents KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: Patient Rights for Safety (p. 27): A liquid
formulation may be necessary if the drug must be given through a feeding tube.
A needle should not be necessary for g-tube administration. Documentation
should not occur until after the medication is given. Clients should be asked
to state name and birth date for proper identification.
7. ANS:
D
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: Amphetamine
mixtures KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Medication Administration Table 3.1 (p. 28): Adderall
and Advair each have other drugs with look-alike/sound-alike names. Adderall is
used to treat ADHD symptoms. Advair is provided in diskus/inhalation format for
clients with asthma and food is not a factor in its provision. These two
medications can be given at the same time.
8. ANS:
B
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification:
Laxatives
KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Table 3.2: NPO means nothing by mouth; PO means
orally. Giving specific directions/instructions, including times for prep, will
help ensure that clients understand and follow the correct procedure for
medication administration.
9. ANS:
C
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification:
Amionoglycocides
KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Table 3.2 and 3.3: IV means intravenous (into a
vein), but without a zero in front of the decimal point, this order should be
clarified.
10. ANS:
B
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification:
Antibiotics
KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Factors Affecting Medication Administration (p.
31): Administering tetracycline with calcium prevents the absorption of the
antibiotic. Most antibiotics work best when taken on an empty stomach. Many
antibiotics can cause diarrhea, so drinking extra fluids is important.
11. ANS:
D
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: Lipid lowering
agents KEY:
Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Age, gender and culture (p. 31): Toxic drug
levels can be found in elderly patients, even with normal doses. The aging
process alters liver and kidney function and leads to accumulation of
medications. Atorvastatin can cause muscle breakdown, a condition that is
worsened in the presence of kidney or liver disease, so it will be important to
have the client evaluated and have laboratory testing done.
12. ANS:
D
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: Medication
administration KEY: Analysis
MSC: NCLEX Category: Dosage Calculations
NOT: See Age, gender and culture (p. 31): The aging
process alters liver and kidney function and leads to accumulation of
medications. Because of these factors, doses may need to be adjusted for
elderly patients.
13. ANS:
B
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: NA
KEY:
Analysis MSC: NCLEX
Category: Coordinated Care
NOT: See Age, gender and culture (p. 31): Of special
concern are sedative-hypnotics. These medications are commonly associated with
adverse drug events and can worsen agitation and exacerbate dementia. Another
concern for geriatric patients is polypharmacy, but this is not the highest
priority in this scenario. Anticoagulant medication is an appropriate treatment
for deep vein thrombosis. A reading of 88 g/dL is a normal fasting blood
glucose.
14. ANS:
D
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX
Category: Physiological Adaptation
NOT: See Patients with Organ Dysfunction (p. 34):
Decreased serum protein levels can alter the capacity of a drug to bond. More
unbound medication is therefore available and this can lead to side effects.
Serum protein levels may indirectly impact blood volume and therefore blood
pressure, but this is not the highest priority. Recent CBC results may be
indirectly affected by low serum protein levels, but this is not the highest
priority for this scenario.
15. ANS:
A
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: NA
KEY:
Analysis MSC: NCLEX
Category: Pharmacological Therapies
NOT: See Patient Emergencies (p. 36): A severe allergic
reaction is called anaphylaxis. Patients experiencing anaphylaxis have
difficulty breathing and may have other symptoms such as itching, wheezing,
anxiety, and light-headedness.
16. ANS:
A
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: NA
KEY:
Analysis MSC: NCLEX
Category: Safety and Infection Control
NOT: See Patient Emergencies (p. 36): If you receive a
call from a patient who has ingested a toxic substance, call 911. This child
needs immediate medical attention, which should take priority over other
actions or assessment. Learning more about the medications will be helpful and
milk may be appropriate to reduce acidity, but the priority is to have
emergency personnel respond first.
17. ANS:
B
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: Medication
Administration KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Consent (p. 35): Patients have the right
to receive medications in a quiet, private place. The first action in this
scenario is to attempt to provide client privacy by pulling the bedside curtain
and speaking in subdued tones.
MULTIPLE RESPONSE
1. ANS:
A, B, C, E,
F
PTS: 1
DIF: Easy
TOP: Therapeutic Classification: Medication
Administration KEY: Knowledge
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26) The seven right
of medication administration include right patient, right drug, right dose,
right time, right route, right technique, and right documentation.
