F
A nurse plans to teach a 4-year-old about what to expect after his broken arm has been casted by:
a. bringing a doll and casting materials to the room, showing the casting materials and actually casting the doll’s arm, and explaining the purpose of the cast.
b. telling the child that while he is asleep, the doctor will take off his arm and wrap it up.
c. breaking up the patient education sessions into two separate 5-minute sessions.
d. being treated as an adult because this approach helps the child to feel “grown up.”
C
Children benefit from patient education that is geared toward their age and level of understanding. Patient education in short sessions, allowing for the child’s brief attention span, will enhance patient education. Children are very literal and improbable stories will be believed.
The best way for a nurse to reinforce learning during a return demonstration by the patient is for the nurse to:
a. give recognition and praise for the parts the patient does well and to assist or teach when the patient becomes confused or forgetful.
b. watch quietly until the return demonstration is finished and then list the errors.
c. instruct the patient to read the written material again when an error is made.
d. stop the patient each time he makes a mistake and have him start again after the nurse reviews the procedure with him.
A
Praise and “walking through” the procedure reinforces learning.
A patient states, “I don’t think I’ll ever be able to give myself an injection.” The best reply by the nurse is:
a. “Everyone feels like that at first. You’ll get over it.”
b. “Don’t be afraid. It’s an easy skill for anyone to learn.”
c. “What bothers you most about the idea of giving yourself an injection?”
d. “I know just how you feel. I would have trouble giving myself an injection.”
C
When a patient lacks self-confidence, the nurse needs to explore the patient’s feelings.
The nurse takes into consideration that when using printed patient education material for a 65-year-old Middle Eastern patient who speaks perfect English, the nurse should:
a. use patient education material printed in English.
b. determine if the patient can read English.
c. engage a translator to read the English material to the patient.
d. use English material that is printed in bold type on white paper.
B
Determine if the patient is literate in English. If not, a translator may be able to rewrite the instructions in the preferred language. Simply reading the English version is not helpful if the patient is to refer to the material after discharge. Bold print will not help a person who does not read English.
Because a person may learn best in a particular manner, to improve patient education, the nurse should:
a. ask the patient whether he learns best visually, aurally, or kinesthetically.
b. use a hands-on approach, because it works best for most people.
c. test the patient’s reading comprehension before using visual handouts.
d. use a combination of the three modes of learning to enhance learning.
D
Many people do not know which mode of learning is their dominant one, and most people learn best with a combination of patient education/learning techniques.
Once a patient education plan is formulated and placed in the nursing care plan for a hospitalized patient:
a. one nurse will be designated to teach the plan on a priority basis.
b. behavioral objectives are used to identify expected outcomes.
c. it is printed and given to the patient as a guide for learning.
d. it outlines all that will be taught before the patient is discharged.
B
Behavioral objectives identify actions that can be measured; thus they serve as evaluation tools of expected outcomes. Many people are involved in a patient education plan, with responsibility designated in the plan. Not all of the patient education plan may be accomplished during the hospital stay. Priorities identify which learning needs are most important to teach before discharge and which can be taught by the community nurse after discharge.
A nurse is showing a diabetic patient how to draw insulin out of a syringe. The mode of learning that the nurse is using is:
a. auditory learning.
b. visual learning.
c. kinesthetic learning.
d. oral learning.
B
Visual learning is based on learning through what the learner sees.
A nurse has an order to administer a schedule II drug to a patient. When working with medications of this type, the responsibility of the nurse is to:
a. leave the medication in a cup at the bedside.
b. ask another licensed nurse to check the dose.
c. sign out the drug on a narcotic control inventory sheet.
d. tell the patient to drink extra water with the pill.
C
Schedule II drugs are narcotics, which are controlled substances that are kept in a locked area on the nursing unit, and each dose must be signed out.
The nurse is aware that the primary care provider has ordered a pain relief drug to be delivered in the manner in which postoperative pain would be relieved most rapidly. This method is:
a. intradermally.
b. orally.
c. intramuscularly.
d. intravenously.
D
Intravenously administered medications are absorbed more quickly than medications administered by other routes.
A nurse is administering a medication to an older adult patient who is normally highly protein bound. The nurse would be concerned about increased drug activity and possible toxicity if the patient’s laboratory values show:
a. low albumin levels.
b. high glucose levels.
c. low sodium levels.
d. high potassium levels.
A
Albumin is a type of protein, and this patient is at risk if the albumin level is low, because this larger amount of drug will circulate in unbound form, increasing risk of adverse and toxic effects.
A patient with liver disease is beginning medication therapy with a drug that is metabolized in the liver. The nurse anticipates the dose of the medication to be:
a. increased above the normal dose.
b. double the normal dose.
c. unchanged from the normal dose.
d. lower than the normal dose
D
When there is a decrease in liver function resulting from disease or aging, a smaller dose may be ordered to prevent excess drug accumulation and development of toxicity.
not given late to keep the circulating drug level above the:
a. peak concentration level.
b. minimum concentration level.
c. average concentration level.
d. baseline concentration level.
B
If a drug is given late, the concentration level of the drug in the circulation could drop below the minimum effective concentration level.
A patient is receiving an initial dose of penicillin for pneumonia. The nurse should be alert and monitor for:
a. hives.
b. nausea.
c. fever.
d. dizziness.
A
A rash or hives can indicate allergic response; nausea and dizziness are examples of adverse drug effects. With an allergic reaction the patient is cautions to never take the drug again.
