Pharmacology Exam 1 Review

1. When Patient has been prescribed an ointment, what does nurse do first. Make sure skin clean and dry – not wet or dirty. 2. What do you do when you are unsure of an abbreviation? Best Action: Contact doctor and clarify. 3. Providing Medication to a patient with Alzheimer’s. What do you do first? Look at Label before anything. 4. Patient has gone home had a mastectomy home for three days, they have a child under age of 12 – what would be a concern in that household? Fear child has access to medication. 5. Providing care to patient with gtube you are giving them medication cambial – prior to medication what action should nurse do first? Ask if medication comes in liquid form. 6. Working on the floor and you see an order that says .25 mg digoxin IV now. What is the problem? Order incomplete – clarify order with physician – correct form “0.25 mg” 7. Working on geriatric unit the nurse is more like to find what concerning? 72-year-old given a sleeping pill who is confused when they wake up. 8. A patient that takes Vicodin every 6 hours for pain, patient tells patient medication is not working anymore. Generally, means patient has built tolerance to medication. 9. You have an order for Xanax 0.25 by mouth 3 times a day. What would be the best action by the nurse? Space evenly throughout the day. 10. Medication and note that abbreviation is not recognized – you would refer to the institutions approved medication list. 11. Patient with prescription for oxycodone/acetaminophen (Percocet). Nurse must caution patient to avoid what? Avoid anything with Tylenol, cold remedies, etc… Percocet already has Tylenol in it. 12. Completing d/c teaching for a client and instructing on a new prescription on a transdermal patch (fentanyl). Which of the following statements allows the nurse to understand that the patient has understanding of the instructions? Nice and clean area, hairless, dry, nice and clean, if there is hair you can clip it not shave it. 13. Nurse is administering antifungal to the buccal mucosa TID – Nurse explains to the client this medication will be delivered where? Losange will be held between outer teeth and cheek. 14. Applying hydrocortisone cream to a rash – which statement would be included in nurses instructions to patient – it absorbed thru the skin to help reduce itch. 15. An instructor is supervising a medication administration in a home setting, which one requires intervention? Would question student who folds old patch in half and discards in trash can. 16. While teaching patient to begin ophthalmic ointment and drops the nurse should instruct patient to place ointment where – inner aspect of lower eyelid. 17. Ear drops for someone who has a lot of ear wax and you want to soften it – which action by the nurse would be the best? Adult: pull pinna up and back Child: lower part of ear back and down 18. You have a Patient you have to give saline nasal spray – 2 sprays per nostril TID PRN. Prior to admin best action by nurse is? Blow nose to clear passage. 19. which of the following methods is not a parenteral method of drug administration? Parenteral (means IV): Intravenous, intramuscular, subcutaneous Only one not parenteral is Oral 20. Intramuscular injection to ventrogluteal site. What are the identifying landmarks for that? - the greater trochanter - form a v with the middle finder toward the iliac crest - the index finger toward the anterior iliac spine 21. What is the angle of insertion when you give and IV for Diabetic Injection. 45 Degree angle, stay subcutaneous level IM – 90 Degree Angle TB – 15 Degree Angle 22. You have a patient that turns call light on – states IV Site is painful and seems to be leaking what would you do? First thing assess site for tissue damage, STOP whatever is infusing if anything, then remove IV 23. Select all that applies. Which measures are taken to keep a patient safe when dealing with medication orders - whats pay attention to the attained written or typed order. See order in writing. If verbal or phone call there must be a read back to prevent errors. Make sure prescription is accurate and legible. Must educate patient if is a new drug. 24. which of the following are considered enteral routes: anything by mouth: ex: tablets, capsules, sublingual, buccal, via nasogastric tube or gastrostomy tube. Oddyx – is not Intramuscular – is not Transdermal – is not Because the don’t go through hepatic first-pass effect and digestive enzymes (they go right to blood stream. If you give someone a tube feed and it is not a PEG Tube, it is by the mouth it’s an enteral feed bc it passes thru the mouth and into the stomach. The nasal and buccal are enteral also absorbed thru the skin, there is still saliva and etc. that will bring it down to your stomach. 25. You are reviewing a patient’s health records notes – new prescription for Lisinopril 10mg PO 1 a day. Nurse identifies medication as a routine medication. 26. will have you look at a syringe and ask you to tell where a certain mL is. 27. Medication label – the supply dose is blank per blank mls 28. Order written out and you have to convert it into how it’s supposed to look “Demerol 75.00 mg IM as needed for pain.” Ans: Demerol 75mg IM PRN, pain 29. Know what the five rights of medication administration are. 1. Right Patient 2. Right Medication 3. Right dose 4. Right route of Administration 5. Right time of delivery. 