2. ANS:
E,
F
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: Medication
administration KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26) The seven
rights of medication administration include right patient, right drug, right dose,
right time, right route, right technique, and right documentation. Before you
administer any medication, make sure that you have the right patient by asking
the individual to state his or her full name and birth date. Verify that you
have the correct medication for the patient. In a hospital, scanning a bar code
to double-check a medication with a computer system may help reduce medication
errors. 1800 is 6 p.m.; this is not a morning medication and would not be
provided at this time. Both first and last name and birthdate should be stated
prior to provision of medications.
3. ANS:
A,
E
PTS:
1
DIF:
Hard
TOP: Therapeutic Classification: NA
KEY: Knowledge MSC: NCLEX
Category: Pharmacological Therapies
NOT: See Pregnancy and Table 3.5 (p. 33): Category A
medications have the lowest risk. Category B medications have slight risk, with
animal studies showing no risk or, if risk is noted, human studies have shown
no risk. Category C medications have moderate risk based on animal studies, and
controlled studies have not been done on women. Category X medications have the
highest risk as studies have shown significant risk. Teratogenic drugs cross
the placental barrier and cause deformities.
4. ANS:
B, D
PTS:
1
DIF: Hard
TOP: Therapeutic Classification: NA
KEY: Knowledge MSC: NCLEX
Category: Pharmacological Therapies
NOT: See Age, gender and culture (p. 32–33): Medications
are absorbed and distributed in the body more quickly in men than in women.
Smoking cigarettes induces liver enzymes to metabolize drugs more rapidly, so
clients may need larger doses of liver-metabolized drugs. Teratogenic effects
are related to fetal development and will not impact male clients. Lipase
secretion is decreased in infants as compared with adults.
5. ANS:
A, C, E
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX
Category: Physiological Adaptation
NOT: See Patient Emergencies (p. 36): Actions will depend
on the type of toxin but may include administration of activated charcoal,
lavage (pumping of the patient’s stomach), and monitoring the patient for
changes in vital signs, including heart rate (telemetry). Blood transfusion,
dialysis, and MRI testing is not immediately anticipated and would only be
ordered if the client was experiencing bleeding, kidney failure, or symptoms of
a stroke, respectively.
6. ANS:
A, B, C, D PTS: 1
DIF: Moderate
TOP: Therapeutic Classification:
Narcotics
KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Protecting the Patient: Ethical and Safety
Considerations (p. 34): It is your responsibility as a health professional to
educate the patient about the risks associated with taking more than the
prescribed dose.
7. ANS:
A, B, C
PTS:
1
DIF: Hard
TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX
Category: Coordinated Care
NOT: See Patient consent (p. 35): A patient who is taking
an experimental drug has the right to informed consent, which includes
understanding the treatment and its effects, alternative treatments, and
possible outcome if the treatment is declined. It is essential to document
informed consent. Clients are generally not paid to participate in clinical
trials. RNs are not able to order medications.
MATCHING
1. ANS:
A
PTS:
1
DIF: Easy
TOP: Therapeutic Classification: Medication
Administration KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Before you
administer any medication, make sure that you have the right patient by asking
the individual to state his or her full name and birth date. Verify that you
have the correct medication for the patient. In a hospital, scanning bar codes
to double-check a medication with a computer system may help reduce medication
errors.
2. ANS:
D
PTS:
1
DIF: Easy
TOP: Therapeutic Classification: Medication
Administration KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Before you
administer any medication, make sure that you have the right patient by asking
the individual to state his or her full name and birth date. Verify that you
have the correct medication for the patient. In a hospital, scanning bar codes
to double-check a medication with a computer system may help reduce medication
errors.
3. ANS:
B
PTS:
1
DIF: Easy
TOP: Therapeutic Classification: Medication
Administration KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Before you
administer any medication, make sure that you have the right patient by asking
the individual to state his or her full name and birth date. Verify that you
have the correct medication for the patient. In a hospital, scanning bar codes
to double-check a medication with a computer system may help reduce medication
errors.
4. ANS:
C
PTS:
1
DIF: Easy
TOP: Therapeutic Classification: Medication
Administration KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Before you
administer any medication, make sure that you have the right patient by asking
the individual to state his or her full name and birth date. Verify that you
have the correct medication for the patient. In a hospital, scanning bar codes
to double-check a medication with a computer system may help reduce medication
errors.
Chapter 4. Regulations
Multiple Choice
Identify the choice that best completes the statement or answers
the question.
