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CHAPTER 35: Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford

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Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford Chapter 35: Medication Administration Multiple Choice Questions 1. The nurse identifies which medication that has the highest potential for abuse according to the Controlled Substances Act? A. Methylphenidate (Ritalin)---schedule II B. Alprazolam (Xanax)---schedule IV C. Acetaminophen & codeine (Tylenol #3)---schedule III D. Diphenoxylate & atropine (Lomotil)---schedule V Answer: A Explanation: Schedule II drugs like methylphenidate have the highest abuse potential with strict prescription regulations, while schedules III-V have progressively lower risks. Why Other Options Are Wrong: B, C, and D are lower-schedule medications with reduced abuse potential compared to schedule II. 2. The nurse is preparing a patient to self-administer medication injections at home. How can the nurse best confirm the patient's understanding of proper technique? A. Provide written instructions B. Observe the patient self-administer an injection C. Call the patient the next day to check for difficulties D. Ask the patient to verbally explain the process Answer: B Explanation: Direct observation allows the nurse to correct technique errors immediately and provide reassurance. Why Other Options Are Wrong: A and D don't demonstrate practical competency. C delays feedback. 3. The nurse must provide rapid pain relief to a patient in agonizing pain. Which medication route will achieve the fastest effect? A. Morphine (MSContin) 10 mg PO B. Hydromorphone (Dilaudid) 1 mg IV push C. Meperidine (Demerol) 75 mg IM D. Fentanyl (Duragesic) 50 mcg transdermal patch Answer: B Explanation: IV administration provides immediate systemic absorption and pain relief. Why Other Options Are Wrong: A has delayed GI absorption. C requires muscle absorption. D has slow transdermal absorption. 4. After medication administration, the patient develops an itchy rash and feels unwell. What is the nurse's priority action? A. Notify the provider and pharmacist B. Assess for breathing difficulties C. Document the reaction D. Request hydrocortisone cream Answer: B Explanation: Airway assessment is critical to identify anaphylaxis, which can progress rapidly to respiratory compromise. Why Other Options Are Wrong: A, C, and D are secondary to ensuring airway safety. 5. The nurse identifies which medication order to be administered PRN (as needed)? A. Zolpidem (Ambien) 10 mg PO at night if unable to sleep B. Prednisone 10 mg PO daily with a taper C. Humulin R 10 units subcutaneously before meals D. Cefazolin (Ancef) 1 g IVPB pre-op Answer: A Explanation: PRN orders specify administration only when specific criteria (like insomnia) are met. Why Other Options Are Wrong: B, C, and D are scheduled medications without PRN parameters. 6. After antibiotic administration, the patient develops hives, difficulty breathing, and hypotension. What is the nurse's assessment? A. Mild allergic reaction requiring antihistamines B. Anaphylaxis requiring epinephrine C. Septic shock requiring blood cultures D. Toxic shock requiring antibiotic change Answer: B Explanation: The triad of respiratory distress, hypotension, and cutaneous signs indicates life threatening anaphylaxis. Why Other Options Are Wrong: A underestimates severity. C and D don't match the acute allergic presentation. 7. The nurse makes a medication error. What is the first action? A. Complete an incident report B. Inform the patient of the error C. Assess for adverse reactions D. Document the event Answer: C Explanation: Patient safety is prioritized by immediately evaluating for harm before documentation or reporting. Why Other Options Are Wrong: A, B, and D follow after ensuring patient stability. 8. The nurse prepares to administer MS Contin (morphine sulfate extended-release). Which instruction is correct? A. "Swallow the pill whole." B. "Crush it and mix with applesauce." C. "Place it under your tongue." D. "Let it dissolve in your mouth." Answer: A Explanation: Extended-release formulations must remain intact to prevent rapid dose dumping. Why Other Options Are Wrong: B, C, and D alter the drug's release mechanism, risking overdose. 9. On a busy shift, which patient requires the nurse's immediate attention? A. Requesting acetaminophen for a headache B. Questioning daily medications C. Needing antibiotic discharge teaching D. Post-nitroglycerin for chest pain Answer: D Explanation: Chest pain evaluation takes priority under the ABC (airway, breathing, circulation) framework. Why Other Options Are Wrong: A, B, and C are non-urgent needs. 10. The nurse reviews a patient's medication list. Which factor poses the highest risk for drug interactions? A. Long-term use of the same medications B. Taking a large number of medications C. High-dose prescriptions D. Multiple administration routes Answer: B Explanation: Polypharmacy exponentially increases interaction risks due to complex pharmacokinetic effects. Why Other Options Are Wrong: A, C, and D are less predictive of interactions than total medication count. 11. To help a patient avoid dangerous drug interactions, what should the nurse recommend? A. Use only OTC medications B. Fill all prescriptions at one pharmacy C. Avoid generic medications D. Take only "necessary" medications Answer: B Explanation: A single pharmacy can comprehensively screen for interactions across all prescriptions. Why Other Options Are Wrong: A and D are unsafe without provider input. C is irrelevant to interaction risks. 12. Which discharge prescription requires correction before giving to the patient? A. Warfarin 5 mg PO daily before dinner B. Methotrexate "8 tablets PO weekly" C. Levothyroxine 137 mcg PO daily D. Zolpidem 5 mg PO PRN for sleep Answer: B Explanation: Prescriptions must specify the drug's dose (e.g., "20 mg" for 8 x 2.5 mg tablets), not just tablet count. Why Other Options Are Wrong: A, C, and D contain complete dosing instructions. 13. The nurse identifies which symptoms as indicating an allergic reaction rather than a side effect? A. Hair loss and sweating B. Nausea and constipation C. Heartburn and bad taste D. Itchy rash and dyspnea Answer: D Explanation: Pruritus with respiratory symptoms suggests IgE-mediated hypersensitivity. Why Other Options Are Wrong: A, B, and C describe expected pharmacologic effects. 14. To assess for drug toxicity, which question should the nurse ask? A. "When was your last dose?" B. "Have you taken extra doses?" C. "Are you on other medications?" D. "Have you taken this before?" Answer: B Explanation: Toxicity results from excessive dosing, whether accidental or intentional. Why Other Options Are Wrong: A, C, and D don't directly evaluate overdose risks. 15. The nurse must draw a vancomycin trough level for a 10:00 a.m. dose. When should the blood be drawn? A. 7:30 a.m. B. 9:30 a.m. C. 11:30 a.m. D. 1:30 p.m. Answer: B Explanation: Trough levels reflect the lowest drug concentration, measured immediately before the next dose. Why Other Options Are Wrong: A is too early. C and D would measure post-dose levels. 16. The nurse flushes an IV before/after phenytoin to avoid crystallization with D5W. What interaction is this preventing? A. Antagonism B. Potentiation C. Synergism D. Incompatibility Answer: D Explanation: Physical incompatibility causes precipitate formation when drugs/solutions are mixed. Why Other Options Are Wrong: A, B, and C describe pharmacologic (not physical) interactions. 17. The nurse notes a TID medication order. Which administration schedule is correct? A. 9 a.m., 1 p.m., 5 p.m., 10 p.m. B. 9 a.m. and 9 p.m. C. 9 a.m., 1 p.m., 5 p.m. D. At bedtime Answer: C Explanation: TID (three times daily) typically follows morning, midday, and evening intervals. Why Other Options Are Wrong: A is QID. B is BID. D is HS. 18. An NPO patient is prescribed carvedilol (Coreg) 25 mg PO. What should the nurse do? A. Crush and mix with applesauce B. Give with a sip of water C. Contact the provider D. Administer IV equivalent Answer: C Explanation: NPO status requires provider clarification for any oral medications to ensure safety. Why Other Options Are Wrong: A and B violate NPO. D is unsafe without explicit orders. 19. The nurse must administer 1 mL of prochlorperazine (Compazine) 10 mg IM. Which syringe is appropriate? A. 1 mL TB syringe, 27G ½" needle B. 3 mL syringe, 23G 1½" needle C. 1 mL syringe, 27G ⅝" needle D. 3 mL syringe, 18G 1" needle Answer: B Explanation: Adult IM injections require 1–3" needles (21–25G) to ensure intramuscular deposition. Why Other Options Are Wrong: A and C needles are too short. D's 18G is unnecessarily large. 20. The nurse must administer 15 mg of morphine oral solution (20 mg/mL). How much should be drawn up? A. 0.5 mL B. 0.75 mL C. 1.3 mL D. 1.5 mL Answer: B Explanation: 15 mg ÷ 20 mg/mL = 0.75 mL for the prescribed dose. Why Other Options Are Wrong: A is 10 mg. C and D exceed the ordered dose. 21. A patient struggles to manage multiple medications. Which nursing diagnosis is most applicable? A. Activity intolerance B. Impaired health maintenance C. Risk for aspiration D. Powerlessness Answer: B Explanation: Difficulty adhering to complex regimens directly relates to impaired health maintenance. Why Other Options Are Wrong: A, C, and D don't address medication management challenges. 22. A patient takes 6 methotrexate 2.5 mg tablets weekly. What is the total dose? A. 10 mg B. 15 mg C. 20 mg D. 25 mg Answer: B Explanation: 2.5 mg × 6 tablets = 15 mg per weekly dose. Why Other Options Are Wrong: A, C, and D are incorrect calculations. 23. The nurse must administer 45 mg of phenobarbital (15 mg tablets). How many tablets are needed? A. 1 tablet B. 2 tablets C. 3 tablets D. 4 tablets Answer: C Explanation: 45 mg ÷ 15 mg/tablet = 3 tablets. Why Other Options Are Wrong: A, B, and D don't provide the prescribed dose. MULTIPLE RESPONSE QUESTIONS 1. An NPO patient with a PEG tube can receive which medications? (Select all that apply.) A. Zolpidem sublingual tablet B. Ondansetron oral disintegrating tablet C. Cefaclor oral suspension D. Oxymorphone extended-release tablet E. Phenytoin chewable tablet F. Potassium chloride solution Answer: C, E, F Explanation: Suspensions, chewable tablets (crushed), and solutions are PEG-compatible. Sublingual, disintegrating, and extended-release forms cannot be altered for tube administration. Why Other Options Are Wrong: A, B, and D require specific absorption mechanisms that tubes bypass. 2. Which medications are administered via parenteral routes? (Select all that apply.) A. Bisacodyl suppository B. Prochlorperazine IM injection C. Brimonidine eye drops D. Albuterol inhaler E. Fentanyl transdermal patch F. Insulin subcutaneous injection Answer: B, F Explanation: Parenteral administration includes IM and subcutaneous injections. Suppositories, topical, ophthalmic, inhaled, and transdermal routes are non-parenteral. Why Other Options Are Wrong: A is rectal. C is ophthalmic. D is pulmonary. E is transdermal.

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Instelling
Fundamentals Of Nursing
Vak
Fundamentals of Nursing

Voorbeeld van de inhoud

Fundamentals of Nursing, 2nd Edition – Active Learning for
Collaborative Practice by Yoost & Crawford
Chapter 35: Medication Administration
Multiple Choice Questions
1. The nurse identifies which medication that has the highest potential for abuse according
to the Controlled Substances Act?
A. Methylphenidate (Ritalin)---schedule II
B. Alprazolam (Xanax)---schedule IV
C. Acetaminophen & codeine (Tylenol #3)---schedule III
D. Diphenoxylate & atropine (Lomotil)---schedule V
Answer: A

Explanation: Schedule II drugs like methylphenidate have the highest abuse potential with strict
prescription regulations, while schedules III-V have progressively lower risks.

Why Other Options Are Wrong: B, C, and D are lower-schedule medications with reduced abuse
potential compared to schedule II.



2. The nurse is preparing a patient to self-administer medication injections at home. How
can the nurse best confirm the patient's understanding of proper technique?
A. Provide written instructions
B. Observe the patient self-administer an injection
C. Call the patient the next day to check for difficulties
D. Ask the patient to verbally explain the process

Answer: B
Explanation: Direct observation allows the nurse to correct technique errors immediately and
provide reassurance.
Why Other Options Are Wrong: A and D don't demonstrate practical competency. C delays
feedback.


3. The nurse must provide rapid pain relief to a patient in agonizing pain. Which
medication route will achieve the fastest effect?
A. Morphine (MSContin) 10 mg PO
B. Hydromorphone (Dilaudid) 1 mg IV push

, C. Meperidine (Demerol) 75 mg IM
D. Fentanyl (Duragesic) 50 mcg transdermal patch

Answer: B

Explanation: IV administration provides immediate systemic absorption and pain relief.

Why Other Options Are Wrong: A has delayed GI absorption. C requires muscle absorption. D
has slow transdermal absorption.



4. After medication administration, the patient develops an itchy rash and feels unwell.
What is the nurse's priority action?
A. Notify the provider and pharmacist
B. Assess for breathing difficulties
C. Document the reaction
D. Request hydrocortisone cream

Answer: B
Explanation: Airway assessment is critical to identify anaphylaxis, which can progress rapidly to
respiratory compromise.
Why Other Options Are Wrong: A, C, and D are secondary to ensuring airway safety.



5. The nurse identifies which medication order to be administered PRN (as needed)?
A. Zolpidem (Ambien) 10 mg PO at night if unable to sleep
B. Prednisone 10 mg PO daily with a taper
C. Humulin R 10 units subcutaneously before meals
D. Cefazolin (Ancef) 1 g IVPB pre-op

Answer: A

Explanation: PRN orders specify administration only when specific criteria (like insomnia) are
met.

Why Other Options Are Wrong: B, C, and D are scheduled medications without PRN
parameters.



6. After antibiotic administration, the patient develops hives, difficulty breathing, and
hypotension. What is the nurse's assessment?
A. Mild allergic reaction requiring antihistamines
B. Anaphylaxis requiring epinephrine

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Fundamentals of Nursing

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