A nurse administers a does of an oral medication for hypertension to a patient who immediately vomits after swallowing the pill. What would be the appropriate initial action of the nurse in this situation?
Readminister the medication and notify the primary care provider
Readminister the pill in a liquid form if possible
Assess the vomit, looking for the pill
Notify the primary care provider
A nurse is administering an oral medication to a patient via a gastric tube. The nurse observes the medication enter the tube, and the tube becomes clogged. What would be the appropriate initial action of the nurse in this situation?
Attempt to dislodge the medication with a 10 mL syringe
Remove the tube and replace it with another tube
Flush the tube with 60 mL of water
A nurse who is administering medications to patients in an acute care setting studies the pharmacokinetics of the drugs being administered. Which statements accurately describe these mechanisms of action?
Distribution occurs after a drug has been absorbed into the bloodstream and is made available to body fluids and tissues
Metabolism is the process by which a drug is transferred from its site of entry into the body to the bloodstream
Absorption is the change of a drug from its original form to a new form, usually occurring in the liver
During first-pass effect, drugs move from the intestinal lumen to the liver by way of the portal vein instead of going into the system's circulation
The gastrointestinal tract, as well as sweat, salivary, and mammary glands, are routes of drug absorption
Excretion is the process of removing a drug, or its metabolites (products of metabolism) from the body
A nurse is reconstituting powdered medication in a vial. Which action is a recommended step in this process?
The nurse draws up the proper amount of powdered medication into the syringe
The nurse inserts the needle through the rubber stopper of the diluent vial
The nurse gently agitates the powdered medication vial to mix the powder and diluent completely
The nurse draws up the prescribed amount of medication while holding the syringe horizontally at eye level
A medication order reads "K-Dur, 20 mEq po bid" When and how does the nurse correctly give this drug?
Daily at bedtime by subcutaneous route
Every other day by mouth
Twice a day by the oral route
Once a week by transdermal patch
A nurse is preparing medications for patients in the ICU. The nurse is aware that there are patient variables that may affect the absorption of these medications. Which statements accurately describe these variables?
Patients in certain ethnic groups obtain therapeutic responses at lower doses or higher doses than those actually prescribed
Some people experience the same response with a placebo as with the active drug used in studies
People with liver disease metabolize drugs more quickly than people with normal liver functioning
A patient who receives a pain medication in a noisy environment may not receive full benefit from the medication's effects
Oral medications should not be given with food as the food may delay the absorption of the medications
Circadaian rhythms and cycles may influence drug action
A physician orders a pain medication for a postoperative patient that is a PRN order. When would the nurse administer this medication?
A single dose during the postoperative period
Doses administered as needed for pain relief
One dose administered immediately
Doses routinely administered as a standing order
A nurse is administering a pain medication to a patient. In addition to checking his identification bracelet, the nurse correctly verifies his identity by
Asking the patient his name
Reading the patient's name on the sign over the bed
Asking the patient's roommate to verify his name
Asking, "Are you Mr. Brown?"
The nurse is administering a medication to a patient via a nasogastric tube. Which are accurate guidelines related to this procedure?
Crush the enteric-coated pill for mixing in a liquid
flush open the tube with 60 mL of very warm water
Check for proper placement of the nasogastric tube
Give each medication separately and flush with water between each drung
Lower the head of the bed to prevent reflux
Adjust the amount of water used if patient's fluid intake is restricted
A medication order reads "Hydromorphone, 2 mg IV every 3 to 4 hours PRN pain" The prefilled cartridge is available with a label reading "Hydromorphone 2mg/ 1 mL" The cartridge contains 1.2 mL of hydromorphone. Which nursing action is correct?
Give all the medication in the cartridge because it expanded when it was mixed
Call the pharmacy and request the proper dose
Refuse to give the medication
Dispose of 0.2 mL correctly before administering the drug
A patient requires 40 units of NPH insulin and 10 units of regular insulin daily subcutaneously. What is the correct sequence when mixing insulins?
Inject air into the regular insulin vial and withdraw 10 units; then using the same syringe, inject air into the NPH vial, and withdraw 40 units of NPH insulin
Inject air into the NPH insulin vial, being careful no to allow the solution to touch the needle; next inject air into the regular insulin vial and withdraw 10 units; then w/draw 40 units of NPH insulin
Inject air into the regular insulin vial, being careful no to allow the solution to touch the needle; next, inject air into the NPH insulin vial and w/draw 40 untis, then w/draw 10 units of regular insuling
Inject air into the NPH insulin vial and w/draw 40 units; then using the same syringe, inject air into the regular insulin vial and w/draw 10 units of regular insulin
Ms. Hall has an order for hydromorphone (Dilaudid), 2 mg intravenously, q 4 hours PRN pain. the nurse notes that according to Ms. Hall's chart, she is allergic to Dilaudid. The order for medication was signed by Dr. Long. What would be the correct procedure for the nurse to follow in this situation?
