Medication Administration
A student nurse is administering meds to a client through a G-tube. Which of the following actions requires the clinical instructor to intervene? A.) The student places all meds in different medicine cups, B.) The student evaluates each med and holds the feeding before administering a med that needs to be given on an empty stomach, C.) The student flushes the tube with 30 mL of water between each med, D.) The student crushes Nifedipine extended-release and mixes with water before administering.
What is: D.) The student crushes Nifedipine extended-release and mixes with water before administering.
For which of the following health problems is a client who has a 40-year smoking history at risk? A.) Alcoholism and HTN, B.) Obesity and DM, C.) Stress-related illness, D.) Cardiopulmonary disease and lung cancer
What is: D.) Cardiopulmonary disease and lung cancer
A nurse is preparing to administer Amoxicillin 0.25 g PO Q8hr. The amount available is Amoxicillin oral suspension 250 mg/5 mL. How many mL should the RN administer/dose? (If needed, round to the nearest tenth).
What is: 5 mL
Ex 1) Ordered 0.25 g x 1000 = 250 mg/250 mg = 1 x 5 mL
Ex 2) x mL = 5 mL x 1000 mg x 0.25 g
250 mg 1 g
= 1250/250 = 5
A client who had a CVA/Stroke has persistent problems with dysphagia. The nurse caring for him should initiate a referral with which of the following members of the inter-professional health care team? A.) Social Worker, B.) Assistive Personnel, C.) Occupational Therapist, D.) Speech-Language Pathologist
What is: D.) Speech-Language Pathologist
A nurse is planning care for a client that has AIDS. The nurse knows to wear gloves under which of the following circumstances? (Select-all-that-apply): A.) When the client has an open wound, B.) During all contact with the client, C.) When starting an IV catheter, D.) When drawing blood
What is: A.) When the client has an open wound, C.) When starting an IV catheter, D.) When drawing blood
A nurse admits a 72 year-old client with a medical history of HTN, HF, RF and Depression to a med/surg unit. The nurse reviews the client's medication orders and notes that she has 3 HC providers who have ordered 13 different meds. What action should the nurse take? A.) Do 2 patient identifiers, then give the meds, B.) Provide education to help with medication adherence, C.) Review the list of meds with the HC providers to confirm if the client needs all 13, D.) Set up a med administration schedule that is least disruptive to the client while in the hospital.
What is: C.) Review the list of meds with the HC providers to confirm if the client needs all 13
A client is admitted with a diagnosis of L-sided HF. What adventitious lung sounds are expected upon auscultation? A.) Sonorous wheezes in Left LL, B.) Rhonchi mid sternum, C.) Crackles only in apex of lungs, D.) Inspiratory crackles in lung bases
D.) Inspiratory crackles in lung bases
A nurse is preparing to administer Heparin 8,000 units subcutaneously Q12 hr. Available Heparin injection is 10,000 units/mL. How many mL should the RN administer/dose? (if needed round to nearest tenth)
What is: 0.8 mL
Ex 1) Ordered 8,000 IU/Available 10,000 IU = 0.8 mL
Ex 2) x mL = 1 mL x 8,000 IU = 0.8
10,000 IU
A nurse is performing an admission assessment for an older adult client. After gathering the assessment data and performing a review of systems (ROS), which of the following actions is a priority for the nurse? A.) Orient the client to the room, B.) Conduct a patient care conference, C.) Review the medical prescriptions, D.) Develop a plan of care
What is: A.) Orient the client to the room
The RN is performing a nutrition assessment on a client. Which of the following clinical findings are suggestive of malnutrition? (Select-all-that-apply): A.) Poor wound healing, B.) Brittle, dry hair, C.) BP 130/80, D.) Weak hand grips, E.) Impaired gait and coordination
What is: A.) Poor wound healing, B.) Brittle, dry hair, D.) Weak hand grips, E.) Impaired gait and coordination
After receiving an IM injection in the deltoid the client states, "My arm really hurts. It's burning and tingling where I got my injection". What should the nurse do next? (Select-all-that-apply): A.) Assess the injection site, B.) Administer an oral med for pain, C.) Notify the HC provider of assessment findings, D.) Document the findings and interventions in the EHR, E.) This is a normal finding, so nothing needs to be done, F.) Apply ice t the site to relieve the burning.
What is: A.) Assess the injection site, C.) Notify the HC provider of assessment findings &D.) Document the findings and interventions in the EHR
The nurse assesses a new client and finds the client is short of breath with a respiratory rate of 32 and lying supine in bed. What is the priority nursing action? A.) Raise the HOB to 45 degrees or higher, B.) Get the O2 sat with the pulse oximeter, C.) Take the BP and RR, D.) Notify the HC provider of the SOB
What is: A.) Raise the HOB to 45 degrees or higher
A nurse is preparing to administer Dextrose 5% in water (D5W) 500 mL IV to infuse over 4 hr. The nurse should set the IV pump to deliver how many mL/hr? (If needed round to nearest whole number)
What is: 125 mL/hr
Ex 1) 500 mL/4 hr = 125 mL/hr
Ex 2) x mL = 500 mL = 125 mL/hr
hr 4 hr
The RN is educating a client who has Anemia about dietary intake if Iron. Which of the following is a non-heme source of Iron? A.) Ground beef, B.) Dried beans, C.) Salmon, D.) Turkey
What is: B.) Dried beans
What is: A.) Try calling again and apologize to the client for the wait *D is possible if no other help is available, but should really use another staff member or lifting device.
