QMA STATE EXAM BEST STUDYING MATERIAL WITH VERIFIED ANSWERS LATEST VERSION UPDATE 2024, Exams of Real Estate Management

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QMA STATE EXAM BEST STUDYING

MATERIAL WITH VERIFIED ANSWERS

LATEST VERSION UPDATE 2024- 2025

Hyperglycemia is a result of too munch insulin and not enough carbohydrates. True or False?

• ANSWER False. Insulin lowers the blood sugar. So that would be hypoglycemia. Mrs. Smith is 87 years old and is hard of hearing, a diabetic has hypothyroidism and constant pain. The doctor may have which medication as part of her regimen to treat her hypothyroidism?
• ANSWER levothyroxine Adverse effects of Levothyroxine are...
  • ANSWER Heart palpitations, Tremors, Weight gain, Nervousness, Insomnia Steroid medications can mask the signs of other infections. True or False?
  • ANSWER True It is okay to abruptly stop taking steroid medicine. True or False?
• ANSWER False Analgesics : - ANSWER Drugs that relieve pain. There are two main types: non-narcotic analgesics for mild pain, and narcotic analgesics for severe pain. Antacids: - ANSWER Drugs that relieve indigestion and heartburn by neutralizing stomach acid. Antianxiety Drugs:
  • ANSWER Drugs that suppress anxiety and relax muscles (sometimes called anxiolytics, sedatives, or minor tranquilizers). Antiarrhythmics:
  • ANSWER Drugs used to control irregularities of heartbeat. Antibacterials:
  • ANSWER Drugs used to treat infections.

Antibiotics:

• ANSWER Drugs made from naturally occurring and synthetic substances that combat bacterial infection. Some antibiotics are effective only against limited types of bacteria. Others, known as broad spectrum antibiotics, are effective against a wide range of bacteria. Anticoagulants and Thrombolytics:
  • ANSWER Anticoagulants prevent blood from clotting. Thrombolytics help dissolve and disperse blood clots and may be prescribed for patients with recent arterial or venous thrombosis. Anticonvulsants:
• ANSWER Drugs that prevent epileptic seizures. Antidepressants:
• ANSWER There are three main groups of mood-lifting antidepressants: tricyclics, monoamine oxidase inhibitors, and selective serotonin reuptake inhibitors (SSRIs). Antidiarrheals : - ANSWER Drugs used for the relief of diarrhea. Two main types of antidiarrheal preparations are simple adsorbent substances and drugs that slow down the contractions of the bowel muscles so that the contents are propelled more slowly. Antiemetics:
• ANSWER Drugs used to treat nausea and vomiting. Antifungals:
  • ANSWER Drugs used to treat fungal infections, the most common of which affect the hair, skin, nails, or mucous membranes. Antihistamines:
  • ANSWER Drugs used primarily to counteract the effects of histamine, one of the chemicals involved in allergic reactions. Antihypertensives:
• ANSWER Drugs that lower blood pressure. The types of antihypertensives currently marketed include diuretics, beta-blockers, calcium channel blocker, ACE (angiotensin- converting enzyme) inhibitors, centrally acting antihypertensives and sympatholytics. Anti-Inflammatorie
  • ANSWER Drugs used to reduce inflammation - the redness, heat, swelling, and increased blood flow found in infections and in many chronic noninfective diseases such as rheumatoid arthritis and gout. Antineoplastics:
  • ANSWER Drugs used to treat cancer.

Antipsychotics:

• ANSWER Drugs used to treat symptoms of severe psychiatric disorders. These drugs are sometimes called major tranquilizers. Antipyretics:
• ANSWER Drugs that reduce fever. Antivirals:
• ANSWER Drugs used to treat viral infections or to provide temporary protection against infections such as influenza. Beta Blockers:
• ANSWER Beta-adrenergic blocking agents, or beta-blockers for short, reduce the oxygen needs of the heart by reducing heartbeat rate. Bronchodilators:
• ANSWER Drugs that open up the bronchial tubes within the lungs when the tubes have become narrowed by muscle spasm. Bronchodilators ease breathing in diseases such as asthma. Corticosteroids:
• ANSWER These hormonal preparations are used primarily as anti-inflammatories in arthritis or asthma or as immunosuppressives, but they are also useful for treating some malignancies or compensating for a deficiency of natural hormones in disorders such as Addison's disease. Cough Suppressants:
• ANSWER Simple cough medicines, which contain substances such as honey, glycerine, or menthol, soothe throat irritation. They are most soothing when taken as lozenges and dissolved in the mouth. As liquids they are probably swallowed too quickly to be effective. A few drugs are actually cough suppressants. There are two groups of cough suppressants: those that alter the consistency or production of phlegm such as mucolytics and expectorants; and those that suppress the coughing reflex such as codeine (narcotic cough suppressants), antihistamines, dextromethorphan and isoproterenol (non-narcotic cough suppressants). Cytotoxics:
• ANSWER Drugs that kill or damage cells. Cytotoxics are used as antineoplastics (drugs used to treat cancer) and also as immunosuppressives. Decongestants:
• ANSWER Drugs that reduce swelling of the mucous membranes that line the nose by constricting blood vessels, thus relieving nasal stuffiness. diurectics:

• ANSWER Drugs that increase the quantity of urine produced by the kidneys and passed out of the body. Diuretics reduce water logging of the tissues caused by fluid retention in disorders of the heart, kidneys, and liver. They are useful in treating mild cases of high blood pressure. Hypoglycemics (Oral):
• ANSWER Drugs that lower the level of glucose in the blood. Oral hypoglycemic drugs are used in diabetes mellitus if it cannot be controlled by diet alone, but does require treatment with injections of insulin. Chest pain is known as?
• ANSWER angina pectoris Ear/respiratory/viral infection is called:
• ANSWER Otitis media Symptoms of inflammation include?
• ANSWER Localized heat, swelling, redness, and pain Who can and instill irrigation fluids?
• ANSWER The nurse If resident's colostomy is on their right, the drainage will be?
• ANSWER Liquid In an emergency the QMA is allowed to administer oxygen at:
• ANSWER 2L When taking a residents blood sugar it is best to use?
• ANSWER Side of the finger When measuring liquid medication read the level from the bottom of the?
• ANSWER Meniscus Do not give gotta if the ear is:
• ANSWER Draining When giving s suspension, what do you need to do before giving it? - ANSWER Shake it up to mix it What is one thing that should not be used with a resident on oxygen therapy? - ANSWER Petroleum jelly hemoccult testing is a screen for?
• ANSWER Fecal occult blood

When instructed to collect a clean catch midstream, what is the "midstream"? - ANSWER The 2nd stream of urine Hypoglycemia

• ANSWER low blood sugar Hyperglycemia
• ANSWER high blood sugar When collecting a iron specimen, it's best to use?
  • ANSWER The 2nd voided specimen of the day How far in front of the residents open mouth do you place the MDI?
  • ANSWER 1-2 inches If the resident is taking more than one puff of medication from the MDI-meter dose inhaler, how long do you wait between puffs?
  • ANSWER One full minute What is classification?for Coumadin?
  • ANSWER Anticoagulant What is an example of a antihypertensive?
• ANSWER Calan What medication is a bronchodilator? - ANSWER Albuterol (a type of inhaler) What is Celexa used for?
  • ANSWER Antidepressant What would be a nursing consideration when giving potassium replacement medication?
  • ANSWER •Give w food/ after meals •Dissolve tablets or powder in 8 ounces of water or juice. •Do not crush. Or break extended release (XR/XL) tablets arteriosclerosis/artherosclerosis:
  • ANSWER Buildup of plaque in blood vessels What is Abilify's classification?
• ANSWER Antipsychotic What is Celebrex used for?
• ANSWER Nonsteroidal Anti-inflammatory What are debridement medications used for?

• ANSWER To remove dead tissue and can be applied only by licensed personnel. What is conjunctivitis?
  • ANSWER Inflammation of mucus membrane in the eye An anti inflammatory steroid you apply to the skin?
• ANSWER Cordran What is Dilatin (phenytoin) used for?
  • ANSWER Blocks histamine. * Histamine=Allergic Reaction What is an example of a cardiotonic
• ANSWER Digoxin nosocomial infection
  • ANSWER a disease acquired in a hospital or clinical setting Side effects of robitussin:
  • ANSWER •Gastric irritation •Nausea •Vomiting What is an example of a potassium replacement medication?
• ANSWER K-Dur or Micro-K What is Nitroglycerin classification?
  • ANSWER Antianginal How do you pour a liquid medication?
• ANSWER Away from the label. What is an adverse effect of anticoagulants? - ANSWER Hemorrhage (increase bleeding) HS - ANSWER at bedtime q.i.d - ANSWER 4 times a day b.i.d - ANSWER twice a day q.d - ANSWER every day q - ANSWER every What drug is given for HIV? - ANSWER Triumeq

What is an example of an antiarrhythmic? - ANSWER Inderal What is Aldactone used for? - ANSWER Water pill-diuretic What is risperadal's classification? - ANSWER Antipsychotic What is an example of a antihistamine? - ANSWER Dimetapp What is dilantin's classification? - ANSWER Anticonvulsant Which disorder causes overproduction of fluid on the eye which causes increased pressure? - ANSWER Glaucoma What is Mylicon used for? - ANSWER Antiflatulent gtt/s - ANSWER drop (s) ________ treats glaucoma. - ANSWER Miotics What would be an example of a antitussive? - ANSWER Codeine What type of treatment would be used for glaucoma? - ANSWER Medications to decrease intraocular pressure. What is Lanoxin (Digoxin) used for? - ANSWER controls heart rate and blood pressure Antacids - ANSWER Relieves indigestion and heartburn by neutralizeing the acids in the stomach. Formation of blood clots - ANSWER thrombosis Emphysema, chronic bronchitis, asthma or a combination of these is referred to as? - ANSWER COPD (chronic obstruction pulmonary disease) increased appetite, weight loss, frequent urination and thirst are symptoms of? - ANSWER diabetes What is Semi-Fowler's position? - ANSWER head of bed elevated 30 to 45 degrees The nurse instructs you to place the resident in fowlers position after tube feeding. How many degrees is fowlers position? - ANSWER 45-60 degrees Pulse located on the neck? - ANSWER carotid pulse Pulse located on the chest? - ANSWER apical pulse

pulse located at the thumb side of the wrist? - ANSWER radial pulse Pulse located at bend of the elbows? - ANSWER branchial Apply B/P cuff where? - ANSWER Above elbow on unaffected arm Hypertension - ANSWER high blood pressure Hypotension - ANSWER low blood pressure Top # in blood pressure - ANSWER systolic Bottom # of blood pressure - ANSWER diastolic Do not crush what medicine? - ANSWER Enteric coated medicine When applying transdermal patch? - ANSWER Press firm with palm of your hand for 10 to 15 seconds wearing gloves When putting medications through a G-tube that is not compatible, how do you give them? - ANSWER Separate with 15 to 30cc of water between the two. Label transdermal patches with? - ANSWER date, time, initials When instilling eye drops, how do you position the eye? - ANSWER Pulling down the lower eyelid to form a pouch After instilling eat drops(gtts) instruct resident to? - ANSWER Remain in position with infected ear up for approximately 5 minutes. When instilling eat drops straighten ear canal by pulling the ear? - ANSWER Up and backward Use contact isolation for? - ANSWER C diff , MRSA & Conjunctivitis Use droplet isolation - ANSWER Influenza, pneumonia, & strep Use airborne isolation for? - ANSWER TB When washing hands, wash hands vigorously for? - ANSWER 10 seconds The G-tube is directly into the? - ANSWER Stomach The J tube is place directly into the? - ANSWER Intestine