Administer the medication; the doctor is responsible for medication administration
Call Dr. Long and ask that she change the medication
Ask the supervisor to administer the medication
Ask the pharmacist to provide a medication to take the place of Dilaudid
A nurse is administering heparin subcutaneously to a patient. What is the correct technique for this procedure?
Aspirate before giving and gently massage after the injection
Do not aspirate; massage the site for 1 minute
Do not aspirate before or massage after the injection
Massage the site of the injection; aspiration is not necessary bu will do no harm
A nurse discovers that she made a medication error. What should be the nurse's first response?
Record the error on the medication sheet
Notify the physician regarding course of action
Check the patient's condition to note any possible effect of the error
Complete an incident report, explaining how the mistake was made
A nurse is teaching an adolescent patient how to use a meter-dosed inhaler to control his asthma. What are appropriate guidelines for this procedure?
Remove the mouthpiece cover and shake the inhaler well
Take shallow breaths when breathing through the spacer
Depress the canister releasing one puff into the spacer and inhale slowly and deeply
After inhaling, exhale quickly through pursed lips
Wait 1 - 5 minutes as prescribed before administering the next puff
Gargle and rinse with salt and water after using the MDL
The correct order for using a meter-dosed inhaler is:
1 - ❌ 2 - ❌ 3 - ❌ 4 - ❌ 5 - ❌ 6 - ❌ 7 - ❌ 8 - ❌ 9 - ❌ 10 - ❌
Nurses are legally responsible for understanding the pharmacotherapeutics of all drugs they administer.
Most drugs are inactivated by the and transformed to inactive substances for .
The excrete most drugs. The are the primary route for the excretion of gaseous substances (anesthetics). Many drugs are excreted through bile in the gastrointestinal tract. The , and glands are also routes of drug excretion.
A student nurse is permitted to accept a verbal order from a physician.
Nurses are not legally responsible for the drugs they administer.
Best practice is to question the patient about ever having received the medication and ask whether the patient is aware of any reaction to the medication.
It is common practice to check controlled substances daily at specified intervals.
If for any reason a controlled substance prepared for administration has to be discarded, a should act as a witness.
If the patient receives several drugs, offer them so that if one is refused or dropped, positive identification can be made and the drug can be recorded or replaced.
Drugs given orally are intended for absorption in the and .
- tablets are released in the and used when the active ingredient of the drug is irritating to the mucosa.
For patients who find it difficult to take liquids from a cup, use an and place the medicine between the and and give the liquid to the patient slowly.
Shake and well and administer them promptly to ensure accurate dosage.
For drugs that discolor the teeth, mix it well with , have the patient use a and encourage them to drink after administration.
Use a to give infants or very young children liquid medications while holding them in a or semi-sitting position; placing the medication between the gum and cheeks to prevent .
Sublingual and buccal meds can be swallowed.
Drugs that deteriorate in solution are usually dispensed as and are reconstituted before injection. Drugs that remain stable in solution are usually dispensed in ampules, bottles, pre-filled cartridges or vials in an or solution or suspension.
If not all medicine from an ampule is used, you can save it for later use.
Use a to remove the medication from an ampule.
Multidose vials are usually good for only .
Prefilled syringes come with excess air. In some cases, this air should not be be( not be, be ) expelled.
Some drugs have limited compatibility (when mixing meds in one syringe) and should be administered w/in of preparation. Incompatible drugs may become or form a precipitate in the syringe.
When preparing meds from an ampule and a vial, prepare the med in the vial ampule( vial, ampule ) first, and then the med in the ampule vial( ampule, vial ).
and cannot be mixed w/other insulin.
Before administering any insulin be aware of the , , and of effects and ensure that proper food is available.
Injections should be given an away from the previous injection site.
route is the most dangerous route because the drug is placed directly into the bloodstream.
Check the patient receiving meds by a continuous IV infusion for possible adverse side effects at least every .
Intravenous Bolus or Push is administered very slowly over at least minute.
Transdermal patches that contain should not be applied to breast tissue due to the associated risks of breast cancer.
Patient should not blow nose before instilling drops.
Ask the patient to before inserting a vaginal medication.
Rectal suppositories can be administered to patients at risk for cardiac arrhythmias.
For better medication delivery, use a whenever administering meds via an MDI.
DPIs are activated.
Teaching about meds is an ongoing process and should begin as soon as the patient is admitted to the health care facility.
