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Rasmussen College - NUR 2407 Pharm Quiz 1. Graded A

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QUESTION 1
1.
A client reports that he has been swallowing his nitroglycerin instead of leaving it under his
tongue. Teaching is needed. What can happen if sublingual medications are swallowed?
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first pass may inactivate the medication
The medication effects will simply be delayed
An esophageal burn will occur
The medication effects will be increased due to first pass effect
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QUESTION 2
1.
Which of these statements regarding controlled substances made by the nurse intern reveals
the need for further teaching? Circle all that apply
When controlled medications drop on the floor they should be wasted with a witness present
Controlled substances of deceased people should be flushed in presence of a witness
Controlled substances should be counted by the oncoming and exiting nurse every shift
Patients should be asked to rate their pain 1:10 both prior to and after giving analgesics.
It is a DHS rule that med carts must be locked whenever the nurse is not watching them.
The cart keys should be hidden in the MAR when the nurse goes to lunch
QUESTION 3 Answers available at https://bit.ly/3bstn7S
1.
Which comment about over the counter (OTC) medications indicates the need for further
teaching?
They tend to have a high therapeutic index
They are generally safe to take in pregnancy
While safe for the general public they may be unsafe for people with renal or hepatic harms
People who take other medications should consult their provider about before taking OTCs
QUESTION 4
1.
When entering the clients room for assessment purposes, which of these steps would be
questionable?
Knocking on the door
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Handwashing
Asking the client to share their name and date of birth
The nurse shares his/her own date of birth
QUESTION 5
1.
A nurse is wondering if advocacy for oral medication is appropriate. What rationale for advocacy
would be appropriate?
Oral medications are more completely absorbed than IV medications.
IV medications should only be given to clients who can’t swallow
A serious infection or injury may start at the site of instillation.
IV medication are more vulnerable to first pass effect than oral medications
QUESTION 6
1.
Which of these is not an essential aspect of a medication order?
Both trade and generic name must be cited together.
The clients name must appear on the order sheet.
The dose of the medication must be cited
The route of the medication must be cited
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QUESTION 7
1.
If phenobarbital has a four day half-life, and a client accidentally took 200 mg of the drug on
Tuesday morning, and no intervention occurred, how much medication will remain in the bloodstream
of that client on Thursday morning?
150 mg
100 mg
75 mg
50 mg
QUESTION 8
1.
Which of these statements made by the trained medication assistant reveals the need for
further teaching? Circle all that apply
It is OK to crush medications in advance when batch prepping them at the station
When a patient has difficulty swallowing, even long acting medicines should be crushed
Suspensions should never be shaken before they are measured
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Suspensions can be measured via syringe but should be given to elderly people in a med cup
Pills should never be touched during the preparation phase
Unused (remnant) half tabs of medication should be returned to the bottle for later use.
Discarded medications should go into the sharps container
QUESTION 9
1.
A laboring mother wants to know why pain medication is not advisable. What rationales could
the nurse offer for this?
The blood brain barrier of an infant isn’t fully developed, so infants are at risk for sedation
The liver of an infant is not well developed, so the effects of sedation can linger in the infant
Epidural analgesia offers an alternative that will not harm the infant.
The baby will not be able to eliminate the medication until it has its first stool
The baby can be given naloxone, so analgesia really isn’t a problem. It just isn’t “natural”.
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QUESTION 10
1.
Which of these is not an essential part of a medication order?
The prescriber’s signature / nurse’s co-signature if telephoned.
The date and time that the prescription was ordered must be cited.
The frequency and timing of the medication must be cited
The related diagnosis must be cited
QUESTION 11
1.
If a medication is ordered by trade name but the pharmacy sends up a medication that has a
different, unfamiliar name, the nurse should
Have a peer confirm that this is the right medication
Look up the generic name of the needed drug to confirm they are the same thing
Use the patient’s supply of medication from home
Hold the medication until the trade name version of the medication is brought up
QUESTION 12
1.
Which of these statements made by the student nurse reveals the need for further teaching?
Circle all that apply
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Reasons for refusals do not need be documented on the MAR. Refusal is a basic right
Pills can be hidden in food without MD and guardian consent whenever necessary
Meds may be documented before giving them because they can be circled if refused.