When checking placement for a G-tube, where do you place the stethoscope? - ANSWER 3 inches below the sternum NPO - ANSWER nothing by mouth Many medications are metabolized by the? - ANSWER Liver A mite that burrows under the skin - ANSWER Scabies A QMA can treat which stage of a decubitus ulcer? - ANSWER Stage 1 A resident spills coffee on themselves resulting in a blister what should you do? - ANSWER Report it to the nurse. This is a 2nd degree burn. QMA's can only treat 1st degree burns. Od? - ANSWER right eye Os - ANSWER left eye Ou - ANSWER both eyes Ketostix are used to test urine for? - ANSWER ketones What is a dietary supplement for potassium? - ANSWER Bananas Virus that breaks down the body's immune system - ANSWER HIV (AIDS) CCR why must antibiotics be prescribed on time? - ANSWER to maintain an adequate amount in the bloodstream at all times. Increased confusion and restlessness in the late afternoon? - ANSWER Sundowning Name the six rights of medication administration - ANSWER Right medication, right dose, right patient, right time, right route, right documentation In nursing facilities all med orders must be reviewed, renewed and resigned by the MD every? - ANSWER 60 days When a resident is on a ABT (antibiotic therapy), what v/s must be monitored? - ANSWER Temp What position do you place a resident in to give an enema? - ANSWER Left side A chronic disturbance of the inner ear is called - ANSWER Meniere's syndrome Ear infection caused by bacteria or fungus? - ANSWER Swimmer's ear

Inflammation of the urinary bladder is called - ANSWER cystitis Every drop of blood passes through the kidneys how many times a day for filtering? - ANSWER 4-6 times When the heart cannot pump effectively and fluids back up in the vessels and tissues causing edema in the tissues, abdomen, and lungs, this is called? - ANSWER CHF congestive heart failure Inflammation of the vein that results in formation of a clot? - ANSWER Thrombophlebitis A medication is registered or patent by a company is known as? - ANSWER the trade or brand name The study of medication and the effect on the body - ANSWER Pharmacology The undesirable effect of toxicity is known as? - ANSWER Adverse effect The action or effect of a medication other than that desired? - ANSWER Side effect The reason a medication is ordered? - ANSWER Primary or desired effect Something that effects the entire body - ANSWER Systemic effect Limited to the area where the medication is applied is called? - ANSWER Local effect A buildup of substance that could lead to toxicity? - ANSWER Cumulative effect A medication that can only be obtained by prescription is called? - ANSWER Legend medication When excess medications and waste products are eliminated by the body, this is called? - ANSWER Excretion When medication is broken down to a substance that can be excreted into the kidneys?

• ANSWER Metabolism When medication is carried by the blood to the body cells - ANSWER Distribution When medication is transferred into the blood stream - ANSWER Absorbtion When medication is introduced to the body? - ANSWER Reception When the nurse takes a telephone order, the MD must sign it on? - ANSWER Their next visit to the facility

Bluish discoloration of the skin caused by lack of oxygen - ANSWER cyanosis Optic means? - ANSWER eye When a medication is rubbed into the skin? - ANSWER Inunction When medication is placed between the teeth and mucus membrane of the cheek? - ANSWER Buccal SL Is the abbreviation for - ANSWER sublingual (under the tongue) Otic refers to? - ANSWER ear What system of measurement is more accurate than the household system but less accurate than the metric? - ANSWER Apothecary 1 L =_______ cc/ml - ANSWER 1000 cc/ml 1 ounce = ___ cc/ml - ANSWER 30 cc/ml 1 tsp = ___ cc/ml - ANSWER 5 cc/ml 1 tbsp = ___ cc/ml - ANSWER 15 ml/cc How many in-service hours do you need every year? - ANSWER 6 How often does the QMA have to recertify & what date? - ANSWER Yearly by March 31st If a resident has trouble swallowing who do you consult? - ANSWER speech therapy Another name for bipolar is? - ANSWER Manic depressive The resident advocate is called? - ANSWER ombudsman 45cc = how many ounces? - ANSWER 1 1/ Safe thing to do when someone is having a seizure? - ANSWER Loosen clothing around neck When a resident is having a seizure do not do what?? - ANSWER Do not put anything in their mouth After a resident has a seizure what position do you put them in? - ANSWER Lateral

