Medication Administration & Safety: A Nurse's Guide

1. A nurse is reviewing the medication history of a client who reports urinary retention. The nurse should recognize that which of the following medications can cause this adverse reaction? Scopolamine. 2. A nurse is caring for a client who started taking amitriptyline 6 days ago. The client reports that the medication is not helping.Which of the following responses should the nurse make? You will need to wait a couple of weeks to feel the therapeutic effect of the medication. 3. A nurse is talking with a client who has been taking levothyroxine to treat hypothyroidism. The nurse should instruct the client to avoid taking which of the following over-the-counter medications within 4 hr of taking levothyroxine? Calcium supplements . 4. A nurse is caring for a client who has been taking epoetin alfa for 3 months.Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication? Hgb 5. A nurse is assisting in the care of a client who is receiving morphine via a continuous epidural infusion.Which of the following findings should the nurse report to the provider immediately? Respiratory rate 10/min . 6. A nurse is reviewing the medication list of a client who has a new prescription for tetracycline. The nurse should instruct the client to take which of the following medications 3 hr before or after taking the tetracycline? Antacid 7. A nurse is reinforcing teaching about the iPLEDGEprogram with a female client who has a new prescription for isotretinoin. The nurse should tell the client that which of the following is a requirement of the program? Sexually active female clients must use two forms of birth control during treatment. 8. A nurse is caring for a client who is receiving acetaminophen for mild pain. The nurse should monitor the client for which of the following adverse effects of this medication? Jaundice 9. A nurse is preparing to administer enoxaparin subcutaneously to a client using a prefilled syringe. The nurse should plan to use which of the following techniques when administering this medication? Inject the medication into abdominal tissue. 10. A nurse who is preparing to administer medications to a client is unfamiliar with a medication that the client takes at home. Which of the following resources should the nurse consult? Nursing drug guide. 11. A nurse is preparing to administer a levothyroxine 50 mcg tablet PO to a client who is receiving an enteral feeding through an NG tube. Which of the following actions should the nurse take? Dissolve the medication in 30 mL of water. 12. A nurse is collecting data from a client who has been taking diazepam several times per day but recently ran out of the medication. Which of the following findings should the nurse recognize as a manifestation of withdrawal from diazepam? Tremors 13. A nurse is preparing to administer digoxin to a client. For which of the following findings should the nurse withhold the medication? Apical pulse 54/min. 14. A nurse is collecting data from a client who is takingaspirin. Which of the following findings should the nurse report to the provider? Rhinitis 15. A nurse is preparing to administer an enteric-coated oral medication to a client who is having difficulty swallowing. Which of the following actions should the nurse take? Place the medication on the client's tongue. 16. A nurse is collecting data from a client who has taken an overdose of oxycodone. Which of the following findings should the nurse expect? Sedation 17. A nurse is planning to administer medications to a client who has trigeminal neuralgia. Which of the following medications should the nurse plan to administer to manage the client's pain? Carbamazepine 18. A nurse is obtaining a medication history from a client who has systemic lupus erythematosus (SLE) and reports taking several herbal supplements daily. The nurse should identify that SLE is a contraindication for taking which of the following herbal supplements? Echinacea 19. A nurse is collecting data from a client who received diphenhydramine 1 hr ago after developing an allergic reaction to trimethoprim-sulfamethoxazole. Which of the following statements by the client should indicate to the nurse that the medication is effective? My voice is no longer hoarse. ” 20. A nurse is reinforcing teaching with a client who has a new prescription for fexofenadine tablets to treat seasonal allergies. Which of the following information should the nurse include? Avoid driving until adverse effects of this medication are known.” 21. A nurse is administering the first dose of ramipril to a client who has hypertension.The client reports feeling dizzy and lightheaded. Which of the following should the nurse administer? IV fluid bolus. 22. A nurse is collecting data from a client following his first dose of captopril. The client's blood pressure is 88/60 mm Hg. Which of the following actions should the nurse take first? Place the client in a supine position. 