The nurse is caring for a client whose prescribed course of cefaclor will soon be completed.What health education should the nurse provide to the client? Show Get answer to your question and much more Which statement is true in regards to the oral administration of tetracyclines? Get answer to your question and much more Which of the following should be included in the nurse's pre-administration assessment prior toa client receiving a penicillin? Select all that apply. Get answer to your question and much more A 75-year-old patient with a history of renal impairment is admitted to the primary health carecenter with a UTI and has been prescribed a cephalosporin. Which of the following interventionsis most important for the nurse to perform when caring for this patient? Get answer to your question and much more A client being treated for tuberculosis (TB) is determined to be drug resistant. Whichmedications will no longer be effective in the treatment of the tuberculosis? Get answer to your question and much more What is the rationale for not administering tetracycline to children under the age of 8 years? Get answer to your question and much more A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered athome. The nurse will instruct the parents to administer the drug Get answer to your question and much more Erythromycin is sometimes used as a penicillin substitute. For prevention of what conditionmight a nurse note a substitute of erythromycin for penicillin? Get answer to your question and much more The health care provider is preparing to order rifampin and pyrazinamide for a female client withactive tuberculosis. What question should the provider ask this client before confirming thisorder? When giving medications, the nurse will follow the rights of medication administration. The rights include the right documentation, the right reason, the right response, and the patient’s right to refuse. Which of these are additional rights? ( Select all that apply .) 1. Right time 2. Right route 3. Right drug 4. Right patient 5. Right dose 6. Right diagnosis The client is to receive acetaminophen Tylenol 1000 milligrams every 8 hours by mouth for pain. Is there any “right” that is missing from this medication order? 1. There is no missing information in this order The client is to receive acetaminophen Tylenol 1000mg every 8 hours by mouth for pain. Today, the nurse was busy and gave the medication two hours after the scheduled dose was due. What type of problem does this represent? The medication order reads, “Give ondansetron (Zofran) 4 mg, 30 minutes before beginning chemotherapy to prevent nausea.” The nurse notes that the route is missing from the order. What is the nurse’s best action? 1. Give the medication orally because the tablets are available in 4-mg doses. When given an intravenous medication, the patient says to the nurse, “I usually take pills. Why does this medication have to be given in the arm?” What is the nurse’s best answer? 1. “The intravenous medication will have delayed absorption into the body’s tissues.” The nurse is administering a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet? Which form of a pain medication would work the fastest to reduce a headache? 1. A capsule The nurse will be injecting a drug into the superficial skin layers immediately underneath the epidermal layer of skin. Which route does this describe? 1. Transdermal
The nurse answers a patient’s call light and finds the patient sitting up in bed and requesting pain medication. What will the nurse do first? The patient’s medication administration record lists two antiepileptic medications that are due at 0900, but the patient is NPO for a barium study. The nurse’s coworker suggests giving the medications via IV because the patient is NPO. What will the nurse do? ANS: D
The day shift charge nurse is making rounds. A patient tells the nurse that the night shift nurse never gave him his medication, which was due at 2100. What will the nurse do first to determine whether the medication was given? B A nurse makes an error when administering medications to a patient. Which action by the nurse requires the supervising nurse to intervene? A patient is prescribed ibuprofen 200 mg PO every 4 hours as needed for pain. The pharmacy sends up enteric-coated tablets, but the patient refuses the tablets, stating that she cannot swallow
pills. What will the nurse do?
