NURSING 1023 Medication and I.V. administration Questions & Answers Graded A+

NURSING 1023 Medication and I.V. administration Questions & Answers A medication order reads "Meperidine 1 ml intramuscular (I.M.) stat." Which action will the nurse responsible for administering the drug base the next step on? Correct response: • The order should be clarified with the physician. Which nursing action is appropriate when administering a glycerin suppository to a client? Correct response: • Applying a lubricant to the suppository A client reports difficulty swallowing when the nurse tries to administer a medication in capsule form. What action should the nurse take to resolve this problem? Correct response: • Check for availability of a liquid preparation. The physician prescribes a loop diuretic for a client. When administering this drug, the nurse anticipates that the client may develop which electrolyte imbalance? Correct response: • Hypokalemia A client is prescribed metformin to control type 2 diabetes. The nurse should monitor for which life-threatening adverse reaction? Correct response: • Lactic acidosis The newly hired graduate nurse asks the nurse preceptor what is the only advantage of using a floor stock system. Which rationale does the preceptor give the graduate nurse? Correct response: • The nurse can implement medication orders quickly. A child with type 1 diabetes develops diabetic ketoacidosis and receives a continuous insulin infusion. Which condition represents the greatest risk to this child? Correct response: • Hypokalemia The nurse is preparing to give a 9-year-old client a preoperative I.M. injection. Which size needle should the nurse use? Correct response: • 22G, 1" A client with hypothyroidism is prescribed levothyroxine 0.05 mg by mouth daily before breakfast. As the nurse gives the client the medication, the client states, "What dose am I getting? I've been taking 0.15 mg every day for years." Which action by the nurse is most appropriate? Correct response: • Verify the dose against the health care provider’s prescription in the client's medical record. When a nurse administers a medication, which details of a client's drug therapy is the nurse legally responsible for documenting? Select all that apply. Correct response: • client's reaction to the drug • time the drug was administered The nurse is initiating an intravenous (IV) access for a client who needs an infusion of normal saline solution. Which nursing action should the nurse perform before the venipuncture? Correct response: • Check for latex allergy before applying the tourniquet. A nurse is administering medication to a client who is allergic to penicillin. Which drug is contraindicated for this client? Correct response: • ticarcillin A nurse is administering iron dextran IM. A client asks why the skin is pulled to the side before the needle is inserted. Which statements are appropriate for the nurse to make? Select all that apply. Correct response: • It prevents medication leaking into subcutaneous tissue. • It prevents staining of the skin. A client who is recovering one day after an extensive abdominal surgery is having incisional pain. When should the nurse plan to administer analgesics for this client? Correct response: • Every 3-4 hours A nurse is preparing to administer ferrous sulfate to a client. What is the nurse’s appropriate action? Correct response: • Dilute with juice and administer through a straw. A nurse is administering eye drops to a client. Which technique is correct? Correct response: • Pull the lower lid down, press the tear duct, and drop medication into the conjunctival sac. A licensed practical nurse (LPN/LVN) is working with the RN in verifying a heparin IV infusion rate. The prescribed dose is 400 units of heparin per hour. The heparin is in a solution of 5,000 units/100 mL NS. How many milliliters per hour should the pump be set? Record your answer using a whole number. Correct response: • 8 The nurse is caring for a client who is receiving warfarin. The nurse reinforces to the client that anticoagulant effects may not be seen for how many days? Correct response: • 3-5 A histamine (H2) receptor antagonist is prescribed for a client with recurrent gastrointestinal discomfort. The nurse is instructing the client from a medication pamphlet and highlights which medications in this classification? Select all that apply. Correct response: • cimetidine • ranitidine • nizatidine • famotidine After laparoscopic cholecystectomy, a client reports pain and nausea. A nurse is preparing 75 mg of meperidine and 12.5 mg of promethazine to be administered IM in the same syringe. If the label on the meperidine reads 50 mg/mL and the label on the promethazine reads 25 mg/mL, how many milliliters should the nurse have in the syringe after the correct doses are drawn up? Record your answer using a whole number. Correct response: • 