A nurse is reinforcing instructions to a patient who is beginning medication therapy with a central nervous system (CNS) depressant drug. The nurse cautions the patient not to drink alcohol, because alcohol and the drug could cause a synergic effect, which means:
a. the alcohol makes the drug have less than the desired effect.
b. the drug undergoes a rapid breakdown and is rapidly excreted.
c. the drug and alcohol increase the effect on the central nervous system.
d. the drug changes the alcohol to a toxic substance.
C
Alcohol has a synergistic effect when combined with any drug that depresses the CNS, because it is also a CNS depressant. The combination of the two makes the drug more powerful.
A patient who is to receive a daily medication by the oral route has had nausea and vomiting for the last 24 hours. The best action to ensure that the patient receives the scheduled dose is to:
a. have the patient take the pill with sips of water.
b. have the patient take the pill with crackers.
c. acquire an order to administer by the rectal or parenteral route.
d. withhold the dose for 1 hour and see whether the nausea subsides.
C
When a patient is experiencing nausea and vomiting, the nurse can consult with the primary care provider to get an order for the drug to be changed to the rectal or parenteral route, as long as the drug is also supplied in that form.
A hospitalized 3-year-old toddler is to receive an oral medication. For the most effective approach, the nurse should tell the child:
a. firmly that the drug is important to take as soon possible.
b. in a confident manner what the medication is for and how it will be given.
c. that the medication is candy and tastes good.
d. that it will make him feel better right away.
B
The best approach is to confidently explain to the child what the drug is for and how it will be given using simple language and short sentences.
An older adult patient with arthritis who has been taking anti-inflammatory drugs for the last 5 years should be monitored for:
a. dizziness and fever.
b. abdominal cramps and bloating.
c. restlessness and dyspnea.
d. gastrointestinal (GI) bleeding and anemia.
D
Older patients who are on long-term anti-inflammatory therapy for arthritis should be monitored for GI bleeding and anemia.
An older adult patient who lives in a skilled nursing facility and who likes to walk is taking a medication that lowers blood pressure by dilating blood vessels. The best nursing action for this patient is to:
a. suggest total bed rest.
b. monitor intake and output.
c. assist the patient when ambulating in the hall.
d. instruct the resident to rise slowly when getting out of bed or a chair.
D
Older adult patients are likely to have greater blood pressure fluctuations with position changes and are more susceptible to falls when taking drugs that cause orthostatic hypotension. Assistance with ambulation may offer safety, but if the patient has already fallen when getting out of bed or a chair, assisted ambulation is pointless.
The nurse explains that a drug may have several names. The trade name is the only name that can be:
a. used in an order.
b. trademarked.
c. recognized as its chemical makeup.
d. used by retailers to sell the drug.
B
The trade name of a drug is patented or trademarked. Generic names cannot be trademarked and are frequently cheaper to purchase under that name. The chemical name is one that identifies the compounds in the drug. Retailers can sell the drug by either name.
The nurse is aware that for a drug to be effectively eliminated from the body, the patient must have a fluid intake of 50 mL/kg/day. The nurse would provide for a patient who weighs 125 pounds ______ mL of water per day.
a. 1560
b. 899.2
c. 2840.9
d. 3039.1
C
The patient’s weight is 125 pounds/2.2 pounds = 56.8 kg ?0´ 50 mL = 2840.9 mL.
Before administering a medication to a newly assigned patient, the nurse should determine why the patient is receiving it by checking the:
a. medication administration record (MAR) or electronic medication administration record (eMAR).
b. medical history.
c. laboratory test results.
d. intake and output record.
B
The medical history contains information about the medical problems a patient has, so the nurse can correlate the reason a drug is being administered.
The nurse is going to administer a medication that must be crushed for the patient to take it. This medication is best given to the patient by:
a. adding it to water.
b. dissolving it in juice.
c. mixing it in applesauce or soft food.
d. sprinkling it on meat or vegetables
C
A drug that is crushed needs to be mixed in something else, such as applesauce.
When the nurse is administering a medication to a patient, the patient states that the tablet looks different from the one usually taken. The most prudent action by the nurse would be to:
a. reassure the patient that the medication is the same as the one ordered.
b. determine why the patient is refusing to take the medication and call the primary care provider.
c. assess for possible causes of this patient’s confusion.
d. withhold the dose and verify the drug order.
D
If a patient questions the dose given, the nurse should stop and verify the order.
A patient is due for a 40 mg dose of furosemide (Lasix), at 9:00 AM on May 5, 2020. The drug label reads “20 mg per tablet.” The tablets in the bottle appear firm and unbroken. The expiration date on the bottle reads “April 2, 2020.” The best nursing action is to:
a. administer two tablets.
b. administer one half tablet.
c. call the pharmacy to see if 40 mg tablets are available.
d. call the pharmacy for a new bottle of the medication.
D
The pharmacy should be called, because the medication is past the expiration date and should not be given to the patient
A nurse is administering medications to a group of patients. The safest way to identify each patient is to:
a. call each patient by his given name, ask for his birthday, and compare with the MAR or eMAR.
b. check the patient’s name on the wristband and compare it with the MAR or eMAR.
c. check the name and identification number on the wristband and compare them to the MAR.
d. check the patient’s identification number on the wristband.
C
The best method is to check both the name and identification number on the wristband and compare them to the MAR or eMAR.