A healthcare worker is obligated to perform care that meets? - ANSWER minimum standards An improper or injurious practice is called what? - ANSWER malpractice Omission or neglect of any reasonable precaution care or action is called? - ANSWER Negligence Keeping resident information private? - ANSWER Confidentiality Bacteria that no longer responds to ABT therapy - ANSWER MRSA Bacterial infection of the lungs spread through the air - ANSWER TB When moving a resident up in bed, where do you place your hands? - ANSWER Around their shoulders and under their thighs When moving someone up in bed where do you place the pillow? - ANSWER Against the headboard What is the first aid procedure for choking? - ANSWER Heimlich maneuver Severe itching without a rash - ANSWER Pruritus Inflammation of the mouth - ANSWER stomatitis Official name of the medication? - ANSWER generic name What position is sideline position? - ANSWER Lateral recumbent code of ethics - ANSWER A voluntary set of rules that influence relationships between people. Distribution - ANSWER The process by which a drug is eliminated from the body? palliative care - ANSWER Afforded relief but not cure. Decadron, Medrol, and Kenalog are all classified as? - ANSWER Steroid anti- inflammatory drugs Gaviscon, Maalox, and Mylanta are classified as? - ANSWER Anti-acids Lomotil, Imodium, and kaopectate are classified as? - ANSWER Anti-diarrheals Compazine, Tigan, and dramamine are classified as? - ANSWER Antiemetics

Soma, Robaxin, Parafon forte, and flexeril are classified as? - ANSWER Muscle relaxants Indocin, Clinoril, Nalfon, and Motrin are classified as? - ANSWER NASID Antipruitics - ANSWER relieves itching Pulse must be measured at ____ or above before cardiotonic drug is given - ANSWER 60 Elavil, Sinequan, and to frankly are used to treat? - ANSWER Depression Thorazine, haldol, mellaril, and stelazine are classified as? - ANSWER Antipsychotics Lithium Carbonate is used to treat _______ - ANSWER bipolar disorder The ____________ gland secretes hormones - ANSWER Endocrine Calcium should not be given with what? - ANSWER Milk or dairy products heroin, marijuana, LSD are schedule ___ drugs - ANSWER Schedule 1 drugs When each dose is sealed, labeled, and dated the medication is called? - ANSWER Scheduled dose Medication should always be checked at least ___ times prior to administering. - ANSWER 3 times Morphine, demerol, codeine, tylox are schedule ____ drugs - ANSWER Schedule 2 antineoplastic drugs - ANSWER drugs used to treat cancer Abbreviation "Pril" - ANSWER Ace inhibitor (maintains blood pressure & fluid balance) Abbreviation "caine" - ANSWER Local anesthetic (causes the absence of pain) Abbreviation "Lam" & "Pam" - ANSWER Antianxiety Abbreviation "Cillin" - ANSWER Antibiotic (fights bacterial infections) Abbreviations "Micin"/"Mycin" - ANSWER Antibiotics (fights bacterial infections) Abbreviation "Oxacin" - ANSWER Antibiotic (fights bacterial infections) Abbreviation "vir" - ANSWER Antiviral (treatment for viral infections like the flu and such)

Betadine, Betagen, and Dakins are... - ANSWER Antiseptics Abbreviation "Statin" - ANSWER Antihyperlipidemics Abbreviation "sone" - ANSWER Steroids Abbreviation "nium" - ANSWER Neuromuscular blocking agents(provides skeletal relaxation during surgery) Abbreviation "dine" - ANSWER H2 blockers (reduces the amount of acid produced by the cells in the stomach) Abbreviation "ide" - ANSWER Oral hypoglycemics (designed to help people with type 2 diabetes) Abbreviation "olol" - ANSWER Beta blockers (reduces blood pressure by blocking the effects of hormone adrenaline) Abbreviation "Mide/zide" - ANSWER Diuretics (designed to increase the amount of salt and water in the urine) Symptoms of hypoglycemia include: - ANSWER drowsiness, perspiration, pallor, confusion, and tremors Which of the following is not oral hypoglycemia medication? - ANSWER Synthroid The endocrine system is composed of a vast network of ducts and glands that secrete hormones and other secretions to regulate body function. True or False? - ANSWER True Which organs produce insulin? - ANSWER Pancreas Byproducts of the breakdown of fat and protein when the body is in a hyperglycemic state are called - ANSWER Ketones Type 1 diabetes is known as NIDDM. True or False? - ANSWER False