2 A client is scheduled for surgery at 8 a.m. While completing the preoperative checklist, the nurse sees that the surgical consent form hasn't been signed. It's time to administer the preoperative analgesic. Which nursing action takes the highest priority in this situation? Correct response: • Notifying the surgeon that the consent form hasn't been signed The nurse is caring for a client who underwent internal fixation of the right hip. Before administering the client's warfarin, the nurse checks the laboratory report for the client's International Normalized Ratio (INR) results. Which indicates the therapeutic range for this client? Correct response: • 2.0 to 3.0 The nurse is identifying a unit of packed red blood cells with a coworker before administration. The client's blood type is AB negative. Which blood type can safely be administered to this client? Correct response: • B negative When preparing to administer a drug dose to a client, the nurse examines the drug label. The nurse understands which information that the Food, Drug, and Cosmetic Act (Canada's Food and Drug Act and Regulations) requires drug labels to display? Correct response: • Presence, quantities, and proportions of certain ingredients The physician prescribes an infusion of 2,400 ml of I.V. fluid over 24 hours, with half this amount to be infused over the first 10 hours. During the first 10 hours, the client should receive how many milliliters of I.V. fluid per hour? Correct response: • 120 ml/hour The physician prescribes 20 units of U-100 regular insulin for a client. The only syringe available is a 1-ml tuberculin syringe. How many milliliters of insulin should the nurse administer? Correct response: • 0.2 A client who's admitted with new-onset diabetes mellitus is prescribed an 1,800-calorie diabetic diet. His insulin orders include regular insulin coverage using a sliding scale, and long-acting insulin every morning just before breakfast. Why was the sliding scale insulin coverage prescribed? Correct response: • Directs the nurse to administer regular insulin doses according to finger-stick glucose levels without notifying the physician A client reports a severe headache and blurred vision. The nurse immediately obtains vital signs, which reveals a blood pressure of 192/110 mm Hg. The nurse reviews the client's medical record and notes a prescription for clonidine 0.1 mg by mouth as needed for systolic blood pressure greater than 170 mm Hg and diastolic blood pressure greater than 100 mm Hg. The nurse checks the client's medication supply, but no clonidine is available. How should the nurse proceed? Correct response: • Inform the pharmacy that the medication is unavailable, ask them to prepare it, and and tell them that someone will pick it up immediately. A client newly diagnosed with diabetes mellitus is experiencing difficulty with self- administration of insulin. Despite further teaching, the client shows little improvement. What action by the nurse is most appropriate? Correct response: • Notify the physician of the client's lack of progress and request a diabetes education department consult. The health care provider prescribes acetaminophen 650 mg by mouth every 4 hours for a client with a temperature of 102°F (38.8°C) who has a feeding tube in place. The nurse has acetaminophen solution on hand containing 160 mg/5 mL. How many milliliters of solution should the nurse administer? Record your answer using one decimal place. Correct response: • 20.3 A client who takes over-the-counter drugs regularly is seen at a clinic. The nurse should take which actions to ascertain the client’s safety when taking these drugs? Select all that apply. Correct response: • Determine whether the client knows the appropriate drug dosages and administration schedules • Determine whether the client knows the correct reason for using the drug and its proper route of administration A client comes to the clinic with back pain that has been unrelieved by continuous ibuprofen use over the past several days. Current prescription medications include captopril and hydrochlorothiazide. Which laboratory value should the nurse report? Correct response: • blood urea nitrogen (BUN) of 26 mg/dL and serum creatinine of 2.35 mg/dL The nurse is caring for a client receiving morphine through a PCA pump who reports severe itching on his or her arms and legs bilaterally. What is the nurse’s best action? Correct response: • Contact the health care provider. A nurse is preparing to administer oral doxycycline to a client. What is the nurse’s appropriate action? Correct response: • Administer with full glass of water. The nurse is caring for four clients on a medical surgical unit. Which interaction between the nurse and a client is the best example of the nurse using the ethical principle of fidelity? Correct response: • The client asked for information regarding a new medication. The