Ati Medication Administration 4

ATI – Medication Administration, IV, and Drip Calculations

a nurse is covering a colleague at lunch when the patient requests a prescribed medication, unfamiliar to the nurse. What is the most appropriate action?
a. delay the administration until the primary nurse returns
b. refuse to treat the patient because the patient’s condition is not fully known by this nurse
c. look up the prescribed medication to see if it is appropriate at this time
d. call the doctor to ask if it is appropriate to administer.
c.
a patient requests pain medication for pain at a surgical site of 8/10. There is a prn “as needed” order for 10mg PO of oxycodone for pain greater than 6/10 on the pain scale. What is the first thing the nurse should do?
a. administer the oxycodone
b. assess the effects of the medication
c. document the administration of the medication
d. determine if the order is appropriate
d
a nurse is reviewing medication orders when she realizes that a patient with renal failure has been prescribed bactrim (an antibiotic contraindicated in patients with severe renal impairment). what action would be most appropriate according to nursing practice laws?
a. administer the medication as ordered, then discuss with the physician
b. refuse to administer the medication since it is contraindicated for this patient
c. call the physician who ordered the medication to discuss this inappropriate order
d. administer the medication and perform frequent assessments for drug effects
c
what is the term used for the concentration of drug in the blood serum that produces the desired effect without causing toxicity?
a. trough level
b. half life
c. therapeutic range
d. peak level
C. therapeutic range
to which of the following patients would the nurse be most likely to administer a PRN medication?
a. a patient who is complaining of pain near surgical site
b. a patient who requires daily medication to control hypertension
c. a patient whose asthma is treated with inhaled corticosteroids
d. a patient who is experiencing severe and unprecedented chest pain
a
when administering oral medications, which of the following practice should the nurse follow (select all that apply)?
a. perform hand hygiene before and after medication administration
b. verify patient’s response to medication 30 minutes after administration, or as appropriate
c. keep patients MAR at bedside at all times to ensure safe identification
d. say at bedside until patient has swallowed all medications
e. dispense multiple liquid medication sinto single cup to reduce number of containers
A, B, D
a child is to receive amoxicillin 80 mg po. the medication is in an oral suspension containing 125 mg/ 5mL. how many mL should the child receive.
a. 2 mL
b. 3.2 mL
c. 32 mL
d. 0.5 mL
B. 3.2 mL
when a medication acts on receptors they can do which of the following? (select all that apply)
a. mimic the action of the bodys own hormones
b. change the enzymes made by the target cell
c. make the receptors respond in new ways
d. change the receptors molecular structure
e. block the action of the body’s own compounds
A, E
after an oral medication has been absorbed, most of the medication is inactivated as the blood initially passes through the liver, producing little therapeutic effect. This is called:
a. tolerance
b. first-pass effect
c. antagonism
d. synergism
b.
intravenous administration of a medication eliminates the need for:
a. absorption
b. distribution
c. metabolism
d. excretion
a.
identify the correct client position for each routes of administration:
a. oral
b. otic
c. vaginal
d. rectal
a. sitting, semi-fowlers, fowlers
b. lyign on side with ear facing up
c. supine with knees bent, feet flat on bed, adn close to hips
d. lying on left side with right knee brought up toward chest (sim’s position)
identify the correct equipment needed for the following types of injections:
a. intradermal
b. subcutaneous
c. intramuscular
d. intravenous
a.tuberculin syringe with fine-guage needle (26-27)
b. short, fine gauge needle (3/8- 5/8 inch, 25-27 gauge)
c. needle size 18-27 (1 – 1 1/2 inch, 22-25 gauge
d. 16 to 24 gauge catheter for adults. smaller for children
nitroglycerin tablets, which are often prescribed for clients who have cardiovascular disorders are given sublingually. This means that the tablets are:
a. crushed and taken with a small amount of food
b. held under the tongue until dissolved
c. taken by mouth with a small amount of water
d. placed between the cheek and gums
b. held under the tongue until dissolved
a nurse prepares an injection of morphine (duramoprh) to give to a client who reports pain. Prior to administering the medication, the nurse is called to another room to assist another client onto a bedpan. This nurse then asks a second nurse to give the injection so that she can help the client needing the bedpan. Which of the following actions should the second nurse take?
a. offer to assist the client needing the bedpan
b. give the injection prepared by the other nurse
c. prepare another syringe and given the injection
d. tell the client needing the bedpan she will have to wait for her nurse
a
for a medication that was prescribed to be administered at 0900, which of the following are acceptable administration times? (select all that apply)
a. 0905
b. 0825
c. 1000
d. 0840
e. 0935
A, D
which of the following nursing actions may prevent medication errors?
a. taking all medications of the unit-dose wrappers before entering the client’s room.
b. checking with the provider when a single dose requires administration of multiple tablets
c. giving the prescribed medication and then looking up the usual dosage range
d. relying on another nurse to clarify a medication prescription
B. if a single dose requires multiple tablets, an error may have occurred.
when implementing medication therapy, the nurse’s responsibilities include which of the following?
a. observing for medication side effects
b. monitoring for therapeutic effects
c. prescribing the appropriate dose
d. changing the dose if side effects occur
e. maintaining an up to date knowledge base
A, B, E
A nurse should use the nursing process when administering medications to prevent errors. Match the step of the nursing action in column A with the appropriate action in column B.
a. assessment/ data collection
b. planning
c implementation
d. evaluation
a. identify client allergies
b. determine client outcomes
c. follow six rights of medication administration consistently
d. recognize side/ adverse effects
what parenteral route of administration has the longest absorption time?
a. intravenous
b. inramuscular
c. intradermal
d. subcutaneous
C. intradermal
A medication is prescribed to be given “TID ac”. what is the correct interpretation for this medication?
a. 3 times a day, before meals
b. three times a day, after meals
c. every 3 hours, after meals
d. every 3 hours, before meals?
A. 3 times a day before meals
what is the nurses responsibility if a patient makes a comment implying that any medication seems unusual in any way?
a. convince the patient to take the medication.
b. hold the medication until the nurse has double-checked the order, supply, patient, and is positive all are correct.
c. have another nurse give the medication
d. explain to the patient that the provider has ordered a new medication
B.
a nurse is preparing to administer demerol, an IM injection in an adult patient’s deltoid site. Which of the following needles should the nurse select for this injection?
a. 2”; 18 gauge
b. 1.5 ”; 18 gauge
c. 5/8 ”; 24 gauge
d. 1”; 22 gauge
D.
never ever use 18 gauge
the main reason a two-day postoperative abdominal surgery patient who is “nothing by mouth” is receiving intravenous therapy is to provide”?
a. venous access so that treatment can administered properly if needed.
b. venous access to administer blood products
c. glucose as a source of energy
d. fluids because the client cannot be given oral intake
D.
when the nurse notes that a patient’s intravenous site is cool to the touch and swollen, the nurse should plan to?
a. continue to monitor the patient’s intravenous site
b. discontinue the intravenous site and restart an infusion at another site
c. flush the intravenous device with saline
d. notify the physician
B.
which of the following are signs and symptoms of infiltration at a catheter site of an intravenous solution?
1. solwing of iv rate
2. tenderness at insertion site
3. edema around the insertion site
4. skin tightness at insertion site
5. warmth of skin at insertion site
6. fluid leaking from insertion site
1,2,3,4,6
with which drug route administration are there no barriers to discharge?
a. intravenous
b. intramuscular
c. subcutaneous
d. oral
intravenous
which of the following demonstrates the correct use of the one six rights of medication administration?
a. administering a patient’s medication by the route the provider has prescribed
b. adhering as closely as possible to the medication schedule the patient follows at home
c. gathering a medication history from the patient before administering any drugs
d. respecting a patient’s refusal to take a new medication the provider has prescribed
A.
which of the following patients is exhibiting drug tolerance?
a. a patient continues to take a medication despite harmful effects
b. a patient requires an increased dose of a medication to achieve continued therapeutic benefit
c. a patient exhibits signs of withdrawal when a medication is discontinued
d. a patient develops an intense craving for a drug.
B
a patient drinks 8 oz of water. which of the following is a correct conversion of the patient’s intake?
a. 1 pint
b. 4 tablespoons
c. 2 cups
d. 240 mL
D
which of the following represents the correct administration of the prescribed medication?
a. acetaminopehn 650 mg PO; 5 tsp of 325 mg/ 10 mL liquid given
b. levothyroxine 100 mcg, PO prescribed; three 0.025mg tablets given
c. amoxicillin 1 g PO prescribed; two 500-mg tablets given
d. diphenhydramine 40 mg IM prescribed; 1.25 mL of 50 mg/ 1mL injection given
C
which of the following is the most appropriate documentation of a patient’s response to a pain medication?
a. “I feel better” 10 minutes after administration
b. patient is sleeping 1 hour after administration
c. the patient is up and walking in the hall 2 hours after administration
d. the patient reports pain decreased to 3/10, 30 minutes after medication administration
D.
a drug’s generic name:
a. chemical name for medication
b. same as its nonproprietary name
c. name under which the drug is marketed
d. formal name of the particular drug
B
you are reading the physicians orders and note date and time of prescriptions as well as the physician’s signature. which of the following prescriptions is complete?
a. aspirin PO 1 tablet daily
b. ferrous sulfate 624 mg PO
c. hydrocodone/ acetaminophen (vicodin); 5/325 mg PRN
d. digoxin 1.25 mg/ PO daily
D
which of the following is your highest priority action for ensuring overall safety during medication administration?
a. have another nurse check the dose you will give.
b. teach the patient about possible adverse effects
c. identify the patient by two acceptable methods
d. confirm that the patient can swallow adequately
C.
an uncommon, unexpected, or individual drug response thought to result from a genetic predisposition is called?
a. idiosyncratic effect
b. allergic response
c. a toxic effect
d. synergistic effect
A. idiosyncratic effect
you have a handwritten medication order that is difficult to read. which of the following si the most appropriate action to take to avoid an error in medication?
a. ask another nurse to decipher the medication order.
b. call the medical provider for clarification of the order
c. rely on your knowledge of the patient to get this order right
d. inquire at the hospital pharmacy about the order
B
you are giving a patient several PO medications to take. The patietn tells you that she can only take one pill at a time. It is appropriate to:
a. place all of the medications in a cup and let the patient decide the order in which to take them
b. crush the pills and mix them in applesauce
c. remain at the bedside until you are sure the patient has taken all of the medications
d. leave the pills at the bedside for the patient to take
C
Which parenteral route of administration has the longest absorption time?