30. How to convert Kg of weigh to lbs. Note: 2.2 lbs equal 1 kg Problem: “Convert 2300kg to pounds” How to set up problem: 2300kg/1 * 2.2lbs/1kg Steps: 1. Kilograms cancel out 2. Multiply 2300 (2.2 lbs) 3. Answer: 5060lbs 31. 15 tsp equals how many mL? Note: 1 tsp equals 5 mL How to set up problem: 15 tsp/1 * 5ml/1tsp = 75mL Steps: 1. Tsp cancel out 2. Multiply 15 (5mL) 3. Answer: 75 mL 32. You are conducting a medication education for patients with hypertension -focus is on enhancing absorption of the med – the nurse determines the patient has understanding when the patient states: you need to be careful about taking medication with certain foods – you know they’ve understood it. 33. Physician orders a loading dose for a patient (loading dose one time large amount of dose to get kick start in the body) to then be followed by a lower dose. When the patient receives lower dose she says to the nurse I think doctor has made a mistake my dose is too low. What would be the next response. Educate patient – larger dose would give relief much quicker – large dose first so meds work quickly. 34. You have a patient with chronic renal failure patient on several medications. What best describes the nurse assessment of the patient. Concerned patient is on too many meds and patient is becoming toxic. 35. Patient on lithium asks nurse why he has to have blood drawn so often. Lithium is a neurologic drug for neurological issues it has a toxicity level. Nurses have to make sure the correct amount of dosage in the patients body at all times 36. all routes of drugs to be excreted. Select all that apply. All but one is the right answer. The nurse recognizes that medication are excreted by which routes. 1. Kidneys 2. Respiratory System 3. Glands 4. Biliary system 37. the instructor prepares to teach student nurses about how effective doses of medication are related to clinical practice as a result of the instruction what is the best understanding of student nurses? Some patients need more or less than the average dose of drug. 38. Patient receives antibiotic for infections, patient asks the nurse why not give more to get better quicker. Best response more than likely already at maximum dose – more than that most likely will not help. More does not equal better. 39. you are conducting medication education about the differences between potency and efficacy. The nurse correctly determines that learning has occurred when the patient makes what response? Best drug for us is the one with the greater efficacy – potency ok but it’s about efficacy is this drug efficient enough to do the job. 40. A patient and his wife receive they same drug for hypertension. Patients wife asks the nurse why she is receiving a higher amount of medication what’s the nurse’s response. We are all unique, everyone responds differently to medication. 41. home health nurse that has discovered that the patient is doubling up on pain medication even though prescription dose was a therapeutic level. Patient says if one pill was good two pills are better. Which statement by the nurse describes the patients action? The patient is more likely to exhibit side effects from additional dose – the higher the dose the more side effects you see. 42. a drug has been prescribed to reduce the effect of an endogenous chemical. The nurse would place this drug in what category? Antagonistic drugs – a drug that tries to compete/removes med from receptors and laches on. 43. In the med surge unit a nurse gives a hypnotic medication to an older adult at 2100 hours (9PM). The next morning the patient is drowsy and wants to sleep instead of eating breakfast. What would be one of the factors in the possible causes of the drowsiness? more than likely this patient is older or has an impaired renal function. Hepatic system function cannot metabolize so they are holding on to the drug. 44. Nurse recognizes that agencies system and checks eliminates system errors – nurse collaborates with the pharmacist when dealing with medications. 45. Nurse administers and evening medication to a patient in the morning. Medication did go to correct patient. You just notify physician of error and then complete an incident report. 46. Nurse is preparing meds for a patient, another person begins telling nurse about her recent engagement. Tell the nurse convo is distracting lets talk about this when I’m finished. 47. You will be given four examples of medication errors. You’re going to choose the right one. which situation is an example of a medication error? Anything that deals with wrong dose, drawn up, even if can be caught and corrected before administration is still a medication error. Anything that deals with wrong dose of medication. Anything that violates the 5 rights. 48. patient is being d/c from hospital with new medication, what needs to be provided? Oral and written drug education. Mandated by Medicare and Medicaid. 49. You are caring for an Elderly in assisted living – what does the nurse assess as a primary contributing factor for drug toxicity in the elderly. Dehydration – it comes with getting old. 50. Public Health Care Nurse notices several patients in a hypertension clinic that have poorly controlled hypertension even though they have been prescribed the appropriate dosage of hypertension drug. Which questions will best enable nurse to assess these patients? Biggest questions is one of the problems you are having cost. Brand name – Generic. Is there a program that absorbs cost of drug? What are community resources.