____ 1. While shopping for an
over-the-counter cough suppressant, the nurse identifies the medication will be
classified as:
|
A. |
A Schedule I medication |
|
B. |
A Schedule III medication |
|
C. |
A Schedule V medication |
|
D. |
Nonscheduled medication |
____ 2. Nurses are protected from
unnecessary job-related risks due to the regulations set by:
|
A. |
Food and Drug
Administration (FDA) |
|
B. |
Drug Enforcement
Administration (DEA) |
|
C. |
Occupational Safety and
Health Administration (OSHA) |
|
D. |
Joint Commission on
Accreditation of Healthcare Organizations (JCAHO) |
____ 3. The nurse provides a
client admitted with gastroesophageal reflux a dose of intravenous pantoprazole
(Protonix). Fifteen minutes later, the client calls for help and is gasping for
breath. Emergency measures are instituted and the client is transferred to the
intensive care unit. Which action should be included in the nurse’s follow-up
activities?
|
A. |
Notify the nursing
supervisor that the client experienced a common side effect to the drug. |
|
B. |
Identify the episode as an
adverse reaction and ensure it is reported to the FDA. |
|
C. |
Call the hospital
administrator to report an act of medication fraud. |
|
D. |
Contact the local news
channel to arrange an investigation. |
____ 4. A client with advanced
colorectal cancer is going to start taking long-acting morphine sulfate (MS
Contin). Which of the following statements by the nurse is best?
|
A. |
“I will call the
prescription into your local pharmacy.” |
|
B. |
“You are only allowed to
have one refill on this medication before you have to see the doctor again.” |
|
C. |
“This is considered a
Schedule IV medication, so there are strict guidelines we must follow.” |
|
D. |
“I am faxing the
prescription to the pharmacy, but you must also take this written
prescription with you to pick it up.” |
____ 5. A client with a compressed
disc in the lumbar region takes Vicodin every 6 hours for pain control. He
tells the nurse, “This pain medication just doesn’t seem to be working
anymore.” Which response by the nurse is best?
|
A. |
“Are you taking the
medication with a full glass of water?” |
|
B. |
“You may be developing a
tolerance to the medication.” |
|
C. |
“We will have to draw some
lab work to see if your stomach is digesting the medication correctly.” |
|
D. |
“How did you rank your pain
on a 0–10 scale with your original injury?” |
____ 6. A co-worker tearfully
confides that she is struggling with a growing dependence on sleeping
medication and other drugs to maintain her work schedule on the night shift.
Which action by the nurse is best?
|
A. |
Refer the co-worker to the
employee assistance program. |
|
B. |
Encourage the co-worker to
switch to herbal remedies. |
|
C. |
Suggest the co-worker try
to get a daytime position. |
|
D. |
Ask if the co-worker needs
help with childcare. |
Multiple Response
Identify one or more choices that best complete the statement or
answer the question.
____ 1. A student nurse is
reminded to follow OSHA guidelines when providing care to clients in the
hospital. Which of the following actions will the student take to comply with
this direction? (Select all that apply.)
|
A. |
Wear a uniform that
identifies the student’s status |
|
B. |
Wear gloves when providing
a client bath |
|
C. |
Hand washing before
providing client care |
|
D. |
Needle disposal in an
identified “sharps” container |
|
E. |
Wear a face mask when
caring for a client with heart failure |
____ 2. A clinical trial nurse is
helping to register a patient to a phase II double-blind trial comparing a new
medication to a placebo. Which of the following would the nurse include in the
patient teaching? (Select all that apply.)
|
A. |
“Neither you, the doctor, or
I will know if you are getting the real medication or not.” |
|
B. |
“A computer will randomly
determine which people get the actual study drug.” |
|
C. |
“This trial is designed to
determine if a benefit is found when using the drug.” |
|
D. |
“Less than 100 people will
be participating in this study.” |
|
E. |
“The results of the study
will not be known for at least 5 years.” |
____ 3. A nurse working with a
client who is experiencing withdrawal from a medication would track which of
the following symptoms? (Select all that apply.)
|
A. |
Tremors |
|
B. |
Pin-point pupils |
|
C. |
Hallucinations |
|
D. |
Low blood pressure |
|
E. |
Emotional distress |
|
F. |
Feelings of euphoria |
____ 4. The nurse manager on a
surgical unit suspects one of the nurses may be dealing with a substance abuse
problem. Which of the following symptoms would support this suspicion? (Select
all that apply.)
|
A. |
The individual’s uniform is
frequently wrinkled or disheveled. |
|
B. |
The individual has called
in sick three times in the past month. |
|
C. |
The individual has made two
medication errors in the past week. |
|
D. |
The individual is irritable
and withdrawn. |
|
E. |
The individual was seen
crying in the medication room after a patient death. |
|
F. |
The individual has lost an
estimated 10 pounds in the past 8 weeks. |
Chapter 4. Regulations
Answer Section
MULTIPLE CHOICE
1. ANS:
C
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: NA
KEY:
Comprehension
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Table 4.4 (p. 45) and Table 4.7 (p. 57): Schedule
I medications have high abuse potential. Schedule III medications have lower
abuse potential with moderate to low dependence risk. Schedule V medications
have even lower abuse potential and include over-the-counter cough
suppressants.