23. A nurse is preparing to mix NPH insulin and regular insulin for administration. Which of the following actions should the nurse take? Inject air into each vial. 24. A nurse is caring for a client who is receiving treatment for chronic alcohol use disorder. Which of the following medications should the nurse plan to administer to assist the client in maintaining abstinence by aversion therapy? Disulfiram 25. A nurse is reinforcing teaching about the varicella vaccine with the guardian of a toddler. Which of the following statements should the nurse include in the teaching? 26. A nurse in an acute care facility is collecting data from a client who has received the meningococcal conjugate vaccine. The nurse should monitor the client for which of the following findings as an adverse effect of the vaccine? Headache 27. A nurse working in an urgent care clinic is collecting data from a client who takes montelukast. Which of the following is an expected therapeutic effect of this medication? Reduced bronchial inflammation. 28. A nurse is caring for an older adult client who has heart failure and a prescription for a repeat dose of furosemide 40 mg orally. Which of the following actions is the nurse's priority? Review the client's electrolyte levels. 29. A nurse is reinforcing teaching with the family of a client who has a new prescription for donepezil. Which of the following therapeutic effects should the nurse inform the family to expect? Improved cognitive function. 30. A nurse is planning care for a client who has angina and a new prescription for nitroglycerin ointment. Which of the following actions should the nurse plan to take? Cover the administration area with plastic wrap. 31. A nurse is preparing to administer an IM injection to a client who has gonorrhea. Which of the following actions should the nurse take? Use the Z-track technique to administer the medication 32. A nurse is administering spironolactone at 0800 to a client who has heart failure. The nurse should monitor the client for which of the following adverse effects? Hyperkalemia 33. A nurse is reinforcing teaching with a client who is to start therapy with insulin lispro and insulin glargine. Which of the following should the nurse include in the teaching? Take insulin lispro right before a meal. 34. A nurse is reviewing data for a client who receives clonidine daily.Which of the following findings indicates the nurse should withhold the next dose? Blood pressure 88/50 mm Hg. 35. A nurse is monitoring a client who received naloxone to counteract the effects of an opioid overdose. Which of the following findings should indicate to the nurse that the medication is effective? Increased respiratory rate. 36. A nurse is collecting data from a client who received levalbuterol 30 min ago. Which of the following findings should the nurse identify as a therapeutic effect of the medication? Wheezing decreases. 37. A nurse is preparing to identify a client prior to medication administration. Which of the following questions should the nurse ask to determine the client's identity? Is your name Sarah Jones?” 38. A charge nurse is evaluating a newly licensed nurse caring for a client who is using a PCA device. Which of the following actions by the nurse requires intervention by the charge nurse? The nurse administers a PCA dose for the client. 39. A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include? Renal excretion time slows for medication. 40. A nurse is reinforcing discharge teaching with a client who has a new diagnosis of type 2 diabetes mellitus and a prescription for exenatide. Which of the following instructions should the nurse include in the teaching? Inject the medication into the subcutaneous tissue of your abdomen.” 41. A nurse is reinforcing teaching with a client who is taking oral prednisone for long-term management of chronic asthma. Which of the following information should the nurse include in the teaching? You should take a calcium supplement while taking this medication.” 42. A nurse is reinforcing discharge teaching with a client who has a new prescription for rifampin. Which of the following information should the nurse include? Take this medication 2 hr following a meal. 43. A nurse is reinforcing teaching with a client who has chronic stable angina and a new prescription for sublingual nitroglycerin. Which of the following instructions should the nurse include in the teaching? Take one tablet before a strenuous activity.” 44. A nurse is caring for a client who is experiencing an acute asthma attack. The nurse should expect to administer which of the following medications? Levalbuterol 45. A nurse is reinforcing discharge teaching about sublingual nitroglycerin with a client who has angina. Which of the following statements indicates an understanding of the instructions? I should feel the effects of the medication within 5 minutes.” 