a. Intravenous
b. Intramuscular
c. Intradermal
d. Subcutaneous

C, D, B, A
A medication is prescribed to be given “TID ac.” What is the correct interpretation for medication administration?

A. Three times a day, before meals
B. Three times a day, after meals
C. Every three hours, after meals
D. Every three hours, before meals

A. Three times a day, before meals
What is the nurse’s responsibility if a patient makes a comment implying that any medication seems unusual in any way?

a. Convince the patient to take the medication because the nurse was careful to obtain the correct medication
b. Hold the medication until the nurse has double-checked the order, the supply, the patient , and is positive all are correct
c. Have another nurse give the medication to reassure the patient that the medication is correct
d. Explain to the patient that the provider (NP, MD, PA) has probably ordered a new medication

b. Hold the medication until the nurse has double-checked the order, the supply, the patient , and is positive all are correct
The nurse is preparing to administer meperidine (Demerol) as an intramuscular injection in an adult patient’s deltoid site. Which of the following needles should the nurse select for this injection?

A. 2″; 18 gauge
B. 1 ½”; 18 gauge
C. 5/8″; 24 gauge
D. 1″; 22 gauge

D. 1″; 22 gauge
An IV of 1000ml NS is to be administered to a patient over 8 hours. The tubing has a drop factor of 20 drops per milliliter. The nurse should regulate the infusion to run at how many drops per minute?

a. 42 drops/minute
b. 1500 drops/minute
c. 420 drops/minute
d. 4.2 drops/minute

a. 42 drops/minute
A nurse is preparing to administer an insulin injection to a patient. Which of the following is appropriate?

a. Rotate injection sites to avoid tissue injury
b. administer no more than 2mL per injection
c. Use the nondominant hand to displace the skin and subcutaneous tissue at the site about 1 to 1.5 inches
d. injection the medication after aspirating the syringe

a. Rotate injection sites to avoid tissue injury
Which of the following terms indicates a medication is given by injection?

a. enteral
b. sublingual
c. transdermal
d. parenteral

d. parenteral
A nurse is preparing to give an intramuscular injection into the left ventrogluteal muscle. Which of the following should the nurse do to locate the appropriate site?

a. measure two fingerbreadths below the acromion process
b. measure a handbreadth above the knee and a handbreadth below the greater trochanter
c. with the heal of the hand on the greater trochanter, point the index finger up toward the anterior superior iliac spine, extending the other fingers back along the iliac crest.
d. divide the buttock into four quadrants and give the injection in the upper, outer quadrant.

c. with the heal of the hand on the greater trochanter, point the index finger up toward the anterior superior iliac spine, extending the other fingers back along the iliac crest.
A nurse is preparing to administer an intradermal injection. Which of the following should the nurse do to ensure proper technique?

