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Medication And IV
Administration
NCLEX Form
A 64-year-old client has just had total hip replacement surgery. The physician orders heparin 8,000 units to be administered subcutaneously. The label on the heparin vial reads: "Heparin 10,000 units/ml." How many milliliters of heparin should the nurse draw up in the syringe to administer the correct dose? - correct answer ✅✅ 0. A 76-year-old client who failed swallowing studies has a nasogastric (NG) tube in place for medication administration. When the nurse checks the client's medications, she notices that only tablets have been dispensed by the pharmacy. How should the nurse proceed? - correct answer ✅✅ 2. Crush those tablets that may be crushed according to the manufacturer and administer them through the NG tube; request an alternate form of those that can't be crushed.
A child with type 1 diabetes develops diabetic ketoacidosis and receives a continuous insulin infusion. Which condition represents the greatest risk to this child? - correct answer ✅✅ 3. Hypokalemia A client admitted with bacterial pneumonia is prescribed cefuroxime axetil (Ceftin) 550 mg I.V. every 4 hours. While assessing the client, the nurse notices that cefazolin (Ancef) 500 mg I.V. is infusing. Which action by the nurse is most appropriate? - correct answer ✅✅ 4. Discontinuing the medication and notifying the physician of the error A client begins taking haloperidol (Haldol). After a few days, he experiences severe tonic contractures of muscles in the neck, mouth, and tongue. The nurse should recognize this as: - correct answer ✅✅ 4. dystonia. A client complains of difficulty swallowing when the nurse tries to administer a medication in capsule form. What should the nurse do to resolve this problem? - correct answer ✅✅ 4. Check for availability of a liquid preparation. A client complains of severe headache and blurred vision. The nurse immediately obtains vital signs, which reveal a blood pressure of 192/110 mm Hg. The
client to repeat the instructions. The nurse is performing which professional role? - correct answer ✅✅ 2. Educator A client is in the bathroom when the nurse enters to give a prescribed medication. What should the nurse do? - correct answer ✅✅ 3. Return shortly to the client's room and remain there until the client takes the medication. A client is prescribed a corticosteroid inhaler along with a bronchodilator inhaler. Which instruction about these drugs should the nurse give the client? - correct answer ✅✅ 2. "Use the bronchodilator first, then wait about 5 minutes before using the corticosteroid." A client is prescribed clozapine (Clozaril) 250 mg by mouth daily. How many tablets should the nurse administer if each tablet contains 100 mg? - correct answer ✅✅ 2. A client is prescribed digoxin (Lanoxin) 0.125 mg by mouth now. The pharmacy dispenses digoxin 0.25 mg. The nurse promptly administers the medication and then realizes she has administered the wrong dose. How should the nurse proceed? - correct answer ✅✅ 1. Obtain vital signs and notify the physician and nursing supervisor immediately of the error.
A client is prescribed metformin (Glucophage) to control type 2 diabetes. The nurse should monitor for which life-threatening adverse reaction? - correct answer ✅✅ 1. Lactic acidosis A client is receiving furosemide (Lasix), 40 mg by mouth twice per day. In the plan of care, the nurse should emphasize teaching the client about the importance of consuming: - correct answer ✅✅ 2. bananas and oranges. A client is scheduled for an excretory urography at 10 a.m. An order states to insert a saline lock I.V. device at 9:30 a.m.. The client requests a local anesthetic for the I.V. procedure and the physician orders lidocaine- prilocaine cream (EMLA cream). The nurse should apply the cream at: - correct answer ✅✅ 1. 7:30 a.m. A client is scheduled for surgery at 8 a.m. While completing the preoperative checklist, the nurse sees that the surgical consent form hasn't been signed. It's time to administer the preoperative analgesic. Which nursing action takes the highest priority in this situation? - correct answer ✅✅ 3. Notifying the surgeon that the consent form hasn't been signed
action or use of each medication before administering it A client newly diagnosed with diabetes mellitus is experiencing difficulty with self-administration of insulin. Despite further teaching, the client shows little improvement. What action by the nurse is most appropriate? - correct answer ✅✅ 3. Notify the physician of the client's lack of progress and request a diabetes education consult. A client requests his medication at 9 p.m. instead of 10 p.m. so he can go to sleep earlier. Which type of nursing intervention is required? - correct answer ✅✅ 4. Independent A client scheduled for a colonoscopy has received nothing by mouth since midnight. The procedure is scheduled for 8 a.m. At 6:30 a.m. the nurse collects a fingerstick glucose sample that registers 40 mg/dl on the glucose monitor. The client is alert, has clear speech, and states, "I don't feel like my sugar is too low." Initially, the nurse should: - correct answer ✅✅ 2. repeat the fingerstick glucose test. A client who sustained a head injury in a motor vehicle accident is prescribed phenytoin (Dilantin) liquid to prevent seizures. The client is unable to take anything
by mouth and has a feeding tube in place for enteral feedings. Which intervention by the nurse is most appropriate when administering phenytoin to this client? - correct answer ✅✅ 1. Administering the phenytoin 2 hours before or 2 hours after beginning the tube feedings A client who underwent abdominal surgery returns from the postanesthesia care unit with a nasogastric (NG) tube in place. The client complains of nausea. While preparing to attach the client's NG tube to intermittent suction, the nurse notices that the ground on the suction machine's plug is broken. What should the nurse do first? - correct answer ✅✅ 2. Obtain another machine from central supply. A client who's admitted with new-onset diabetes mellitus is prescribed an 1,800-calorie diabetic diet. His insulin orders include regular insulin coverage using a sliding scale, and long-acting insulin every morning just before breakfast. Why was the sliding scale insulin coverage prescribed? - correct answer ✅✅ 3. Directs the nurse to administer regular insulin doses according to finger-stick glucose levels without notifying the physician A client who's aphasic and has left-sided paralysis after sustaining a stroke is scheduled for debridement of a left leg ulcer. Whenever passive range-of-motion (ROM)
A client with hypothyroidism is prescribed levothyroxine (Synthroid) 0.05 mg by mouth daily before breakfast. As the nurse gives the client the medication, the client states, "What dose am I getting? I've been taking 0.15 mg every day for years." Which action by the nurse is most appropriate? - correct answer ✅✅ 3. Verifying the dose with the physician's order on the client's medical record A drug must enter the bloodstream before it can act within the body. Which parenteral administration route places a drug directly into the circulation, requiring no absorption? - correct answer ✅✅ 4. I.V. A facility has a system for transcribing medication orders to a Kardex as well as a computerized medication administration record (MAR). A physician writes the following order for a client: "Prednisone 5 mg by mouth daily for 3 days." The order is correctly transcribed on the Kardex. However, the nurse who transcribes the order onto the MAR neglects to place the limitation of 3 days on the prescription. On the 4th day after the order was instituted, a nurse administers prednisone 5 mg by mouth. During an audit of the chart, the error is identified. The person most responsible for the error is the: - correct answer ✅✅ 2. nurse who administered the erroneous dose.
A geriatric client who experiences several adverse drug reactions may benefit from: - correct answer ✅✅ 1. reduced drug dosages. A home care nurse is collecting data on a geriatric client. What is the most common cause of medication errors in noninstitutionalized geriatric clients? - correct answer ✅✅ 1. Deficient knowledge A medication order reads "Meperidine 1 ml I.M. stat." The nurse responsible for administering the drug should base the next action on which understanding? - correct answer ✅✅ 3. The order should be clarified with the physician. A nurse is caring for a client with a history of GI bleeding, sickle cell disease, and a platelet count of 22,000/μl. The client is dehydrated and receiving dextrose 5% in half-normal saline solution at 150 ml/hour. He reports severe bone pain and is scheduled to receive a dose of morphine sulfate. In administering the medication, the nurse should avoid which route? - correct answer ✅✅ 3. I.M. A nurse is teaching a client about a newly prescribed drug. What could cause a geriatric client to have difficulty learning about prescribed medications? - correct answer ✅✅ 2. Sensory deficits
After intentionally taking an overdose of hydrocodone (Vicodin), a client is admitted to the emergency department. Activated charcoal is prescribed. Before administering the drug, the nurse should ensure that the client: - correct answer ✅✅ 4. has audible bowel sounds. After knee replacement surgery, a client is being discharged with a prescription for acetaminophen and codeine tablets, 30 mg, for pain. During discharge preparation, the nurse should include which instruction? - correct answer ✅✅ 1. "Avoid driving a car while taking this medication." After laparoscopic cholecystectomy, a 43-year-old client complains of pain and nausea. The nurse is preparing meperidine hydrochloride (Demerol) 75 mg and promethazine hydrochloride (Phenergan) 12.5 mg to be administered I.M. in the same syringe. If the label on the Demerol reads 50 mg/ml and the label on the Phenergan reads 25 mg/ml, how many milliliters should the nurse have in the syringe after the correct doses are drawn up? - correct answer ✅✅ 2 After reconstituting a multidose vial of medication, the nurse writes the date and time of reconstitution on the vial label. What else should the nurse write on the label? - correct answer ✅✅ 2. Strength of the medication
As a result of a serious motorcycle accident, a client suffers paraplegia. When the nurse tries to administer medication, the client refuses it, saying, "I don't have to take those pills if I don't want to. What good will they do?" Which action by the nurse would be most appropriate? - correct answer ✅✅ 4. Exploring how the client's feelings affect the decision to refuse medication Before administering the evening dose of a prescribed medication, the nurse on the evening shift finds an unlabeled, filled syringe in the client's medication drawer. What should the nurse do? - correct answer ✅✅ 1. Discard the syringe to avoid a medication error. Following a fall from a horse during rodeo practice, an 18-year-old client is seen in the emergency department. He has a large, dirty laceration on his leg. The wound is vigorously cleaned, closed, and dressed. In the past, the client has received the full immunization regimen for tetanus toxoid. The nurse asks the client about his tetanus immunization history, and he says, "I had my last shot when I was 11 years old." The nurse should: - correct answer ✅✅ 3. plan on administering a dose of tetanus vaccine.