46. A nurse in a long-term care facility is collecting data from a client who has a new prescription for glyburide. The client reports feeling anxious and having profuse sweating. Which of the following findings should the nurse expect? Decreased blood glucose level. 47. A nurse in a long-term care facility is collecting data from a client who has a new prescription for glyburide. The client reports feeling anxious and having profuse sweating. Which of the following findings should the nurse expect? Decreased blood glucose level. 48. A nurse is reinforcing discharge teaching with the family of a client who has a new diagnosis of Parkinson's disease and a prescription for levodopa/carbidopa. Which of the following statements made by the client's family indicates an understanding of the teaching? We should watch for an increase in unusual movements.” 49. A nurse is caring for a client who is postoperative following arthroscopy and reports a pain level of 6 on a scale of 0 to 10 after receiving ketorolac 1 hr ago. Which of the following actions should the nurse take? Administer oxycodone 5 mg orally 50. A nurse is reinforcing teaching with a client who has a new prescription for prednisone to treat rheumatoid arthritis. Which of the following statements should indicate to the nurse that the client understands the teaching? "I will report a sore throat to my provider.” 51. A nurse is preparing to administer an antibiotic via intermittent IV bolus for a client who has a continuous IV infusion. Which of the following steps should the nurse take first? Check the IV site for signs of infiltration. 52. A nurse administered ketorolac 30 mg IM to a client who is postoperative. Which of the following information should the nurse document? (Select all that apply) Gauge and length of needle. Dose of medication administered. Site of injection. Time of administration. 53. A nurse is collecting data from a client who has a new prescription for amoxicillin. Which of the following findings indicates that the client is having an allergic reaction to the medication? Wheezing 54. A nurse is collecting data from a client who has hypertension. The nurse should recognize that which of the following over-the-counter medications is contraindicated for this client? Pseudoephedrine 55. A nurse is collecting data from a client who is receiving vancomycin for a Clostridium difficile infection. Which of the following findings is the priority for the nurse to report to the provider? Creatinine 3.1 mg/dL. 56. A nurse is preparing to administer medications to a client through an enteral feeding tube. Which of the following actions should the nurse take? Flush the tube with normal saline following medication administration. 57. A nurse is preparing to administer gentamicin to a child who weighs 44 lb. The provider prescribes 6 mg/kg/day IV to be administered in three equal doses. Available is gentamicin 40 mg/mL. How many mL should the nurse administer with each dose? 1 58. A nurse is preparing to administer amikacin 5 mg/kg IM to a client who weighs 110 lb. Available is amikacin injection 250 mg/mL. How many mL should the nurse administer? 1 59. A nurse is preparing to administer somatropin 0.24 mg/kg/week subcutaneously to be divided into six daily doses to a school-age child who weighs 66 lb. How many mg should the nurse administer per dose? 1.2 60. A nurse is reinforcing teaching with a newly licensed nurse about monitoring morphine patient-controlled analgesia (PCA). Which of the following information should the nurse include? Instruct the client's visitors not to operate the PCA pump. 61. A nurse is collecting data from a client who received diphenhydramine for insomnia.Which of the following findings should the nurse identify as an idiosyncratic reaction? Agitation 1. A nurse is preparing to administer vaccines to an 11year-old child who is up to date on immunizations. Which of the following vaccines should the nurse plan to administer? Quadrivalent human papillomavirus 2. Exhibits Click to highlight the instructions the nurse should reinforce to the client. Prescribed • Medication Albuterol • Nursing Instructions • "Take your albuterol when you are having difficulty breathing."; • • “Take the salmeterol 2 times each day."; • Fluticasone • "Rinse out your mouth after taking the fluticasone 3. A nurse is caring for a client who is taking allopurinol. Which of the following laboratory findings indicates the medication has been effective? Decreased uric acid 4. A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include? Renal excretion time slows for medication. 