nurse provided written instructions. A client receives a short-acting insulin and an intermediate-acting insulin before breakfast at 0800. Using the chart shown, when should the nurse expect the onset of the intermediate-acting insulin to take effect? Correct response: • 1000 A medication nurse is preparing to administer 9 a.m. medications to a client with liver cancer. Which consideration is the nurse’s highest priority? Correct response: • metabolism of the medication Which actions should the nurse take to administer insulin to a client with diabetes? Select all that apply. Correct response: • Rotate the injection sites. • Inject at a slow, steady pace. • Insert the needle at 90 degrees. • Hold the syringe like a dart. The nurse prepares to administer a client’s morning medication. Which action should the nurse take first? Correct response: • Perform hand hygiene. A client is receiving IV lactated Ringer's solution at a rate of 75 mL/hour for fluid volume replacement. The infusion set provides 15 gtts/mL. At which flow rate should the nurse set the IV? Record your answer using a whole number. Correct response: • 19 The nurse is teaching a client how to administer subcutaneous (subQ) insulin injections. Which injection site would be appropriate for the client to use? Correct response: • Anterior aspect of the thigh The nurse is caring for a 62-year-old client with type 2 diabetes. The client takes an oral antidiabetic to control blood glucose levels. The physician prescribed ramipril to help treat this client's elevated blood pressure. The nurse should be alert for which drug interaction? Correct response: • Hypoglycemia A nurse administers the client’s prescribed antibiotic. The client tells the nurse, “I usually take a white tablet, not a yellow tablet.” What is the priority action by the nurse? Correct response: • Perform a recheck of the medication name and strength. A client has a nasogastric (NG) tube. The physician prescribes an oral medication that is not available in liquid form. Which action should the nurse utilize to administer the tablet form to this client? Correct response: • Crush the tablets and prepare a liquid form, and then insert it into the NG tube using using a syringe. The nurse has an order to administer an intramuscular (I.M.) injection using the Z-track technique. When carrying out this order, what nursing intervention should the nurse implement? Correct response: • Simultaneously withdraw the needle and release the skin. When drawing up a medication, the nurse notes there are small air bubbles adhering to the interior surface of the syringe. The nurse knows which effect the bubbles might have on parenteral administration? Correct response: • Altered drug dose The nurse complies with a client's request to administer his medication at 9 p.m. instead of 10 p.m. so he can go to sleep earlier. Which type of nursing intervention is the nurse utilizing? Correct response: • Independent The physician orders nitroglycerin, 5 mg by mouth twice per day, for a client. The drug is dispensed in 2.5-mg tablets. How many tablets will the nurse administer twice per day? Correct response: • Two A client develops hepatic encephalopathy 1 week after portal caval shunt surgery. Her physician prescribes neomycin, 4 g by mouth daily in four divided doses. Her husband asks how neomycin decreases his wife's serum ammonia concentration. How should the nurse respond? Correct response: • "It decreases the number of ammonia-producing bacteria in the GI tract." The nurse is preparing to discharge a child who has rheumatic fever. Which medication would the nurse expect to be prescribed to prevent recurrence of rheumatic fever? Correct response: • Antibiotics The nursing instructor asks the nursing student to select a type of solution, when administered intravenously (I.V.), would cause a shift of fluid from the interstitial space to the intravascular space. Which solution will the student choose? Correct response: • Hypertonic A nurse is reinforcing education with a client about three medications that the client will receive after discharge. While performing the discharge education, the nurse notices that the client suddenly becomes withdrawn and appears anxious. What action should the nurse take? Correct response: • Acknowledge the client's behavior, and seek clarification. After being treated with heparin for a pulmonary embolism, a client is prescribed warfarin using a sliding scale. Which action should the nurse take before administering this drug? Correct response: • Closely monitor prothrombin time (PT) and international normalized ratio (INR) results to determine the dose of warfarin to administer. Two nurses are discussing which types of blood can be safely administered to a client with type AB negative blood. Which blood types can safely be administered to this client? Select all that apply. Correct response: