1.
Mr. Smith is to receive 0.25 mgms of Digoxin once daily for a heart rate greater that 50 beats per minute. It is supplied to you from the pharmacy in .50 mgm tablets. How will you proceed to administer this medication?
Correct Answer
B. Ensure the tablet is scored, break it in half, take Mr. Smiths pulse to ensure it is greater than 50, check the dose with another nurse and then administer drug, staying with Mr. Smith until he has swallowed the pill.
Explanation
The correct answer is to ensure the tablet is scored, break it in half, take Mr. Smith's pulse to ensure it is greater than 50, check the dose with another nurse, and then administer the drug, staying with Mr. Smith until he has swallowed the pill. This approach ensures that the correct dose of 0.25 mgms is administered to Mr. Smith, as prescribed, while also ensuring his heart rate is above 50 beats per minute. Checking the dose with another nurse helps to prevent any medication errors, and staying with Mr. Smith until he has swallowed the pill ensures proper administration and monitoring.
2.
Mrs. Jay receives Fentanyl 50 mgms patch every 72 hours. You are washing Mrs. Jay and notice the patch is not adhering to the skin. What should you do?
Correct Answer
C. Place some tape over the patch to ensure it stays on. Determine if Mrs. Jay is having any pain as poor contact can lead to poor absorption of the drug. Document your findings. You will follow up throughout your shift to ensure that Mrs. Jay is receiving full benefit from her drug.
Explanation
If the Fentanyl patch is not adhering to the skin, the appropriate action would be to place some tape over the patch to ensure it stays on. Additionally, it is important to determine if Mrs. Jay is experiencing any pain as poor contact can lead to poor absorption of the drug. These findings should be documented, and it is necessary to follow up throughout the shift to ensure that Mrs. Jay is receiving the full benefit from her medication.
3.
Mr. Smith wants to know more about his drug. You will tell him what regarding his daily Digoxin dose?
Correct Answer
C. Digoxin slows and strengthens the beat of his heart, he should take his pulse daily and inform his doctor if he finds it lower that 50 beats per minute. Any dizziness or lightheadedness should be reported right away. He should take his dose every day at approximately the same time.
Explanation
The correct answer explains that Mr. Smith should take his daily Digoxin dose regularly once a day and should never skip a dose. It also states that Digoxin slows and strengthens the beat of his heart, so he should take his pulse daily and inform his doctor if he finds it lower than 50 beats per minute. Additionally, any dizziness or lightheadedness should be reported immediately. It emphasizes the importance of taking the dose at the same time every day.
4.
Who are the people you should clarify an order with if you are unsure of how to proceed?
Correct Answer
A. The person ordering the drug, the pHarmacist or your supervisor.
Explanation
If you are unsure of how to proceed with an order, it is important to clarify it with the person who ordered the drug, the pharmacist, or your supervisor. These individuals have the necessary knowledge and authority to provide guidance and ensure that the correct procedures are followed. Clarifying the order with them helps to prevent errors and ensure patient safety.
5.
Mrs. Jackson is taking Amoxil 500 mgms, three times per day. The bottle she receives from her pharmacists says she must complete the entire course of treatment. She is your neighbor. She tells you she feels so much better and after three days has stopped taking her medication because she does not need it anymore. What will you tell her regarding this?
Correct Answer
B. Medication should be taken as directed and if she does not finish the entire course of medication she is likely to have a recurrence and the drug will become ineffective. You can warn her that "superbugs" that are resistant to antibiotics were created in part by incorrect use of antibiotics.
Explanation
If Mrs. Jackson stops taking her medication after feeling better, she is at risk of having a recurrence of her illness and the drug may become ineffective. It is important to complete the entire course of medication as directed to ensure that the infection is completely treated. Additionally, incorrect use of antibiotics has contributed to the development of "superbugs" that are resistant to antibiotics, so it is crucial to follow the prescribed treatment regimen to prevent the emergence of drug-resistant bacteria.
6.
