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NR 224 Fundamentals Final EXAM
WITH 10 0 QUESTIONS AND CORRECTLY
DETAILED ANSWERS (VERIFIED ANSWERS)
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A nurse knows that patient education has been effective when the patient states - ANSWER>>"I will rotate the location where I give myself injections." Which statement by the patient is an indication to use the Z-track method? - ANSWER>>"The last shot like that turned my skin colors." A 2-year-old child is ordered to have ear irrigation performed daily. The nurse correctly performs the procedure by - ANSWER>>Pulling the auricle down and back to straighten the ear canal. A patient has an order to receive 10 units of U-50 insulin. The nurse is using a U-100 syringe. How many units should the nurse draw up in the syringe and administer? - ANSWER>>20 units A patient has an order to receive 20 units of U-50 insulin. The nurse is using a U-100 syringe. How many units should the nurse draw up in the syringe and administer? - ANSWER>>0.4 mL
The patient is to receive phenytoin (Dilantin) at 0900. The nurse knows that the ideal time to draw a trough level is - ANSWER>>0830. A patient who has been receiving intermittent chemotherapy through a peripheral IV site is ordered to receive a high dose of vancomycin through the same vein. Why does this concern the nurse? - ANSWER>>Chemotherapy is irritating to the vascular system and may cause the vein to infiltrate. A physician orders 1000 mL of normal saline to infuse at a rate of 50 mL/hr. The nurse plans on hanging a new bag at what time? - ANSWER>>20 hours The nurse is preparing to administer a 0.5-mL rabies vaccine into the deltoid muscle of a patient. Which needle size is best for the procedure? - ANSWER>>25 gauge x 5/8 inch The nurse knows that the purpose of aspiration on IM injections is to - ANSWER>>Ensure proper placement of the needle. The nurse is giving an IM injection. Upon aspiration, the nurse notices blood return in the syringe. What should the nurse do? - ANSWER>>Withdraw the needle and prepare the injection again. The nurse is planning to administer a tuberculin test with a 27- gauge, 3/8-inch needle. The nurse should insert the needle at an angle of _____ degrees. - ANSWER>> The nurse knows to assess for signs of medication toxicity within older adults because of which physiological change? - ANSWER>>Reduced glomerular filtration A registered nurse interprets that a scribbled medication order reads 25 mg. The nurse administers 25 mg of the medication to a
A patient needs assistance excreting a gaseous medication. What is the correct nursing action? - ANSWER>>Encourage the patient to cough and deep-breathe. A nurse has withdrawn a narcotic from the medication dispenser. Upon checking the drug against the medication administration record, the nurse notices that the narcotic order has expired. What should be the nurse's first action? - ANSWER>>Return the medication to the medication dispenser according to protocol. The nurse knows that patient education about a buccal medication has been effective when the patient states - ANSWER>>"I should let the medication dissolve completely." What is the nurse's priority action to protect a patient from medication error? - ANSWER>>Requesting that the prescriber write out an order, rather than giving a verbal order The patient is in severe pain and is requesting a prn medication before the prn time interval has elapsed. The nurse's priority is to
- ANSWER>>Call the prescriber and request a stat order. A patient is at risk for aspiration. What nursing action is most appropriate? - ANSWER>>Have the patient self-administer the medication. A confused patient refuses his medication. What is the nurse's first response? - ANSWER>>Educates the patient about the importance of the medication A patient who is being discharged today is going home with an inhaler. The patient is to administer 2 puffs of his inhaler twice daily. The inhaler contains 200 puffs. When should the nurse appropriately advise the patient to refill his medication? - ANSWER>>6 weeks from the start of using the inhaler
The nurse knows that a subcutaneous injection takes longer to absorb because - ANSWER>>Fewer blood vessels are found under the subcutaneous level. The nurse realizes which patient is at greatest risk for an unintended synergistic effect? - ANSWER>>72-year-old who is seeing four different specialists Which patient using an inhaler would benefit most from using a spacer? - ANSWER>>25-year-old with multiple sclerosis The prescriber wrote for a 40-kg child to receive 25 mg of medication 4 times a day. The therapeutic range is 5 to 10 mg/kg/day. What is the nurse's priority? - ANSWER>>Notify the physician that the prescribed dose is below the therapeutic range. The nurse is administering an intravenous medication that is to be administered over 10 minutes. Which method should the nurse choose to efficiently administer the medication? - ANSWER>>Attach separate tubing and set the medication syringe in a mini-infusion pump. patient's peripheral IV, the patient complains of pain. Upon assessment, the nurse notices a red streak that is warm to the touch. What is the nurse's initial action? - ANSWER>>Apply a cool compress to the site. The nurse is preparing to administer medications to two patients with the same last name. After the administration, the nurse realizes that she did not check the identification of the patient before administering medication. Which of the following actions should the nurse complete first? - ANSWER>>Return to the room to check and assess the patient.
A patient who is receiving IV fluids notifies the nurse that his arm feels tight. Upon assessment, the nurse notes that the arm is swollen and cool to the touch. What should the nurse's first action be? - ANSWER>>Discontinue the IV site, and apply a warm compress. A patient informs the nurse that his urine is starting to look discolored. How should the nurse respond? - ANSWER>>"Other than the discoloration, has anything changed with your urination?" The physician orders 4 mg of oxycodone to be delivered every 6 hours. After 4 hours, the patient is complaining that she is in more pain. The nurse advises the physician to make which medication adjustment? - ANSWER>>Divide the dose in half and administer 2 mg every 3 hours. Which of the following are methods to reduce the risk of needlestick injury? (Select all that apply.) - ANSWER>>b. Have sharps boxes emptied when three-quarters full. d. Never force a needle into the sharps disposal. e. Clearly mark sharps disposal containers. f. Use needleless devices whenever possible. What methods are used to properly discard narcotics? (Select all that apply.) - ANSWER>>b. Washing liquids down the sink c. Flushing tablets down the toilet A patient is taking 1 tablet of hydrocodone bitartrate 5 mg and acetaminophen 500 mg (Vicodin) every 4 hours. He is also taking 2 tablets of acetaminophen (Tylenol) 325 mg every 12 hours. How many grams of acetaminophen is he taking daily? - ANSWER>>3.
The nurse is administering 250 mg of a medication elixir to the patient. The medication comes in a dose of 1000 mg/5 mL. How many milliliters should the nurse administer? - ANSWER>>1. The patient is to receive amoxicillin (Moxatag) 500 mg q8h; the medication is dispensed at 250 mg/5 mL. How many teaspoons would the nurse administer for one dose? - ANSWER>>2 tsp The nurse is having difficulty reading of physician's order for a medication. He or she know that the physician is very busy and does not like to be called. What is the most appropriate next step for the nurse to take? - ANSWER>>Call the physician to have the order clarified. you must have the right documentation and clarify all orders with the prescriber before administering medications The patient has an order for 2 tablespoons of milk of magnesia. How much medication does the nurse give him or her? - ANSWER>>30 ML 1 table spoon= 15ml 2 tablespoons=30ml In nurses administering ear drops to an 8-year-old patient with an ear infection. How does the nurse pull the patient's ear when administering the medication? - ANSWER>>upward and outward for patients older than 3 years of age The patient is to receive cephalexin (Keflex) 500 mg PO. The pharmacy has sent 250-mg tablets. How many tablets does the nurse administer?. - ANSWER>>2 tablets
What is the nurses next action? - ANSWER>>Ask the patient's reason for refusal. The nurse receives an order to start getting a loop diuretic to a patient to help lower his or her blood pressure. The nurse determines the appropriate route for administering the diuretic according to: - ANSWER>>The prescriber's order. the order from the perscriber needs to indicate the route of administration A patient is receiving intravenous (IV) push medication. If the drug infiltrates into the outer tissues, the nurse: - ANSWER>>Stops the administration of the medication and follows agency policy. If a patient who is receiving intravenous (IV) fluids develops tenderness, warmth, erythema, and pain at the site, the nurses suspects: - ANSWER>>Phlebitis. After seeing a patient, the physician gives a nursing student a verbal order for a new medication. The nursing student first needs to: - ANSWER>>Explain to the physician that the order needs to be given to a registered nurse. A nurse accidentally gives a patient a medication at the wrong time. The nurse's first priority is to: - ANSWER>>Assess the patient for adverse effects. Which of the following factors is associated with rapid absorption of a drug? - ANSWER>>Intravenous route of administration. What is the term used for the concentration of drug in the blood serum that produces the desired effect without causing toxicity? - ANSWER>>Therapeutic range.
What is the term used for the highest plasma concentration? - ANSWER>>Peak level. What is the term used for the point when a drug is at the lowest concentration? - ANSWER>>Trough level. What is the term used for the amount of time it takes for 50% of the blood concentration of a drug to be eliminated from the body?
- ANSWER>>Half-life. Which organ is the primary site for drug metabolism? - ANSWER>>Liver. The nurse transcribes an order that reads: Colace 100 mg PO daily. This is an example of which type of order? - ANSWER>>Standing order. A graduate nurse is administering several medications to a newly admitted patient. Who is legally responsible for the drugs administered by this nurse? - ANSWER>>The nurse administering the drugs. Which system of measurement is most accurate and precise for drug administration? - ANSWER>>Metric system. The nurse is preparing to administer a medication via a nasogastric tube. What guideline is appropriate for the nurse to follow when administering a drug via this route? - ANSWER>>Flush the tube with water between each drug administered. Which parenteral route of administration has the longest absorption? - ANSWER>>Intradermal.
mcg tablets. How many of the tablets will the nurse administer? - ANSWER>>0.5. 125 mcg= 0.125mg. 0.0625 mg/ 0.125 mg= 0.5 tablets At what point should the nurse perform the first of the three checks of medication administration? - ANSWER>>As the nurse reaches for the drug package or container. Which of the following patients receives a drug that requires parenteral route? a. a woman who takes diuretic pill each morning. b. a man who has an antifungal ointment applied to his skin rash daily. c. a man with emphysema who uses nebulized bronchodilators. d. a woman who has been ordered intravenous antibiotics. - ANSWER>>D. a woman who has been ordered intravenous antibiotics. A nurse is providing care for a patient who has a history of dementia. Which of the following methods should the nurse use in order to determine the patient's identity prior to medication administration? - ANSWER>>Check the patient's identification band. The nurse is preparing to administer meperidine (Demerol) as an intramuscular injection in an adult patient's deltoid site. Which of the following needles should the nurse select for this injection? a. 2"; 18 gauge b. 1 1/2"; 18 gauge c. 5/8"; 24 gauge d. 1"; 22 gauge - ANSWER>>D. 1";22 gauge IM injections using the deltoid site require a 20- to 25-gauge needle that is between 1" and 1 1/2" in length
A post-surgical patient's MAR provides for PRN administration of a number of analgesics by various routes. Which of the following routes will likely provide the most rapid pain relief for the patient? a. oral b. intravenous c.intramuscular d. subcutaneous - ANSWER>>B. intravenous A patient with chronic obstructive pulmonary disease has been prescribed an inhaled bronchodilator. Which of the techniques should the nurse implement in order to ensure safe and complete delivery of the prescribed medication? - ANSWER>>Use a spacer or extender with the metered-dose inhaler. When administering oral medications, which of the following practices should the nurse follow? Select all that apply. a. dispense multiple liquid medications into a single cup to reduce the number of containers the patient must handle. b. perform hand hygiene before and after medication administration. c. stay at the bedside until the patient has swallowed all the medications. d. keep the patient's MAR at the bedside at all times to ensure safe identification. e. verify the patient's response to the medication 30 minutes after administration, or as appropriate for the drug. - ANSWER>>B,C,E. The Z-track technique is utilized during drug administration by which of the following routes? - ANSWER>>Intramuscular. What are the 6 rights of medication administration? - ANSWER>>Right Time Right Dose
Parts of the medication order (6) - ANSWER>>Client's full name Date and time order is written Medication name Dosage of drug Route by which drug is to be administered Time and frequency of administration of the drug Signature of person writing the order Box 31- 11 When an error occurs - ANSWER>>Check patient's condition immediately; Observe for adverse effects Notify nurse manager and physician Write description of error and remedial steps taken on medical record Complete an incident report (remember this does not go in chart) Nurses play an essential role in medication reconciliation. Three checks - ANSWER>>1) as you reach for the med
- before opening or pouring
- as you replace the med to drawer and before giving to patient Maintaining patients' rights - ANSWER>>To be informed about a medication To refuse a medication To have a medication history To be properly advised about experimental nature of medication To receive labeled medications safely To receive appropriate supportive therapy To not receive unnecessary medications To be informed if medications are part of a research study p 587
Intradermal Injection Needle Size and Volume Injected: - ANSWER>>Needle Size: 26 or 27 gauge x 3/8 in Volume Injected (mL): Average: 0.1 Range: 0.001-1. Subcutaneous Injection Needle Size and Volume Injected: - ANSWER>>Needle Size: 25 - 27 gauge x 1/2 to 5/8 in. Volume Injected (mL): Average: 0.5 Range: 0.5-1. Intramuscular Injection Needle Size and Volume Injected: - ANSWER>>Gluteus medius Needle size: 20-23 gauge x 1 1/2 to 3 in. Volume Injected (mL): Average: 2-4 Range: 1- 5 Gluteus minimus Needle Size: 20-23 gauge x 1 1/2 to 3 in. Volume Injected (mL): Average: 1-4 Range: 1- 5 Vastus lateralis Needle size: 22-25 gauge x 5/8 to 1 1/2 in. Volume injected (mL): Average: 1-4 Range: 1- 5 Deltoid Injection Needle Size and Volume Injected: - ANSWER>>Needle Size: 23 - 25 gauge x 5/8 to 1 in. Volume injected (mL): Average: 0.5 Range: 0.5- 2 Intravenous bolus Injection Needle Size and Volume Injected: - ANSWER>>Needle Size: 18 - 23 gauge x 1 to 1 1/2 in.