a. rub the injection site after withdrawing the needle.
b. pinch 1/2 inch of skin and administer the injection at a 45 degree angle
c. use a tuberculin syringe with a 3/8 to 5/8 inch, 25 to 27 gauge needle
d. choose a site at least 2 inches from the umbillicus

c. use a tuberculin syringe with a 3/8 to 5/8 inch, 25 to 27 gauge needle
A patient is to receive 30 mg of ketorolac (Toradol) IM every 6 hr for 48 hr. The medication is available in a 60mg/2mL vial. How many mL should the nurse administer for each dose?1mL
The proper needle length when giving an intramuscular injection in the ventrogluteal area to an average-sized adult is which of the following?

a. 1/2 inch
b. 1 inch
c. 1.5 inches
d. 2 inches

c. 1.5 inches
A nurse is administering a subcutaneous injection to a patient. Which of the following data should the nurse recognize as the highest priority to prevent potential complications?

a. Identify the patient’s level of knowledge about the medication
b. identify if the patient has allergies to the medication.
c. identify a specific site for the injection
d. identify the rationale for the patient receiving the medication

b. identify if the patient has allergies to the medication.
A nurse administers the first dose of a patient’s prescribed antibiotic via IV piggyback. During the first 10 to 15 min of administration of the medication, the nurse gives priority to which of the following assessments?

a. IV site for redness or swelling
b. patient for systemic allergic reaction
c. IV dressing for signs of leakage
d. limb for signs of discomfort

b. patient for systemic allergic reaction
A nurse is about to administer an intravenous medication directly into the vein. The nurse should understand that a disadvantage of parenterally administered medications is that they

a. are irreversible
b. have slow onset
c. bypass the liver
d. have less bioavailability

a. are irreversible
A nurse is caring for a patient with a peripherally inserted central catheter (PICC line). Which of the following is true about this type of intravenous route?

a. A PICC line is a short catheter inserted into the jugular vein
b. A PICC line is a catheter that allows for the infusion of IV fluids without an infusion pump
c. A PICC line is a long catheter inserted through the veins of antecubital fossa
d. A PICC line is a catheter that is used for emergent or trauma situations.

c. A PICC line is a long catheter inserted through the veins of antecubital fossa
A patient was admitted to the hospital for same day surgery and has orders for continuous IV therapy. Before performing a venipuncture, the nurse should

a. place a cold compress over the vein
b. inspect the IV solution for fluid color, clarity, and expiration date
c. apply a tourniquet 1 to 2 inches above selected insertion site
d. secure an armboard to the joint

b. inspect the IV solution for fluid color, clarity, and expiration date
A patient is to receive 1g of ceftriaxone (Rocephin) in 100 mL over 30 minutes. The tubing drip rate is 10 gtt/mL. The nurse should adjust the flow rate to what infusion rate?33 gtt/min
A nurse is assessing a patient receiving IV normal saline at 125 mL/hr. Which of the following should the nurse recognize as a possible complication related to the intravenous therapy?

a. Petechiae over the IV site.
b. The skin is cool over the IV site.
c. patient reports cough and shortness of breath.
d. patient’s blood pressure is lower than normal.

c. patient reports cough and shortness of breath.
A nurse is caring for a patient who is receiving D5 with 20 mEq of KCl at 75 mL/hr. The provider has prescribed 1g of ceftriaxone (Rocephin) IV. When preparing to administer this medication by IV piggyback, which of the following data is the highest priority for the nurse to collect?

a. The patient’s vital signs
b. The patient’s level of consciousness
c. The medication’s compatibility with the primary IV solution
d. The amount of IV solution in the primary bag

c. The medication’s compatibility with the primary IV solution
A nurse is caring for a patient receiving 0.9% sodium chloride (normal saline) at 75 mL/hr through a triple lumen central venous catheter. The pump is alarming that there is an occlusion. Which of the following is the first thing the nurse should do?

a. Call the provider who inserted the catheter
b. Flush the line with a 10-mL syringe of heparin
c. Check the line at or above the hub for kinked tubing that is creating a resistance to flow
d. Reposition the patient.

c. Check the line at or above the hub for kinked tubing that is creating a resistance to flow
A nurse is removing an IV catheter from a patient whose IV infusion has been discontinued. Which of the following actions is appropriate?

a. apply firm pressure over the vein
b. leave the roller clamp slightly open
c. pull the catheter straight back from the insertion site
d. lift the hub slightly upward away from the skin

c. pull the catheter straight back from the insertion site
A patient in early stage renal failure is prescribed an infusion of 0.45% sodium chloride. This type of solution is appropriate because it

a. pulls fluid from the cells and increases vascular volume
b. dilutes extracellular fluid rehydrates the cells
c. replaces extracellular volume and maintains intravascular volume
d. draws fluid into blood vessels and reduces interstitial compartments

b. dilutes extracellular fluid rehydrates the cells
A nurse is discontinuing an IV infusion. For which of the following reasons is it important to verify and document the integrity and condition of the IV catheter?