5. A nurse is collecting data from a client who has taken an overdose of oxycodone. Which of the following findings should the nurse expect? Sedation 6. A nurse is reviewing a list of current medications for a client who is starting therapy with furosemide. Which of the following medications should the nurse identify as being contraindicated? Lithium carbonate 7. A nurse is reinforcing teaching about phenytoin with a client who had a tonic-clonic seizure. Which of the following information should the nurse include in the teaching? Monitor for gingival hyperplasia 8. A nurse is reinforcing teaching with a client who has a prescription for sildenafil to treat erectile dysfunction. Which of the following statements by the client indicates an understanding of the teaching? I will avoid eating fatty foods while I take this medication." 9. A nurse working in an urgent care clinic is collecting data from a client who takes montelukast. Which of the following is an expected therapeutic effect of this medication? Reduced bronchial inflammation 10. A nurse is planning to administer a tuberculin skin test to a client who has had an exposure to tuberculosis. Which of the following actions should the nurse plan to take? Select an injection site that is free of scar tissue. 11. A nurse is reinforcing teaching with a client who has a new prescription for sustained-release verapamil. Which of the following statements by the client indicates an understanding of the teaching? I will increase my daily intake of fiber and fluid." 12. A nurse is preparing to administer 0800 medications to a client. The medication administration record (MAR) states "phenobarbital" and the medication the pharmacy supplied is pentobarbital. Which of the following actions should the nurse take? Check the prescription in the client's medical record. 13. A nurse is administering the first dose of ramipril to a client who has hypertension. The client reports feeling dizzy and lightheaded. Which of the following should the nurse administer? IV fluid bolus 14. A nurse is caring for a client who has hypertension and has been taking hydrochlorothiazide. Which of the following laboratory values should the nurse evaluate? Serum electrolyte levels 15. A nurse is reinforcing teaching with a client who has a new prescription for nitroglycerin transdermal patches to treat angina. The nurse should inform the client that which of the following manifestations is an adverse effect of the medication? Headache 16. A nurse is assisting in the care of a client admitted for an acetaminophen overdose. Which of the following prescriptions should the nurse anticipate implementing? Give acetylcysteine. 17. A nurse is caring for a client who has been taking epoetin alfa for 3 months. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication? Hgb 18. A nurse is preparing to administer a daily dose of warfarin to a client. Which of the following laboratory values should the nurse check prior to administration? INR 19. A nurse is collecting data from a client who is taking sumatriptan. Which of the following reports indicates a therapeutic response to the medication? Absence of headache 20. A nurse is reinforcing teaching with the parents of a 13-month-old child following administration of the measles, mumps, and rubella (MMR) immunization. Which of the following statements by the nurse is appropriate? Your child will receive another MMR immunization at 4 to 6 years of age. 21. A nurse is collecting data from a client who has been taking methimazole for 2 months for the treatment of a thyroid imbalance. Which of the following findings indicates that the medication is effective? Weight gain 22. A nurse is monitoring a client who is receiving a transfusion of packed RBCs. The nurse should identify which of the following findings as an indication of a febrile nonhemolytic reaction? Chills 23. A nurse is collecting data from a client who states she recently started taking garlic as an herbal supplement. The nurse should advise the client to stop taking garlic due to a potential reaction with which of the following client medications? Warfarin 24. A nurse is caring for a client who has a prescription for morphine 4 mg IM stat. The medication is dispensed in a 5 mg/mL prefilled syringe. Which of the following actions should the nurse take? Discard the excess medication with a second nurse as a witness. 25. A nurse is preparing to administer enoxaparin 5 mg/kg subcutaneous daily to a client who has deep-vein thrombosis. The client weighs 152 lb. Available is 120 mg/0.8 mL prefilled syringe. Calculate the dosage in mL that the nurse should administer. (Round the answer to the nearest tenth. Use a leading zero if applicable. Do not use a trailing zero.) 2.3 26. A nurse is preparing to administer regular and NPH insulin to a client. Which of the following actions should the nurse take? Withdraw the NPH insulin last. 27. A nurse is preparing to administer acetaminophen 10 mg/kg PO every 6 hr to a toddler who weighs 26.4 lb. Available is acetaminophen 80 mg/0.8 mL liquid. How many mL should the nurse administer with each dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.) 