The nurse is preparing to administer a transdermal patch to a patient and finds that the patient already has a medication patch
on his right upper chest. What will the nurse do? The nurse is giving a medication that has a high first-pass
effect. The health care provider has changed the route from PO to IV. What can the nurse expect with the IV dose? B
A patient is complaining of severe pain and has orders for morphine sulfate. The nurse knows that the route that would give the slowest pain relief would be which route? When teaching a pregnant woman about the use of drugs during pregnancy, which statement will the nurse include? A. Exposure of the fetus to drugs is most detrimental during the second trimester of pregnancy. When administering medications to pediatric patients, the nurse understands that the dosage calculations for pediatric patients are different than for adults because pediatric patients The nurse caring for a pediatric patient calculates the safe range for the prescribed medication. Based on the nurses calculations, the dose ordered exceeds the high limit. What is the nurse’s next action? What does the nurse identify as a pharmacokinetic change that occurs in older adults? Which racial group is predicted to be nearly one in three U.S. residents in 2050? Which of the following statements regarding African Americans’ responses to antihypertensive medication therapy is true? A research group is conducting an investigational drug study on a promising new drug for osteoporosis. It has been difficult to find research participants who meet the criteria. Just before the conclusion of the study, four participants approach the researchers and
express their desire to withdraw from the study. What is the researcher’s priority intervention?
A nurse does not notice that a patient’s IV site is swollen, red, painful, and warm to touch nor that the IV has quit infusing properly. What ethical principle does this involve? A. Breach of duty A nurse has been asked to participate in an elective procedure that violates the nurse’s personal ethical principles. What is the nurse’s best action? In a 2006 IOM study, it was estimated that some form of medication error resulted in harm to how many patients? What is the most common point in the process at which medications errors
occur? The nurse is administering a drug that has been ordered as follows: “Give 10 mg on odd-numbered days and 5 mg on even-numbered days.” When the date changes from May 31 to June 1, what should the nurse do? The nursing student realizes that she has given a patient a double dose of an antihypertensive medication. The tablet was supposed to be cut in half, but the student forgot and administered the entire tablet. The
patient’s blood pressure just before the dose was 146/98 mm Hg. What should the student nurse do first? The nurse is caring for an 85-year-old patient in the hospital and teaching him how to use an inhaler. His 84-year-old wife attends the teaching sessions, and their
daughter comes in to visit in the evenings. The patient is having trouble remembering the steps. What is the nurse’s best approach? A patient with newly diagnosed type 1 diabetes mellitus has completed a diabetes education program. One month later, the patient confesses at a follow-up appointment that he “just didn’t feel like” giving himself the insulin injections. Which nursing diagnosis will the nurse assign the patient? A nurse is
providing patient teaching for a community health center that serves a primarily Portuguese population. How would this nurse best serve this patient population?
After providing education regarding medications to a patient who has been newly
diagnosed with type 2 diabetes mellitus, the nurse would use which part of the nursing process to determine whether the patient understands these new instructions? OTC medications now account for about what percent of all medications used in the United States?
A 56-year-old man is taking OTC antacids for relief of indigestion. He tells the nurse that he consumes at least one bottle a week and has done so for more than 1 month because “it works for me.” What is the nurse’s primary concern? The nurse associates use of which OTC medication with the development of hepatotoxicity? A patient is receiving Augmentin (amoxicillin and clavulanic acid) liquid solution through a percutaneous endoscopic gastrostomy tube. What is the purpose of the clavulanic acid? A.It works synergistically with the antibiotic to improve potency. B. It inhibits the action of the enzymes produced by beta-lactamase–producing bacteria. C. It protects the antibiotic from the harmful gastric acid secretions in the stomach. D. It enhances the absorption of the antibiotic in the small intestine. B The clavulanic acid works to inhibit the action of the enzymes produced by the bacteria, which would normally inactivate the antibiotic. Which of the following does the nurse identify as being a concern for patients receiving tetracycline? A. Tetracycline should not be administered to anyone older than age 65 years. B. Tetracycline has no impact on the effectiveness of oral contraceptives. C. Tetracycline used with warfarin decreases its effectiveness and enhances clot formation. D. Tetracyclines should not be administered with dairy products. When completing an admission assessment, the patient states that she is allergic to sulfa drugs. What will the nurse do next? A. Mark the allergy on her medical record. B. Place an “allergy” armband on the patient. C. Ask the patient for more information about the allergic reaction she had. D. Notify the physician about the patient’s allergy. C Some patients say they are “allergic” to drugs when in fact what they experienced was a common and mild adverse effect. The nurse should clarify the patient’s statements with open-ended questions. A patient has a prescription for a sulfa drug as treatment for a UTI. She is also taking an oral contraceptive, an oral sulfonylurea antidiabetic drug, and phenytoin for a history of seizures. Which drug may pose a potential serious interaction with the sulfa drug? A. The oral contraceptive B. The oral antidiabetic drug C. The phenytoin D. All of these D The combination of the sulfa drug with the oral contraceptive may reduce the effectiveness of the contraceptive. The combination with the oral antidiabetic drug may potentiate the hypoglycemic effect of the sulfonylurea drug, and the combination with the phenytoin may potentiate the toxic effects of the phenytoin. The nurse identifies Zosyn as being a member of which group? A. Cephalosporins B. Macrolides C. Penicillins D. Sulfonamides C Zosyn is a penicillin. The nurse should be aware of the fact that many times, these drugs are referred to by their trade names and do not always end in “cillin,” such as with Zosyn and Augmentin. During intravenous (IV) quinolone therapy in an 88-year-old patient, which potential problem is of most concern when assessing for adverse effects? A. Hepatotoxicity B. Rhabdomyolysis C. Tendon rupture D. Nephrotoxicity C A black box warning is required by the U.S. Food and Drug Administration for all quinolones because of the increased risk of tendonitis and tendon rupture with use of these drugs. This effect is more common in older patients, patients with renal failure, and patients receiving concurrent glucocorticoid therapy (e.g., prednisone). A patient is prescribed linezolid (Zyvox) to treat hospital-acquired pneumonia. It is most important for the nurse to determine if the patient is also taking which medication? A. A diuretic B. An SSRI C. A cardiac glycoside D. A thyroid replacement drug B Linezolid has the potential to strengthen the vasopressor (prohypertensive) effects of various vasopressive drugs such as dopamine by an unclear mechanism. Also, there have been postmarketing case reports of this drug causing serotonin syndromewhen used concurrently with serotonergic drugs such as the SSRI antidepressants. It is recommended that SSRIs be stopped while patients are receiving linezolid therapy, if possible. A 58-year-old man is receiving vancomycin as part of the treatment for a severe bone infection. After the infusion, he begins to experience some itching and flushing of the neck, face, and upper body. He reports no chills or difficulty breathing. What should the nurse suspect? A. An allergic reaction has occurred. B. An anaphylactic reaction is about to occur. C. The medication will not be effective for the bone infection. D. The IV dose may have infused too quickly. D These symptoms are know as red man syndrome and may occur during or after an infusion of vancomycin. This syndrome is characterized by flushing or itching of the head, face, neck, and upper trunk area. Symptoms can usually be alleviated by slowing the rate of infusion to at least 1 hour. Red man syndrome is bothersome but usually not harmful. Rapid infusions may also cause hypotension. A group of office workers is concerned because a package was opened that contained a white powder substance. There is a concern that the white powder is anthrax. Which drug does the nurse anticipate being prescribed for the office workers? A. Daptomycin (Cubicin) B. Colistimethate (Coly-Mycin) C. Ciprofloxacin (Cipro) D. Quinupristin–dalfopristin (Synercid) C Ciprofloxacin (Cipro) is the drug of choice for the treatment of anthrax (infection with Bacillus anthracis). Which condition does the nurse anticipate when assessing a patient with tumor lysis syndrome?A. Hyperuricemia B. Hypophosphatemia C. Hypokalemia D. Hypercalcemia A. Manifestations of tumor lysis syndrome include hyperphosphatemia, hyperkalemia, and hypocalcemia. These electrolyte abnormalities are often treated with diuretics such as mannitol, intravenous calcium supplementation, oral or rectal potassium exchange resin, and oral aluminum hydroxide. Hyperuricemia can lead to nephropathy, and hemodialysis may be required in severe cases of tumor lysis syndrome. A patient who is receiving high-dose chemotherapy with methotrexate is also receiving leucovorin. What is the purpose of the leucovorin? A. Produces an additive effect with the methotrexate by increasing its potency against the cancer cells B. Reduces the incidence of cardiomyopathy caused by the methotrexate C. Adds its antiinflammatory effects to the treatment regimen D. Reduces the BMS caused by the methotrexate D Leucovorin “rescue” is prescribed to reduce the BMS that is associated with high-dose methotrexate therapy. The nurse identifies which of the following as the most significant neurotoxin of the cytotoxic drug class? A. Paclitaxel (Taxol) B. Docetaxel (Taxotere) C. Vincristine (Vincasar PFS) D. Etoposide (Toposar) C. Vincristine is the most significant neurotoxin of the cytotoxic drug class, but it continues to be used in part because of its relative lack of BMS. Special care must be taken not to inadvertently give vincristine via the intrathecal route. Several deaths have been reported because of this error. A pregnant woman has been diagnosed with cancer and is meeting with her oncologist to plan treatment. Which statement about chemotherapy and pregnancy is true? A. She will have to wait until the baby is born before starting chemotherapy. B. The greatest risk of fetal harm from chemotherapy is during the third trimester. C. Chemotherapy treatment during the second or third trimester poses less risk to the fetus. D. Chemotherapy is unsafe during pregnancy, but radiation therapy is safe in low doses. The nurse is caring for a patient who received chemotherapy 24 hours ago. The patient’s white blood cell count is 4,400 mcL. Which symptom, if experienced by the patient, should the nurse report to the prescriber immediately? A. Fatigue B. Diarrhea C. Fever D. Nausea and vomiting When working with a patient who is neutropenic, the nurse identifies which as the most effective measure to prevent the patient from developing an infection? A. Administer prophylactic antibiotics. B. Stop administration of the chemotherapeutic drug. C. Perform hand hygiene. D. Vaccinate the patient to prevent bacterial infection. Which cytotoxic antineoplastic does the nurse identify as most likely to cause pulmonary fibrosis?A. Plicamycin B. Mitoxantrone C. Mitomycin D. Bleomycin Bevacizumab (Avastin) is an angiogenesis inhibitor. Which statement correctly describes the mechanism of action of an angiogenesis inhibitor? A. It inhibits the formation of blood cells. B. It inhibits the creation of new blood vessels in the tumor mass. C. It interferes with the synthesis of DNA in the cancer tumor. D. It causes cell death by inhibiting enzymes. What is a primary action when the nurse is handling and administering vesicant drugs? A. Double flush the patient’s bodily secretions in the commode. B. Use sterile towels to clean up after chemotherapy spills. C. Mix chemotherapeutic drugs in the patient’s room. D. Teach the patient how to administer parenteral chemotherapeutic drugs. An 82-year-old woman is unable to take the influenza vaccine because of allergies, but she has been exposed to the virus through a family reunion. She does not yet have symptoms of the flu. Which option would be best for her? A. She should receive the flu vaccine as soon as possible. B. She should receive zanamivir (Relenza) in the inhalation form. C. She should begin oral oseltamivir (Tamiflu) therapy when symptoms begin. D. She should begin oral oseltamivir (Tamiflu) therapy as soon as possible. 9 rights of medication administration Right patient Right drug Right route & form Right dose Right time Right documentation Right reason/indication Right response Right to know/refuse The drug is absorbed into the systemic circulation through the oral or gastric mucosa or the small intestine. Oral Sublingual Buccal Rectal
What forms of oral meds cannot be crushed? Gels, enteric coated capsule, capsules, or extended-release caplets. What is the slowest route of drug admin? What is the fastest route of drug admin? For PO routes, what is the fastest? Powder or liquid bc it doesn't need to be broken down. Impact of medication administration for the elderly
Impact of medication administration for pediatrics and neonatal
Impact of medication for third trimester of pregnancy baby is now absorbing medications via placenta and can get the effects of the medication. FDA Categories of Medication (A,B,C,D,X) A. remote risk of fetal harm B. slightly more risk than A, no info on humans C. animal studies show risk of fetal harm, no studies have been done in humans D. Possible risk of fetal harm but have to weigh the risk versus benefit X. Proven risk of fetal harm/ fetal abnormalities Patients reading level for understanding is: Medication Administration Precautions: Three safety checks first check- take med out, check order and med second check- compare med to the MAR third check- when talking to the patient, verify ID, etc. A participant tells the nurse that she is seeing her family physician for treatment of depression and that she has been taking a serotonergic drug. The participant tells the nurse that she wants to start to take St. John’s wort because she has heard that this herb will help her depression get better faster. The nurse bases his response based on the fact that use of St. John’s wort with serotonergic drugs has what effect? Use of St. John’s wort with serotonergic drugs may lead to serotonin syndrome. Patients should inform their health care providers of all OTC medications as well as herbal and dietary supplements they are taking. A participant tells the nurse that she would like to start taking gingko. Before starting this herb, it is most important for the nurse to ask the patient if she is taking which type of medication? Use of gingko may increase risk of bleeding in patients who are taking anticoagulants such as warfarin and heparin as well as antiplatelet drugs such as aspirin and clopidogrel. A nurse has been asked to provide teaching at a community health fair on the topic of use of herbs and dietary products. A participant tells the nurse, “I have high blood pressure and hardening of my arteries. I go to the doctor and take prescription pills, but I have added herbs because they are natural and totally safe.” The nurse understands use of herbal products in patients with cardiovascular disease has what significance? Herbal products can increase bleeding risk with warfarin, potentiate digoxin toxicity, increase the effects of antihypertensive agents, and cause heart block or dysrhythmias. A serious, potentially life-threatening allergic reaction to a. medication Lowest concentration of medication attained within the body after it is reduced from the peak level Change in the pharmacologic or pharmacokinetic activity when two medications are administered in combination and can initiate a potentially undesirable effect Which patient does the nurse identify as being at highest risk for the development of adverse drug reaction? A. A 1 month old patient whose mother has allergies to penicillin. B. A 16 year old patient with multiple traumatic injuries who is taking morphine C. A 54 year old patient with multiple sclerosis who has been enrolled in a new clinical drug trial. D. A 84 year old patient with diabetes, heart failure, and hypertension who takes seven prescription medications each day. A patient is prescribed a medication that is potentially hepatotoxic. Before administering the medication, it is most important for the nurse to assess what? A. Blood urea nitrogen and serum creatinine B. Aspartate aminotransferase and alanine aminotransferase C. Prolonged QT interval on the ECG D. Serum potassium, serum sodium, and serum magnesium The healthcare provider writes a medication order that the nurse cannot read. What should the nurse do? A. consult with the charge nurse to verify the order B. Discuss the order with the pharmacist C. Check with the patient to determine the correct medication D. Contact the prescriber to clarify the order The nurse reviews a patient admission orders written by the healthcare provider. Which medication order should the nurse question? A. Cyanocobalamin 100mcg IM every month B. MSO4 2.0 mg IV Every 2-4 hrs as needed for pain C. Levothyroxine 75 mcg orally every morning D. Enoxaparin 40 mg subQ every day for 7 days The nurse is preparing to administer a dose of penicillin. Before administering the medication, the nurse assesses the patients allergy history. Which aspect of drug therapy does this represent? A. Identifying high-risk patients B.Ensuring proper dosage C. Making PRN decisions D. Evaluating therapeutic effects The nurse is preparing to administer a medication with the following order: "Aldomet 250 mg daily." what should the nurse do? A. administer the medication by mouth B. Administer the medication as it was given last time C. Verify the order with the prescriber D. Ask the patient how this medication is usually given. Which aspect of drug therapy indicates to the nurse whether a drug is having a beneficial effect? A. minimizing adverse effects B. Performing a pre-administration assessment C. Evaluation therapeutic responses D. Managing Toxicity The nurse is managing the care of a group of patients with cancer who will be receiving chemotherapy. The nurse defines goals, sets priorities, identifies interventions, and establishes criteria for evaluation success. Which phase of the nursing process does this represent? A. Implementation B. Planning C. Evaluation D. Assessment The nurse identifies which as the goal of drug therapy in the treatment of patients? A. follow up with the prescriber B. cure of the disease C. correct admin. technique D. production of max. benefit with min. harm When questioning a patient about his or her allergic reaction to a drug, the nurse should ask for which additional info? A. The type of reaction B. The dose taken C. Who gave the drug D. What was eaten with the drug When educating patients about their medications, the nurse includes info. about which topics? (select all that apply) A. symptoms of adverse effects B. The duration of the treatment C. What to do if a dose is missed D. The method of drug storage E. Prescription drug coverage A diabetic patient is taught the signs and symptoms of hypoglycemia with insulin use. The patient knows to eat fast-acting carbs. This is an example of which goal? A. Managing toxicity B. Minimizing adverse interactions C. Promoting therapeutic effects D. Minimizing adverse effects The administered 2 mg of morphine intravenously to a postoperative patient. In addition to the following Rights of Drug Administration, what responsibility does the nurse have as a patient advocate? A. To administer the drug as often as possible B. To minimize adverse effects by reducing the next dose of morphine C. to know the possible reactions to morphine D. to inform visitors that the patient has received morphine A nurse is preparing to administer epinephrine to a patient who is having a severe allergic reaction. Which route of administration should the nurse use to provide the fastest and most complete absorption of epinephrine? A. Intravenous B. Intramuscular C. Subcutaneous D. Oral When preparing to administer a sustained-release capsule to a patient, the nurse understands that which of the following is true for sustained-release capsules? A. They are usually more costly than pills B. They are rapidly absorbed C. They need to be crushed for appropriate absorption to take place D. They need to be taken at regular intervals throughout the day Digoxin has a half-life of 36-48 hours. Because of the length of the half-life, the nurse expects doing to occur how often? A. 4 times per day B. 3 times per day C. 2 times per day D. Once a day The nurse identifies which patient as being at highest risk for slow drug metabolism? A. A 2 year old boy who is prescribed an oral antibiotic B. A 14 year old girl who takes 4 prescription drugs C. A 56 year old man who has chronic hepatic disease. D. A 76 year old woman who has an elevated temp. A patient is taking two prescription medications that both cause bradycardia. The nurse should monitor the patient for which type of effect? A. An increased therapeutic effect B. An increased adverse effect C. A Reduced therapeutic effect D. A reduced adverse effect Which of the following antimicrobial classes contain a blackbox warning regarding potential adverse reactions including CNS dysfunction, exacerbation of muscle weakness in patients with Myasthenia Gravis, and tendinitis and tendon rupture? A. Carbapenums B. Tetracyclines C. Fluroquinolones D. Aminoglycosides Which class of medications is known for causing tooth discoloration and enamel hypoplasia and is therefore contradicted in children and during pregnancy? A. Macrolides B. Aminoglycosides C. Tetracycline D. Penicillins Which class of medications poses a significant risk for ototoxicity and hearing loss, especially when administered with a loop diuretic? A. Macrolides B. Aminoglycosides C. Fluroquinolones D.Tetracyclines The class of antimicrobials is most commonly used to treat parasitic infections like tapeworm: A. Antihelmintics B. Antimalarials C. Antiprotozoals D. Antivirals This class of medication is commonly used to treat giardia. A. antiviral B. antiprotozoals C. amtihelmintic D. antifungals Candida Albicans (yeast) is commonly treated with which class of antimicrobial medications: A. antiviral B. antiprotozoal C. antifungal D. antitubercular Which food should the nurse teach a client to avoid when prescribed a diet limiting purine rich foods?Since the buildup of purines can lead to elevated levels of uric acid, which in turn may result in gout, it's best to avoid or strictly limit these foods.. grouse.. mutton.. chicken.. partridge.. pheasant.. Which nursing action is likely to improve client satisfaction?Sit with Patients
In addition to communicating clearly and with empathy, nurses can improve patient satisfaction simply by sitting at a patient's bedside instead of standing. This seemingly small act has been shown to help nursing staff connect with patients.
What precautions should be taken with computer monitors that display client health information to ensure client confidentiality?1. Orient the screen facing the client rooms so that healthcare personnel can access the information easily. 2. Have the screen placed facing away from any visitor or client care area where information could be viewed by unauthorized persons.
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What should the nurse include when providing education to a client receiving tetracycline
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