a. A broken-off catheter tip indicates the risk for an embolus
b. Catheter erosion indicates that it was left in place too long
c. Blood within the catheter could indicate clot formation
d. discoloration of the catheter could be a sign of phlebitis

a. A broken-off catheter tip indicates the risk for an embolus
A nurse initiating a peripheral IV infusion punctures the skin and selected vein and observes blood return in the flashback chamber of the IV catheter. Which of the following actions should the nurse perform next?

a. secure the catheter to the skin with a transparent dressing.
b. lower the catheter until it is almost flush with the skin
c. advance the catheter about 1/4 inch into the vein
d. remove the stylet slowly from the lumen of the catheter

b. lower the catheter until it is almost flush with the skin
A patient is to receive 1,000 mL of 5% dextrose in lactated Ringers over 8 hours. Using tubing with a drop factor of 15 gtt/mL, the nurse should regulate the fluid to infuse at how many drops per minute?31 gtt/min
A nurse who has just initiated an IV infusion explains to the patient that complications are possible and that she will monitor the infusion regularly. The nurse should teach the patient that which of the following findings is an indication of early infiltration?

a. Moisture
b. Bruising
c. Tingling
d. Coolness

d. Coolness
A nurse finds a patient’s IV insertion site red, warm, and slightly edematous. Which of the following actions should the nurse perform first?

a. Check for a blood return
b. Elevate the extremity
c. Discontinue the IV line
d. Apply warm, moist heat

c. Discontinue the IV line
Which of the following is an important nursing action when converting an IV infusion to a saline lock?

a. Open the roller clamp of the primary infusion to prime the saline lock
b. Apply pressure with a syringe to clear resistance in the IV catheter
c. Attach a secondary tubing to allow mobility
d. Flush the IV catheter to confirm patency

d. Flush the IV catheter to confirm patency
A nurse has just inserted a peripheral IV catheter for a continuous infusion. To secure the catheter, the nurse should

a. Leave the connection between the hub and the tubing uncovered
b. Wrap tape around the circumference of the patient’s arm
c. Tape the IV catheter’s hub securely to the patient’s skin
d. Place a piece of paper tape over the insertion site

a. Leave the connection between the hub and the tubing uncovered
A nurse is covering for a colleague at lunchw hen the patient requests a prescribed medication, unfamiliar to the nurse. What is the most approriate action?
a. delay the administration until the prmary nurse returns
b. refuse to treatment the patient because the patient’s condition is not fuly known by this nurse.
c. look up the prescribed medicatin to see if it is appropriate at this time.
d. call the doctor to ask if it is appropriate to administer
c
a patient requests pain medication for pain at a surgical site of 8/10. there is a prn, or “as-needed” order for 10 mg PO of oxycodone for pain greater than 6/10 on the pain scale What is the first thing the nurse should do?
a. administer the oxycodone
b. asses the effects of the medication
c. documen tthe administration of the medication
d. determine if the order is appropriate
D
a nurse is reviewing the medication orders when she realizes that patient with renal failure has been prescribed bacterium (contraindicated for patients with severe renal impairment). What action would be most appropriate according to nursing practice laws?
a. administer the medication as ordered, then discuss with physician
b. refuse to administer the meidcation since it is contraindicated for this patient
c. discuss what the medication is for and why it is important to take it
d. ask the patient why she has been refusing her medications
C
A nurse administers a prescribed dose of IV morphine for pain. the next day the patient reports constipation. Which of the following best describes this adverse reaction?
a. tolerance
b. side effect
c. allergic reaction
d. anaphylatic reaction
B
a A nurse is about to adminster a dose of supplementary potassium PO. which information should be checked prior to administration? Select all that apply.
a. MAR to confirm dose, time, route, meidcation
b. adequate venous access
c. ability to swallow and diet order
d. serum potassium lab value
A, C, D
a nurse is administering 5000 units / 0.5mL dose of SQ heparin. The medication is stocked in single dose glass vials. What should the nurse select as an appropriate needle for SQ injections? Select all that apply
a. 1/2 to 5/8
b. 1 to 3
c. 19 to 23 gauge
d. 26 to 30 gauge
A, D
a 2 year old is seen in a well child checkup and needs a flu vaccine, 1mL. how should this be administered?
a. IM injection in the deltoid
b. z track method must be used
c. IM injection in vastus lateralis
d. using long needle more than an inch
C. not A because you can only give UP TO 0.5 for children in the deltoid!