1.2 28. A nurse is reinforcing discharge teaching about sublingual nitroglycerin with a client who has angina. Which of the following statements indicates an understanding of the instructions? "I should feel the effects of the medication within 5 minutes." 29. A nurse is preparing to administer erythromycin PO to a client who has an infection. The nurse checks the client's medical record and notes that the client has a severe allergy to penicillin. Which of the following actions should the nurse take? Administer the medication to the client. 30. A nurse is caring for a client who is receiving treatment for chronic alcohol use disorder. Which of the following medications should the nurse plan to administer to assist the client in maintaining abstinence by aversion therapy? Disulfiram 31. A nurse is planning to administer medications to a client who has trigeminal neuralgia. Which of the following medications should the nurse plan to administer to manage the client's pain? Carbamazepine 32. A nurse in a mental health facility is collecting data from a client who is taking lithium. Which of the following findings should the nurse report to the provider as an indication of lithium toxicity? Slurred speech 33. A nurse is caring for a client who has a new prescription for a nitroglycerin transdermal patch. Which of the following actions should the nurse take? Take the patch off prior to bathing the client. 34. A nurse is collecting data from a client who has been taking carbamazepine. Which of the following is an adverse effect of carbamazepine and should be reported to the provider? Sore throat 35. A nurse in an influenza clinic is collecting data from four clients. Which of the following clients should the nurse identify as having a contraindication for receiving the live attenuated form of the influenza vaccine? A client who is at 27 weeks of gestation 36. A nurse is reviewing the medical record of a client who has a new prescription for celecoxib to treat osteoarthritis. Which of the following should the nurse recognize as a contraindication for this medication? Sulfonamide allergy 37. A nurse is reinforcing teaching about the IPLEDGE program with a female client who has a new prescription for isotretinoin. The nurse should tell the client that which of the following is a requirement of the program? Sexually active female clients must use two forms of birth control during treatment. 38. A nurse is preparing to administer an insulin injection for a client. Which of the following actions should the nurse take? Insert the needle into the right thigh at a 90" angle. 39. A nurse is reinforcing teaching with a client who has a new prescription for prednisone to treat rheumatoid arthritis. Which of the following statements should indicate to the nurse that the client understands the teaching? I will report a sore throat to my provider. 40. A nurse is caring for a client who has a prescription for ceftriaxone. The nurse should monitor the client for which of the following adverse effects? Maculopapular rash 41. A nurse is preparing to administer medication to a client who has a new prescription. Which of the following actions should the nurse take first? Identify the client using two means of identification 42. A nurse is reinforcing teaching with a client who has aprescription for nystatin oral suspension. Which of the following instructions should the nurse include in the teaching? Swish the medication in your mouth." 43. A nurse is caring for a client who has chronic hypertension. The client's morning vital signs include BP 140/80 mm Hg, heart rate 54/min, and respiratory rate 18/min. Which of the following medications should the nurse plan to withhold? Atenolol 44. A nurse is monitoring a client who received naloxone to counteract the effects of an opioid overdose. Which of the following findings should indicate to the nurse that the medication is effective? Increased respiratory rate 45. A nurse in a provider's office is assisting in the care of a client. Exhibits Which of the following instructions should the nurse include when reinforcing teaching to the client about their medication? Select all that apply. o Nurses Notes o 2 days ago: o Client presented to the emergency department with reports of chest pain after shoveling snow. Cardiac work-up was normal. Client diagnosed with angina related to physical activity and told to follow up with their primary care provider. o Today: o Client presents to the office for a follow-up with the provider for diagnosis of angina. Client reports experiencing angina again following a large meal yesterday. Provider prescribed nitroglycerin patch. Reinforced teaching with the client about their new prescription. o A. Remove the patch if you experience a headache. o B. Lie down with feet elevated if dizziness occurs while taking this medication. o C. The medication will be effective 30 to 45 min following application o D. Apply the patch daily to a hairless area of the skin. o E. Remove the patch 12 to 14 hr following application.