Safety Questions
A mother complains that her child's teeth have become yellow in color. With prolonged use,
which medication may be responsible for the child's condition?
1. Tetracycline
2. Promethazine
3. Chloramphenicol
4. Fluoroquinolones
1
rationale:
When administered to neonates and infants, tetracycline may cause staining of developing
teeth. Promethazine can cause respiratory depression in children under 2 years of age.
Chloramphenicol can cause Gray baby syndrome, and fluoroquinolones may cause tendon
rupture in pediatric clients.
The medication prescribed for an infant is to be given intramuscularly. Which site will the nurse
select for administration of the medication?
1. Vastus lateralis
2. Ventrogluteal
3. Dorsogluteal
4. Deltoid
1
rationale:
Intramuscular injections are given in the vastus lateralis muscle of the thigh in infants. The
ventrogluteal site is not used until children have been walking. The dorsogluteal site is
considered high risk for damage to the sciatic nerve or a major blood vessel. The deltoid site in
the arm has a small muscle mass that limits the amount of medication that can be injected.
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A nurse reviews the medication charts of four clients. Which medication prescription will cause
the nurse to notify the primary healthcare provider?
1. Client A
2. Client B
3. Client C
4. Client D
1
rationale:
Client A has acromegaly, which is a result of increased growth hormone production. This
condition should be treated with octreotide and lanreotide instead of conivaptan; conivaptan is
used to treat SIADH. The treatment of Cushing's syndrome involves the administration of
aminoglutethimide. SIADH is treated with vasopressin receptor antagonists such as tolvaptan.
Pheochromocytoma is treated with adrenergic blockers such as phenoxybenzamine.
The nursing leader is teaching the newly hired nurse about the use of an electronic medication
administration record. Which statement of the newly hired nurse indicates effective learning?
1. "It will identify medication errors."
2. "It will be accessible to a single user."
3. "It will decrease the accuracy of charge capture."
4. "It will decrease the accuracy of pharmacokinetic monitoring."
1
rationale:
An electronic medication administration record will generate reports to track medication errors
with the visibility of near misses. The electronic medication administration record will be
accessible to multiple users. It will increase the accuracy of charge capture between
administration time and the time when the drug is dispensed. It will improve the accuracy of
pharmacokinetic monitoring.
, The home health care nurse discards outdated and leftover medications from previous
prescriptions at the home of an elderly client. Which Quality and Safety Education for Nurses
(QSEN) competency does this intervention involve?
1. Safety
2. Quality Improvement
3. Evidence-based practice
4. Teamwork and collaboration
1
rationale:
The nurse ensures the safety of the client by discarding medications that are outdated. It is
important to prevent harm to the client who may unintentionally take a medication that is no
longer required. Quality improvement requires the nurse to use data to monitor the outcomes of
care processes. The nurse ensures evidence-based practice by integrating the best current
evidence with clinical expertise, client, and family values for delivery of optimal health care. The
nurse functions effectively within nursing and interprofessional teams to promote open
communication and mutual respect while applying teamwork and collaboration competency.
A young woman tells the nurse, "My partner prevents me from taking my medications." What
should the nurse do to deal with the situation?
1. Conduct an interview with the client alone, when the partner is not around.
2. Notify the primary healthcare provider to conduct an interview with the client.
3. Collaborate with multiple community resources to obtain adequate health care.
4. Evaluate the client's and the family's cultural beliefs, values, and practices to determine their
specific needs.
1
rationale:
The statement provided by the young woman indicates that the individual may be a victim of
abuse, so the nurse should interview the client alone when the client has privacy and the
individual suspected of being the abuser is not present. Discussing the problems with the
primary healthcare provider might cause fear of retribution in the abused client. When dealing
with people with mental illness, the nurse should collaborate with multiple community resources
to obtain adequate health care. When dealing with vulnerable populations, the nurse should
evaluate their cultural beliefs, values, and practices to determine their specific needs.
Which first line medication would the nurse state is used to treat anaphylactic reactions?
1. Epinephrine