A patient has been prescribed several drugs and fluids to be given intravenously. Before the nurse starts the intravenous administration, a priority assessment of the patient will be to note the
A) heart rate.
B) body weight and height.
C) blood pressure.
D) skin surrounding the potential IV site.
A nurse is caring for a postsurgical patient who has small tortuous veins and had a difficult IV insertion. The patient is now receiving IV medications on a regular basis. What is the best nursing intervention to minimize the adverse effects of this drug therapy?
A) Monitor the patient's bleeding time
B) Check the patient's blood glucose levels
C) Record baseline vital signs
D) Monitor the IV site for redness, swelling, or pain
A nurse who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.)
A) provide regular feedback about product safety issues.
B) accredit new medical facilities and hospitals.
C) facilitate the reporting of adverse reactions of drugs.
D) increase awareness of serious reactions caused by drugs or medical devices.
E) report medication errors that occur in hospitals.
In response to a patient's nausea, the nurse has mixed a dose of an antiemetic with 50 mL of sterile normal saline and will administer the dose by IV piggyback. What is the rationale for the use of IV piggyback?
A) The patient is receiving continuous IV fluids in addition to IV medications.
B) The patient must be continuously monitored to gauge the effect of the medication.
C) The patient has failed to adhere to the prescribed treatment regimen.
D) The patient's electrolyte levels are volatile.
A home health nurse notes that there have been changes to a patient's oral drug regimen. The nurse will closely monitor the new drug regimen to
A) track the exact route of metabolism as a research project.
B) identify any changes in drug absorption that would change the drug effect.
C) monitor only for the adverse effect of immunotoxicity.
D) determine the speed of chelation.
A patient who has been admitted to the hospital for a mastectomy has stated that she has experienced adverse drug effects at various times during her life. Which of the following strategies should the nurse prioritize in order to minimize the potential of adverse drug effects during the patient's stay in the hospital?
A) Administer the patient's drugs in doses that are smaller and more frequent than ordered
B) Monitor the patient vigilantly for signs and symptoms of potentially adverse drug effects
C) Encourage the patient to bring herbal supplements and complementary remedies with her to the hospital
D) Alter the administration of the patient's medications in favor of the intravenous, rather than oral, route.
An older adult patient with a history of Alzheimer's disease and numerous chronic health problems has been prescribed several medications during his current admission to hospital and recent declines in the patient's cognition have impaired his ability to swallow pills. Which of the following medications may the nurse crush before administering them to this patient?
A) Enteric coated ASA
B) A sustained release antidepressant
C) An immediate release opioid analgesic tablet
D) A sublingual benzodiazepine
A mother brings her 4-year-old child, who is vomiting and has a temperature of 103°F into the emergency department (ED). The ED physician orders acetaminophen (Tylenol) for the fever. The best form of Tylenol to give the child, considering her presentation, would be
The nurse is caring for a patient receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which of the following will alert the nurse that the patient may be experiencing nephrotoxicity?
A) Visual disturbances
B) Yellowing of the skin
C) A decrease in urine output
D) Ringing noise in the ears
For which of the following patients would a nasogastric tube most likely be considered to aid in the administration of medications?
A) An 81-year-old woman who wishes to stop taking her cardiac medications
B) A 78-year-old man who is unable to swallow following an ischemic stroke
C) A 60-year-old man who has just had a hemicolectomy (bowel resection) for the treatment of colon cancer
D) A 49-year-old woman who is experiencing frequent nausea and vomiting during her current round of chemotherapy
A patient has a blood serum drug level of 50 units/mL. The drug's half-life is 1 hour. If concentrations above 25 units/mL are toxic and no more of the drug is given, how long will it take for the blood level to reach the nontoxic range?
A) 30 minutes
B) 1 hour
C) 2 hours
D) 3 hours
The nurse's assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this?
A) "I tend to get sick in the stomach when I take antibiotics."
B) "I've been told that aspirin might have caused my stomach bleed a few years back."
C) "I broke out in hives and got terribly itchy when I started a new prescription last year."
D) "When I fell last year, the doctor said that it might have been because of my blood pressure pills."
A nurse is caring for a patient who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the patient's care, the nurse should consider a possible alteration in which of the following aspects of pharmacokinetics?
In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient's hypertension?
A) The adverse effects of each drug may cancel each other out.
B) Using two drugs for a health problem tends to increase patient compliance with the drug regimen.
C) Using lower doses of two separate drugs may lessen the risk of adverse reactions.
D) Using the two drugs to treat a health problem may create a synergistic effect.
A patient who has ongoing pain issues has been prescribed meperidine (Demerol) IM. How should the nurse best administer this medication?
A) Into the patient's vascular space using a large-gauge needle
B) Into the patient shoulder muscle using a small-gauge needle
C) Into the patient's buttocks using a small- to medium-gauge needle.
D) Into the patient's thigh using a large-gauge needle.
A 56-year-old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat the spasms. She has a poorly documented allergy to eggs, synthetic clothes, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not experience an allergic reaction?
A) Call the prescriber immediately regarding her allergic reactions
B) Hold the medication for her muscle spasms until she can be treated for a possible allergic reaction
C) Post an allergies notice on the front of the chart and document the allergies in the appropriate area of the patient's record
D) Call the dietary staff and make sure that the patient is not served eggs for breakfast
In order to promote therapeutic drug effects, the nurse should always encourage patients to
A) take their medication with meals.
B) take their medication at the prescribed times.
C) increase medication dosages if necessary.
D) use alternative therapy to increase the effects of their medications.
In which of the following patients would a nurse expect to experience alterations in drug metabolism?
A) A 35-year-old woman with cervical cancer
B) A 41-year-old man with kidney stones
C) A 50-year-old man with cirrhosis of the liver
D) A 62-year-old woman in acute renal failure
An unconscious patient has been brought to the hospital, and the physician has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication?
A) Intravenous infusion.
B) Subcutaneous administration.
C) Intrathecal administration.
D) Intramuscular administration.
A nurse is instructing a patient concerning a newly prescribed drug. Which of the following should be included to help improve patient compliance and safety?
A) A list of pharmacies where the drug can be obtained
B) Measures to alleviate any discomfort associated with adverse effects
C) The cost of the brand drug compared with the generic form
D) Statistics related to phase III of testing for the prescribed drug
The culture and sensitivity testing of a patient's wound exudate indicates that a specific antibiotic is necessary for treatment. The United States Pharmacopeia–National Formulary indicates that the drug in question is 96% protein bound. What are the implications of this fact?
A) Dosages of the drug must be large in order to be effective.
B) The patient must maintain a high-protein diet for the duration of treatment.
C) Nearly all of each dose of the drug is free and active.
D) Absorption and excretion of the drug will occur rapidly.
5 ml = _______________tsp
During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives
A) may cause nutrient deficiencies.
B) may counter the therapeutic effect of other drugs.
C) causes acidic urine and urinary tract infections.
D) inhibits biotransformation of drugs.
A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. The nurse suspects that the change in the effectiveness of the drug is related to
A) the impact of the placebo effect on the patient's response.
B) the accumulative effect of the drug if it has been taken for many years.
C) the impact of the warmer climate on the patient's physical state.
D) problems with patient compliance with the drug regimen due to the move.
A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to
A) passive diffusion.
B) active transport.
C) glomerular filtration.
D) first-pass effect.
A community health nurse is performing a home visit to an elderly client who receives twice-weekly wound care. The client has mentioned that she has been having difficulty sleeping, a problem that she has not previously experienced. Which of the following measures should the nurse suggest?
A) Having the client ask her physician for a benzodiazepine during her next scheduled visit
B) Purchasing an over-the-counter sleep aid and trying it for 1 to 2 weeks
C) Encouraging the patient to change her diet and exercise habits
D) Having the client ask her physician for an off-label hypnotic medication
A nurse is caring for a 78-year-old patient with renal insufficiency and chronic heart failure who is receiving rapid infusions of high-dose furosemide. It will be a priority for the nurse to monitor for
A) hepatic encephalopathy.
C) vascular thrombosis.