Prescription errors can be minimized by observing all of the following practices, EXCEPT for:
Correct Answer
B. Using abbreviations
Explanation
Using abbreviations can actually increase the risk of prescription errors. Abbreviations can be misinterpreted or misunderstood by healthcare professionals, leading to medication errors. Therefore, it is important to avoid using abbreviations and instead write out the full medication names and instructions to ensure clarity and accuracy in prescriptions.
7.
Prescriptions should include the full names of drugs, both brand-name and generic.
Correct Answer
A. True
Explanation
Including the full names of drugs, both brand-name and generic, in prescriptions is important for several reasons. Firstly, it ensures clarity and accuracy in prescribing medications, reducing the risk of medication errors. Secondly, it helps pharmacists in dispensing the correct medication, as brand names can vary across different manufacturers. Additionally, including both names allows for easy identification and substitution of medications when necessary. Therefore, it is crucial for prescriptions to include the full names of drugs, both brand-name and generic.
8.
Regarding prescription instructions, nurses should:
Correct Answer
B. Explain what the medication is and does, as well as its potential side effects
Explanation
Nurses should explain what the medication is and does, as well as its potential side effects to the patient. This is important for the patient's understanding and informed decision-making. By providing this information, nurses can ensure that the patient is aware of the purpose of the medication and how it may affect them. Additionally, informing patients about potential side effects allows them to monitor their own health and report any adverse reactions to healthcare professionals. This explanation helps promote patient autonomy and safety.
9.
Why should numbers / quantities for controlled substances be fully written?
Correct Answer
A. To prevent alterations by the patient
Explanation
Numbers/quantities for controlled substances should be fully written to prevent alterations by the patient. This is because fully written numbers are harder to alter compared to numerical digits, making it more difficult for patients to change the prescribed quantity of the controlled substance. This helps ensure that patients do not manipulate their prescriptions for personal gain or misuse of the medication.
10.
Since the dosage amounts "5 mg" and "5.0 mg" mean the same thing, nurses can use them interchangeably.
Correct Answer
B. False
Explanation
The statement is false because although "5 mg" and "5.0 mg" may seem to mean the same thing, in medical practice, the use of decimal places is important for accurate dosing. A dosage of "5 mg" could be interpreted as a whole number, while "5.0 mg" indicates a specific measurement to the nearest tenth. Nurses should follow precise dosing instructions to ensure patient safety and avoid medication errors.
11.
What should a nurse do if she thinks that the prescribed medication may be wrong for a particular patient?
Correct Answer
A. Challenge it – get clarification and confirmation from her supervisor and/ or the doctor
Explanation
If a nurse believes that the prescribed medication may be wrong for a particular patient, the best course of action is to challenge it. This involves seeking clarification and confirmation from her supervisor and/or the doctor. This is important to ensure the safety and well-being of the patient, as medication errors can have serious consequences. By seeking additional input from higher authorities, the nurse can make an informed decision and prevent any potential harm to the patient.
12.
Which of the following is most important to check prior to administering a medication to a patient?
Correct Answer
D. Allergy status
Explanation
It is important to check a patient's allergy status prior to administering a medication to ensure that they do not have any known allergies to the medication being given. This is crucial in order to prevent any potential allergic reactions or adverse effects that could harm the patient. Checking the medical condition, vital signs, and other prescription medications are also important considerations, but allergy status takes precedence as it directly relates to the safety and well-being of the patient.
13.
- If a nurse is really busy, it is acceptable for her to prepare the medication in advance, and leave it for the patient to take, or for another professional to administer.
Correct Answer
B. False
Explanation
It is not acceptable for a nurse to prepare medication in advance and leave it for the patient to take or for another professional to administer, even if they are busy. Medication administration requires careful monitoring and assessment of the patient's condition, and it is the nurse's responsibility to ensure the correct dosage and timing. Leaving medication for the patient or another professional to administer can lead to errors, potential harm to the patient, and legal implications. Therefore, the statement is false.
14.
A client is nauseated, has been vomiting for several hours, and needs to receive an antiemetic (anti-nausea) medication. Which of the following is accurate?
Correct Answer
C. A parenteral route is the route of choice.
Explanation
When a client is nauseated and vomiting, their ability to absorb oral medications may be compromised. Therefore, the parenteral route, which involves administering medication through injection or infusion, is the preferred route in this situation. This allows for direct absorption into the bloodstream, bypassing the gastrointestinal tract. Giving an enteric-coated medication or a rectal suppository may not be effective as the client may continue to vomit or have difficulty absorbing the medication.
15.
- A 76-year-old client lives alone and takes medication without supervision. Which of the following is the most appropriate question for his home health nurse to ask in regard to his medication regimen?
Correct Answer
D. “Have you been taking other substances than those ordered by the pHysician?”
Explanation
The most appropriate question for the home health nurse to ask in regard to the client's medication regimen is whether they have been taking other substances than those ordered by the physician. This question is important because the client lives alone and takes medication without supervision, so there is a possibility that they may be taking additional medications or substances that could interact with their prescribed medication. This question helps the nurse assess the client's compliance with their medication regimen and identify any potential risks or issues that may arise from the use of additional substances.
16.
A male client who has severe burns is receiving H2 receptor antagonist therapy. The nurse In-charge knows the purpose of this therapy is to:
Correct Answer
A. Prevent stress ulcer
Explanation
H2 receptor antagonist therapy is used to prevent stress ulcers in patients with severe burns. Severe burns can lead to increased gastric acid secretion, which can cause stress ulcers. H2 receptor antagonists work by reducing the production of gastric acid, thus preventing the formation of stress ulcers. This therapy does not block prostaglandin synthesis, facilitate protein synthesis, or enhance gas exchange.
17.
The physician orders penicillin for a patient with streptococcal pharyngitis. The nurse administers the drug as ordered, and the patient has an allergic reaction. The nurse checks the medication order sheet and finds that the patient is allergic to penicillin. Legal responsibility for the error is:
Correct Answer
D. The pHarmacist, pHysician, and nurse are all liable for the mistake
Explanation
The physician, nurse, and pharmacist all are licensed professionals and share responsibility for errors.
18.
James Oamil Movilla, a nurse on a geriatric floor, is administering a dose of digoxin to one of his patients. The woman asks why she takes a different pill than her niece, who also has heart trouble. James replies that as people get older, liver and kidney function decline, and if the dose is as high as her niece’s, the drug will tend to:
Correct Answer
B. Accumulate.
Explanation
The decreased circulation to the kidney and reduced liver function tend to allow drugs to accumulate and have toxic effects.
19.
The most important instructions a nurse can give a patient regarding the use of the antibiotic ampicillin prescribed for her are to:
Correct Answer
C. Take all of the medication prescribed even if the symptoms stop sooner
Explanation
Frequently patients do not complete an entire course of antibiotic therapy, and the bacteria are not destroyed.
20.
Mrs. Aisha has been dealing with uterine cancer for several months. Pain management is the primary focus of her current admission to your oncology unit. Her vital signs on admission are BP 110/64, pulse 78, respirations 18, and temperature 99.2 F. Morphine sulfate 6mg IV, q 4 hours, prn has been ordered. During your assessment after lunch, your findings are: BP 92/60, pulse 66, respirations 10, and temperature 98.8. Mrs. Gately is crying and tells you she is still experiencing severe pain. Your action should be to:
Correct Answer
C. Report your findings to the MD, requesting an alternate medication order
Explanation
Morphine sulfate depresses the respiratory center. When the rate is less than 10, the MD should be notified.
21.
A nurse is preparing the client’s morning NpH insulin dose and notices a clumpy precipitate inside the insulin vial. The nurse should:
Correct Answer
C. Draw the dose from a new vial
Explanation
The nurse should always inspect the vial of insulin before use for solution changes that may signify loss of potency. NPH insulin is normally uniformly cloudy. Clumping, frosting, and precipitates are signs of insulin damage. In this situation, because potency is questionable, it is safer to discard the vial and draw up the dose from a new vial.
Question 12 WRONG
22.
A client with histoplasmosis has an order for ketoconazole (Nizoral). The nurse teaches the client to do which of the following while taking this medication?
Correct Answer
C. Avoid exposure to sunlight
Explanation
The client should be taught that ketoconazole is an antifungal medication. It should be taken with food or milk. Antacids should be avoided for 2 hours after it is taken because gastric acid is needed to activate the medication. The client should avoid concurrent use of alcohol, because the medication is hepatotoxic. The client should also avoid exposure to sunlight, because the medication increases photosensitivity.
23.
A nurse has taught a client taking a xanthine bronchodilator about beverages to avoid. The nurse determines that the client understands the information if the client chooses which of the following beverages from the dietary menu?
Correct Answer
B. Cranberry juice
Explanation
Cola, coffee, and chocolate contain xanthine and should be avoided by the client taking a xanthine bronchodilator. This could lead to an increased incidence of cardiovascular and central nervous system side effects that can occur with the use of these types of bronchodilators.
24.
A client is taking famotidine (Pepcid) asks the home care nurse what would be the best medication to take for a headache. The nurse tells the client that it would be best to take:
Correct Answer
C. AcetaminopHen (Tylenol)
Explanation
The client is taking famotidine, a histamine receptor antagonist. This implies that the client has a disorder characterized by gastrointestinal (GI) irritation. The only medication of the ones listed in the options that is not irritating to the GI tract is acetaminophen. The other medications could aggravate an already existing GI problem.
25.
A nurse is providing instructions to a client regarding quinapril hydrochloride (Accupril). The nurse tells the client:
Correct Answer
B. To rise slowly from a lying to a sitting position
Explanation
Accupril is an angiotensin-converting enzyme (ACE) inhibitor. It is used in the treatment of hypertension. The client should be instructed to rise slowly from a lying to sitting position and to permit the legs to dangle from the bed momentarily before standing to reduce the hypotensive effect. The medication does not need to be taken with meals. It may be given without regard to food. If nausea occurs, the client should be instructed to take a non cola carbonated beverage and salted crackers or dry toast. A full therapeutic effect may be noted in 1 to 2 weeks.
26.
Auranofin (Ridaura) is prescribed for a client with rheumatoid arthritis, and the nurse monitors the client for signs of an adverse effect related to the medication. Which of the following indicates an adverse effect?
Correct Answer
D. Proteinuria
Explanation
Auranofin (Ridaura) is a gold preparation that is used as an antirheumatic. Gold toxicity is an adverse effect and is evidenced by decreased hemoglobin, leukopenia, reduced granulocyte counts, proteinuria, hematuria, stomatitis, glomerulonephritis, nephrotic syndrome, or cholestatic jaundice. Anorexia, nausea, and diarrhea are frequent side effects of the medication.
27.
A female client tells the clinic nurse that her skin is very dry and irritated. Which product would the nurse suggest that the client apply to the dry skin?
Correct Answer
A. Glycerin emollient
Explanation
Glycerin is an emollient that is used for dry, cracked, and irritated skin. Aspercreme and Myoflex are used to treat muscular aches. Acetic acid solution is used for irrigating, cleansing, and packing wounds infected by Pseudomonas aeruginosa.
28.
When a drug binds to a receptor to produce a pharmacologic effect, the drug may be called a(n):
Correct Answer
A. Agonist
Explanation
An agonist is the action described in the stem. B and C are synonymous. ELiminate choice D because there is no such action described in drug nomenclature.
29.
An unexpected effect of the drug is known as a(n):
Correct Answer
B. Adverse effect
Explanation
An adverse reaction is a harmful and unexpected reaction. A side effect is expected and predictable. C and D are incorrect because a toxic reaction is a type of adverse reaction.