2. ANS:
C
PTS:
1
DIF:
Easy
TOP: Therapeutic Classification: NA
KEY: Knowledge MSC: NCLEX
Category: Pharmacological Therapies
NOT: See Modern Regulating Agencies (p. 46): OSHA is a
branch of the Department of Labor that helps ensure all workers are not exposed
to unnecessary job-related risks.
3. ANS:
B
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: GERD agents
KEY: Analysis
MSC: NCLEX Category: Safety and Infection Control
NOT: See Food and Drug Administration (p. 47): A side
effect that can cause severe harm or death is commonly called an adverse
reaction. An example is airway swelling. It is your responsibility as an allied
health professional to report an adverse reaction to a medication to the FDA’s
MedWatch.
4. ANS:
D
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification:
Narcotics
KEY: Analysis
MSC: NCLEX Category: Psychosocial Integrity
NOT: See Drug Control (p. 57): Morphine is a Schedule II
medication. An office assistant cannot call in the prescription, and no refills
are permitted. The office staff may fax the prescription to the pharmacy, but
the clients must also give a handwritten prescription to the pharmacist to
receive the medication.
5. ANS:
B
PTS: 1
DIF: Moderate
TOP: Therapeutic Classification:
Narcotics
KEY: Analysis
MSC: NCLEX Category: Psychosocial Integrity
NOT: See Substance Abuse (p. 59): Requiring greater
amounts of a drug occurs when clients develop a tolerance to the medication.
The amount of water consumed will not contribute to drug efficacy. Kidney or
liver dysfunction may contribute to drug metabolism, but lab results are not
typically used to determine digestion of a medication. The level of pain
associated with the original injury is not helpful to the current situation.
6. ANS:
A
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX
Category: Coordinated Care
NOT: See Treating Substance Abuse (p. 60): Follow your
facility’s protocol on referral of impaired employees for substance abuse
treatment. Many employers have employee assistance programs or support groups
organized through the human resource department.
MULTIPLE RESPONSE
1. ANS:
B, C, D
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: NA
KEY:
Analysis MSC: NCLEX
Category: Safety and Infection Control
NOT: See Modern Regulating Agencies (p. 46): OSHA
regulations for protecting yourself on the job include hand washing before any
patient is handled. Medications should not be touched without wearing gloves.
Gloves should be worn during client care in case of exposure to blood or body
fluids. Sharp objects should be disposed of in a specialized sharps disposal
container. Face masks are part of additional precautions when providing care
for clients with a respiratory infection – a client with heart failure is not
considered infectious.
2. ANS:
A, B, C
PTS:
1
DIF: Hard
TOP: Therapeutic Classification: NA
KEY:
Analysis MSC: NCLEX
Category: Pharmacological Therapies
NOT: See Clinical Trials (p. 51-52) and Table 4.6: Clinical
trials are studies performed after testing is done in a laboratory. During the
study the effect of the active drug is compared to a placebo (an inactive
substance). Most studies are double-blind, meaning neither the participant nor
the clinicians know who is receiving the active drug. Phase II clinical trials
involve hundreds of patients and are designed to see whether a drug works as
desired. Phase II trials last several months to 2 years.
3. ANS:
A, C, E
PTS:
1
DIF: Moderate
TOP: Therapeutic Classification: NA
KEY: Knowledge MSC: NCLEX
Category: Psychosocial Integrity
NOT: See Substance Abuse (p. 59): Patients who stop taking
a medication may experience symptoms of withdrawal, such as tremors, emotional
distress, and hallucinations.
4. ANS:
A, B, C, D,
F
PTS: 1
DIF: Moderate
TOP: Therapeutic Classification:
NA KEY: Application
MSC: NCLEX Category: Psychosocial Integrity
NOT: See Box 4.3 (p. 61): Signs of possible substance
abuse include: being late or absent frequently due to illness, irritable and
defensive or withdrawn behavior, frequent mistakes, changes in appearance such
as weight change, and poor or deteriorated hygiene.
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