A 70-year-old woman is starting on an acidic drug. The nurse is aware that food and nutrient intake can affect drug excretion by changing the urinary pH. About which of the following will the nurse question the patient concerning her diet?
A) The intake of sodium
B) The amount of meat and vegetables
C) The use of grapefruit
D) The intake of foods high in protein
A nurse is conducting an assessment of a patient who has recently had several changes made to her drug regimen. What assessment question most directly addresses the safety implications of the patient's drug regimen?
A) "Do you prefer to take liquid medications or are you fine with taking pills?"
B) "Do you take any herbal supplements or alternative medications?"
C) "What effect are you expecting that these medications will have on your health?"
D) "Which pharmacy do you use to fill your prescriptions?"
A 70-year-old woman with a history of atrial fibrillation has been admitted with a lower gastrointestinal bleed. During the nurse's admission assessment, the nurse realizes that the patient has been taking ginkgo biloba supplements in addition to her prescribed warfarin, a combination that has resulted in bleeding. What nursing diagnosis should the nurse identify when planning this patient's care?
A) Risk for Injury related to adverse effects from excessive use of vitamins or herbs
B) Health-Seeking Behaviors related to the use of nutritional supplements
C) Risk for Injury related to low protein levels and malnutrition
D) Risk for Injury related to drug interactions of vitamins, herbs, or food intake with prescribed drug therapy
A nurse is caring for a 92-year-old patient who is taking multiple drugs and displaying increased cognitive impairment and memory loss. The initial action of the nurse would be to
A) try to distinguish between normal signs of aging and the adverse drug effects.
B) report adverse effects of drug therapy to the prescriber.
C) wait several days to see if the symptoms subside.
D) hold the patient's medications until a doctor can see the patient.
B) Electrolyte levels
D) Body temperature
A nurse is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the nurse will also be careful to observe for
A) possible drug toxicity.
B) decreased therapeutic effects.
C) altered drug absorption.
D) increased drug metabolism.
A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse's advice?
A) Integrating the new drug into the patient's existing schedule promotes adherence.
B) Combining a new drug with one or more existing drugs mitigates the risk of adverse effects.
C) Taking several drugs at one time maximizes recovery time for the liver and kidneys.
D) Rapid drug clearance fostered when a patient is able to minimize the number of drug administration times.
An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the patient that
A) the tablet would have no effect if crushed and ingested.
B) there is risk of an extremely high dose available all at once if the tablet is crushed.
C) crushing the tablet increases the drug's efficacy.
D) crushing the tablet is a safe option
A 77-year-old man with a long history of absence seizures has been treated with ethosuximide for many years. The man is now in the process of moving to a long-term care facility and a nurse is creating a plan of care. The nurse understands the potential adverse effects of this drug and would consequently prioritize which of the following nursing diagnoses?
A) Risk for Impaired Gas Exchange
B) Risk for Altered Urinary Elimination
C) Risk for Falls
D) Risk for Impaired Skin Integrity
A nurse is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The nurse will base the patient's plan of care on the understanding that there is
A) an increase in drug excretion.
B) a decrease in the effectiveness of the prescribed drugs.
C) an increase in the production of creatinine.
D) a decrease in the amount of creatinine to be filtered.
An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for
C) xerostomia (dry mouth).
A 72-year-old man is taking Adderall XR for the treatment of narcolepsy. He is currently having problems with not being able to swallow large tablets or capsules. The man also wears dentures, which makes it even more difficult for him to swallow medication. He is in the clinic to talk to the nurse about his problem. The nurse will instruct him to
A) swallow the capsule with 8 ounces of water.
B) ask his physician to prescribe an alternative drug.
C) open the capsule and sprinkle the beads in applesauce.
D) open the capsule and crush the beads.
An elderly man has been admitted to a residential care facility and the nurse has conducted a medication reconciliation. The man has taken numerous drugs in the past, including a course of bicalutamide (Casodex) several years earlier. The nurse recognizes this drug as being an antiandrogen and is consequently justified in presuming that the man has a history of what disease?
B) Lung cancer
C) Skin cancer
D) Prostate cancer