A nurse prepares an injection of Morphine to administer to a client who reports again, then asks a second nurse to give the injection because another client needs to use a bedpan. Which of the following actions should the second nurse take? A.) Offer to assist the client who needs to use the bedpan, B.) Administer the injection to the first client, C.) Prepare another syring to administer the injection or D.) Tell the client who needs the bedpan to waitf while the first nurse gives the injection
What is: A.) Offer to assist the client who needs to use the bedpan
What is: B.) Oropharyngeal suctioning of a stable client & D.) Permanent trach tube suctioning
A nurse is preparing to administer Ranitidine 150 mg by intermittent IV bolus. The available dose is Ranitidine 150 mg in 100 mL of 0.98% NaCl to infuse over 30 min. *We don't have an IV pump. the drop factor of the IV tubing is 10 gtt/mL. The nurse should administer manual IV infusion to deliver how many gtt/min? (If needed round to the nearest whole number).
What is: 33 gtt/min
Ex 1) mL x gtt/mL = 100 mL x 10 gtt/mL
time (in min) 30 min
= 1000/30 = 33.3333 = round down to 33 gtt/min
Ex 2) gtt = 10 gtt x 100 mL = 1000/30
min 1 mL 30 min
What is: A.) Pulses, B.) Capillary refill, C.) Skin temperature, E.) Pain, tingling, numbness or inability to move toes
A triage nurse is reviewing messages from 4 clients. Which client is the nurses' priority? A.) Adult male with cloudy urine and fever of 38.6 F/101.4F, B.) Adult female with pain in the jaw and back pain that has become more intense in the past 15 minutes, C.) Adult female with hot flashes and irritability to sleep for the past 4 nights, D.) Older adult male with a closed fracture of the tibia who rates his pain level as 7/10
What is: B.) Adult female with pain in the jaw and back pain that has become more intense in the past 15 minutes
A nurse educator is teaching newly-licensed RNs about safe medication administration. Which of the following statements indicates understanding? (Select-all-that-apply): A.) "I will observe for adverse effects", B.) "I will monitor for therapeutic effects", C.) "I will prescribe the appropriate dose", D.) "I will change the dose if adverse effects occur", or E.) "I will refuse to give a medication if I believe it is unsafe"
What is: A.) "I will observe for adverse effects", B.) "I will monitor for therapeutic effects" & E.) "I will refuse to give a medication if I believe it is unsafe"
A client was admitted following an MVA with multiple fractured ribs. Respiratory assessment includes signs/symptoms of secondary pneumothorax. Which are the most common assessment findings associated with a pneumothorax? (Select-all-that-apply): A.) Sharp pleuritic pain that worsens on inspiration, B.) Crackles over lung bases of affected lung, C.) Tracheal deviation toward affected lung, D.) Worsening dyspnea, E.) Absent lung sounds to auscultation on affected side
What is: A.) Sharp pleuritic pain that worsens on inspiration, D.) Worsening dyspnea & E.) Absent lung sounds to auscultation on affected side
A nurse is preparing to administer Cefixime 8 mg/kg/day PO to divide equally every 12 hr to a toddler who weighs 22 lb. Available Cefixime suspension is 100 mg/5 mL. How many mL/dose will the RN administer? (If needed round answer to the nearest whole number).
What is: 2 mL/dose
Ex 1) Order 8 mg/1 kg/1 day
Available 100 mg/5 mL
x kg = 1 kg x 22 lb = 10 kg
2.2 lb
(8 mg x 10 kg)= 80 mg/day *can divide in 1/2 now to 40 mg BID
Order 40 mg/Available 100 mg = 0.4 x 5 mL = 2 mL
Ex 2) x mL = 5 mL x 40 mg/kg/12 hr = 200
100 mg 100
= 2 mL
Mr. Vargas has supraventricular tachycardia and has a maintenance infusion of Esmolol 100 mcg/kg/min ordered. The medication is available as Esmolol 10 mg/mL. The client's weight is 80 kg. At what rate in mL/hr should the RN set the IV pump? (If needed round to the nearest whole number).
What is: 48 mL/hr
Ex 1) Order (100 mcg x 80 kg) = 8,000 mcg/kg/60 min/Available (10 mg x 1000) = 10,000 mcg/mL
480,000/10,000 = 48 mL/hr
Ex 2) x mL = 1mL x 1mg x 8000 mcg/kg x 60 min
hr 10 mg x 1000 mcg x 1 min x 1 hr
480,000/10,000 = 48 mL
The MD orders a medication to be given at 5 mg/kg. The client weighs 155 lb. How many mg/dose will the RN administer? (If needed round to the nearest whole number).
What is: 352 mg/dose
Ex 1) Order 5 mg/kg, weight is 155 lb
x kg = 1 kg x 155 lb = 155/2.2 = 70.45 kg x 5 mg
2.2 lb
= 352.27 round down to 352 mg/dose
Ex 2) x mg = 5 mg x 1 kg x 155 lb
1 kg x 2.2 lb
775/2.2 = 352 mg/dose