Small air bubbles adhering to the interior surface of the syringe might have which effect with parenteral administration? - correct answer ✅✅ 4. Altered drug dose The client is to receive an I.V. infusion of 3,000 ml of dextrose and normal saline solution over 24 hours. The nurse observes that the rate on the infusion pump is set at 150 ml/hour. If the solution runs continuously at this rate, the infusion will be completed in: - correct answer ✅✅ 2. 20 hours. The label of a drug package reads "hydralazine (Apresoline), 20 mg/ml." How many milliliters would the nurse give a client for a 25-mg dose? - correct answer ✅✅ 3. 1. The nurse administers an I.M. injection. Afterward, the nurse should: - correct answer ✅✅ 3. discard the uncapped needle in a puncture-proof container. The nurse administers hydromorphone (Dilaudid) 2 mg I.V. to a client complaining of incisional pain. While documenting the administration, the nurse notes that the medication was prescribed by the I.M. route. Which action should the nurse take? - correct answer ✅✅ 3. Obtain vital signs and notify the physician and nursing supervisor of the error.
The nurse has an order to administer an I.M. injection using the Z-track technique. When carrying out this order, what should the nurse do? - correct answer ✅✅ 4. Simultaneously withdraw the needle and release the skin. The nurse has an order to administer an iron dextran 50 mg I.M. injection. When carrying out this order, the nurse should: - correct answer ✅✅ 4. use the Z-track technique. The nurse inadvertently gives a client a double dose of a prescribed medication. After discovering the error, whom should the nurse notify? - correct answer ✅✅ 2. The prescriber The nurse is administering ampicillin (Polycillin) 125 mg I.M. every 6 hours to a 10-kg child with a respiratory tract infection. The drug label reads, "The recommended dose for a client weighing less than 40 kg is 25 mg to 50 mg/kg/day I.M. or I.V. in equally divided doses at 6- to 8-hour intervals." The drug concentration is 125 mg/5 ml. Which nursing interventions are appropriate at this time? - correct answer ✅✅ 3. Assess the client for allergies to penicillin.,
- Administer the medication because it's within the
drug produces when given alone? - correct answer ✅✅ 4. Synergism The nurse is calculating the proper dosage of medication for a child. What parameters should this calculation be based on? - correct answer ✅✅ 2. Body weight The nurse is caring for a 62-year-old client with type 2 diabetes. The client takes an oral antidiabetic to control blood glucose levels. The physician prescribed ramipril (Altace) to help treat this client's elevated blood pressure. The nurse should be alert for which drug interaction? - correct answer ✅✅ 1. Hypoglycemia The nurse is caring for a 72-year-old client with heart failure. When administering drug therapy, the nurse must stay especially alert for adverse effects. Which factor makes geriatric clients more vulnerable than younger clients to adverse drug effects? - correct answer ✅✅ 2. Hepatic and renal changes The nurse is caring for a client who is taking an anticoagulant. The nurse should teach the client to: - correct answer ✅✅ 2. avoid foods high in vitamin K.
The nurse is caring for a client who underwent internal fixation of the right hip. Before administering the client's warfarin (Coumadin), the nurse checks the laboratory report for the client's International Normalized Ratio (INR) results. Which of the following indicates the therapeutic range for this client? - correct answer ✅✅ 3. 2.0 to 3. The nurse is checking a client's I.V. infusion rate at the beginning of her shift. The nursing Kardex states that the infusion should run at 125 ml/hour. To verify the I.V. drip rate, the nurse must know the drip factor, which is: - correct answer ✅✅ 2. the number of drops in one milliliter. The nurse is delivering the client's 10 a.m. medications. The client is away from his room for a diagnostic study. Which action is most appropriate for the nurse to take? - correct answer ✅✅ 3. Lock the medications in the medicine preparation area until the client returns. The nurse is developing a teaching plan for a client who has just been diagnosed with breast cancer. The nurse should include information about which medication? - correct answer ✅✅ 3. Tamoxifen (Nolvadex)