Two patient identifiers should also be used in a long term care setting
Unopened insulin, eye drops, vaccines & suppositories should be stored at 35O—46O F.
Food may be kept in refrigerators holding medications if it is dated.
QUESTION 13
1.
When a nurse checks the MAR, pulls out needed medications, inserts them in a common cup,
signs the medications off, then gives them to the patient after checking name and allergy bands, he or
she is
Adhering to accepted guidelines for medication administration
Being hyper-vigilant (overly cautious)
Falsifying the record by signing that the med was given before the patient took it
Completing the three needed checks
QUESTION 14
1.
A client who takes Theo-24 (theophylline) for asthma, is experiencing theophylline toxicity.
Which of these may be a contributing factor? (Select all that apply)
First pass effect.
Forgetfulness (double dosing)
Chewing the capsule
Cirrhosis with Gallstones
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Taking the medication with food
QUESTION 15
1.
Which of these assessments is not considered essential prior to giving medications to an acutely
ill client
Vital signs and O2 saturations
Pain rating
Level of consciousness
*e. Mood
QUESTION 16
1.
A nurse is prioritizing what step to take first when beginning to care for a client before entering
the room
What step should occur first?
Prepare the morning medications
Introduce self and confirm the patient’s identity
Assess the patient and document the findings
Check the patients chart & last set of vital signs
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QUESTION 17
1.
Which of these practices is most apt to contribute to time related medication errors?
Avoiding the use of abbreviations
Documenting in military time
Giving HS (hour of sleep) medications whenever the patient is ready to retire
Allowing the nurse to give medications within a ½ hour leeway either before or after a
medication is scheduled
QUESTION 18
1.
Which of these factors might impair the absorption of and oral medication?
The presence of food in the stomach
Renal insufficiency
Hepatic insufficiency
High serum albumin
QUESTION 19
1.
Which statements made by the nurse peer reveal the need for further teaching?
Class C medications are controlled substance medications
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Class D medications can be safely taken during pregnancy
Class X medications refer to illicit substances like Cocaine
Herbal remedies need not go through FDA efficacy trials before being marketed.
Controlled substances cannot be refilled by phone
QUESTION 20
1.
A malnourished elderly client has a low albumin level. What is the implication of this finding?
(Select all that apply)
Less protein binding will occur. Medication will be more free to bind with target receptors. This
may cause excessive effects.
Blood brain barrier crossover will be impaired. Albumin is a lipid. More medicine will be needed.
Low albumin levels will lead to receptor disintegration, so more medication will be needed.
Protein insufficiency can lead to loss of metabolizing enzymes and consequential drug
accumulation
Albumin insufficiency signifies impaired absorption. Doses will need to be increased
Question 1
1.
A client asks what is meant by the term "first pass effect"? How would the nurse explain the
term?
"It refers to the first sign that the medication is starting to work."
" It refers to the bodies push-back response to medicines it isn't familiar with."
"It means that the liver starts to break down oral medicines before they even hit their intended
receptors."
"It means that the body becomes sensitized to the medicine so lower doses will be needed in
the future."
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Question 2
1.
A nurse is ready to administer the first dose of a new oral penicillin prescription to a client. The
client states she tool penicillin 3 years ago and developed a rash. Based on this information, the nurse
should
Withhold the medication and inform the provider of the client's previous reaction.
give the medication as prescribed and observe for a reaction
Administer the medication intravenously to bypass gastric absorption.
Combine the medication with an antihistamine to decrease the possibility of a reaction.
Question 3
1.
An older patient must learn to administer a medication using a device that required manual
dexterity. The patient becomes frustrated and expresses lack of self-confidence in performing this task.
Which action will the nurse perform next?
Ask the patient to keep trying until the skill is learned.
Schedule multiple sessions and practice each step separately.
Provide written instructions with illustrations showing each step of the skill.
Teach the procedure to family members who can administer the medication for the patient.
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Question 4
1.
If a medication is ordered by trade name but the pharmacy sends up a medication that has a
different, unfamiliar name, the nurse should:
Have a peer confirm that this is the right medication
Look up the generic name of the needed drug to confirm they are the same thing
Use the patient’s supply of medication from home
Hold the medication until the trade name version of the medication is brought up
Question 5
1.
In order to ensure that a medication is given to the right patient, the nurse must perform which
action?
Ask the patient to spell their last name.
Match the patient with a photo ID.
Swipe a bar code on the patient's ID bracelet.
Verify the patient using two identifiers.
Question 6
1.
Medication dosages may need to be decreased for which of the following reasons?
Increased renal excretion.
Increased medication-metabolizing enzymes.
Liver failure.
Peripheral vascular disease.
Concurrent use of medication metabolized by the same pathway.
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Question 7
1.
The nurse administers a narcotic analgesic to a patient who has been receiving it for 1 day after
orthopedic surgery. The patient reports no change in pain 30 minutes after the medication is given. The
nurse recognizes that this patient is exhibiting which of the following:
Drug-seeking behavior
Drug tolerance
The placebo effect
Tachyphylaxis
Question 8
1.
The nurse gives 800mg of a drug that has a half-life of 8 hours. How much drug will be left in the
body in 24 hours if no additional drug is given?
None
50 mg
100 mg
200 mg
Question 9
1.
The nurse reviews a patient's database and learns that the patient lives alone, if forgetful, and
does not have an established routine. The patient will be sent home with three new medications to be
taken at different times of day. The nurse develops a daily medication chart and enlists a family
member to put the patient's pills in a pill organizer. This is an example of which phase of the nursing
process?
Assessment
Evaluation
Implementation
Planning
Question 10
1.
When a nurse checks the MAR, pulls out needed medications, inserts them in a common cup,
signs the medications off, then gives them to the patient after checking name and allergy bands, he or
she is
Answers available at https://bit.ly/3bstn7S
Adhering to accepted guidelines for medication administration
Being hyper-vigilant (overly cautious)
Falsifying the record by signing that the med was given before the patient took it
Completing the three needed checks
Question 11
1.
When the nurse practices the "5-plus-5" rights of medication administration, what does it
ensure?
Adequate information is given.
Informed consent for drug administration
Safe administration of medications
Cost -effective use of medications
Question 12
1.
Which lab value will best reflect renal function in a client taking multiple medicines?
Creatinine clearance
Potassium levels
Sodium levels
Urinalysis
Question 13
1.
Which of these assessments is not considered essential prior to giving medications to an acutely
ill client?
Vital signs and O2 saturations
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Pain rating
Level of consciousness
Mood
Question 14
1.
Which of these factors might impair the absorption of and oral medication?
The presence of food in the stomach
Renal insufficiency
Hepatic insufficiency
High serum albumin
Question 15
1.
Which of these is not an essential aspect of a medication order?
Both trade and generic name must be cited together.
The clients name must appear on the order sheet.
The dose of the medication must be cited
The route of the medication must be cited
Question 16
1.
Which of these is not an essential part of a medication order?
The prescriber’s signature / nurse’s co-signature if telephoned.
The date and time that the prescription was ordered must be cited.
The frequency and timing of the medication must be cited
The related diagnosis must be cited
Answers available at https://bit.ly/3bstn7S
Question 17
1.
Which of these practices is most apt to contribute to time related medication errors?
Avoiding the use of abbreviations
Documenting in military time
Giving HS (hour of sleep) medications whenever the patient is ready to retire
Allowing the nurse to give medications within a ½ hour leeway either before or after a
medication is scheduled
Question 18
1.
Which of these statements made by the student nurse reveals the need for further teaching?
Select all that apply
Reasons for refusals do not need be documented on the MAR. Refusal is a basic right
Pills can be hidden in food without MD and guardian consent whenever necessary
Meds may be documented before giving them because they can be circled if refused.
Two patient identifiers should also be used in a long term care setting
Question 19
1.
Which of these statements made by the trained medication assistant reveals the need for
further teaching? Select all that apply
It is OK to crush all medications in advance when batch prepping them at the station
When a patient has difficulty swallowing, even long acting medicines should be crushed
Pills should never be touched during the preparation phase
A double check system is used for safety during med pass.
Question 20
1.
Which teaching point is correct with respect to the concept of "tolerance"?
Tolerance is a state where people become used to pain, and therefore need less pain medicine.
In tolerance higher doses of medication are needed to achieve prior effects because a body
learns to push back.
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Tolerance occurs in slow metabolizers. Slow metabolism leads to prolonged sedation.
When sedative help people cope better with their suffering, we call it "drug tolerance."
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