7. Which form of diabetes is the most common type? - ANSWER Type II
8. Adverse effects of glucophage (Micronase) are... - ANSWER Renal impairment, skin rash, headache, nausea & vomiting What does systemic effect mean? - ANSWER Affecting the entire body, rather than a single organ or body part

What is cumulative effect? - ANSWER A term used to describe how exposure to more than one chemical might affect the body. Why are medications given - ANSWER To help relieve symptoms or cure diseases Factors that affect absorption - ANSWER Lipid solubility, food, hemodynamics, diseases, molecular size, chemical nature, degree of ionization, disintegration time, ionization and gastric emptying, medications, presence of other substances What is metabolism, excretion, distribution, absorption - ANSWER Metabolism - The chemical reactions in the body's cells that change food into energy Excretion - The elimination of waste products from the body Distribution - The disbursement of an unmetabolized drug as it moves through the body's blood and tissues Absorption - The transportation of the unmetabolized drug from the site of administration to the body circulation system Synergistic effect - ANSWER The interaction of two or more drugs when their combined effect is greater than the sum of the effects seen when each drug is given alone. Antagonistic effect - ANSWER An inhibitory mechanism where one drug blocks or reduces the effect of another drug. What is the generic name/trade name - ANSWER Generic drug - refers to a drug produced after the active ingredient of the brand name drug Trade name - refers to the name giving by the producing company What is a synthetic drug - ANSWER A substance that is man-made by synthesis, rather than being produced by nature What are the forms of medication - ANSWER Liquid, tablet, capsules, topical medicines, suppositories, drops, inhalers, injections, implants or patches, buccal or sublingual tablets, and further tips What does medication action mean - ANSWER A term used to describe how a drug or other substance produces an effect in the body Which drugs are absorbed the fastest/slowest - ANSWER Fastest - Intravenously Slowest - Transdermal application Does the dosage affect the absorption - ANSWER no What does enteric coating mean - ANSWER When a tablet or capsule is coated with a substance that prevents the medication from being released until it reaches the small intestine, where it can then be absorbed

What does half life mean - ANSWER The time it takes for the amount of a drug's active substance in your body to reduce by half Abbreviations - OU OS OD QD BID TID PO SL HS Q PC AC - ANSWER OU - Both eyes OS - Left eye OD - Right eye QD - Daily BID - Twice daily TID - Three times a day PO - By mouth SL - Sublingually HS - Bedtime Q12 - Every 12 hours PC - 30 Mins after meals AC - 30 Mins before meals Apothecary - ANSWER The oldest system of measurement. Usually expressed in lower or upper case Roman numerals and is gradually being replaced by the metric system Metric - ANSWER Uses numbers before abbreviations to designate amounts. The most preferred system in medicine. Any amount less than a whole number must have a zero and a period in front of it Household - ANSWER Used in the home for administering medications with varying types of measuring devices. This system uses numbers and fractions Topical medications - ANSWER Applied to specific site (Creams, ointments, and lotions) What's included in a medication order - ANSWER Must specify the date and time the order was written, name of resident, name of medication, drug dosage, frequency of administration, and route of administration. Order must also include the signature of the ordering practitioner

How many cc in an ounce - ANSWER 30 cc = 1 oz What is a vasodilator - ANSWER Medicines that open, also called dilate, blood vessels, works directly on the vessel walls Prednisone is classified as a what - ANSWER Anti-inflammatory (steroid medication) What is a broncodilator/ what is the most common one - ANSWER Proventil, ventolin (albuterol)/ albuterol is the most common one What is an expectorant/what is the most common one - ANSWER Robitussin, mucinex (guaifenesin)/ mucinex is the most common one What is a nasal decongestant/what is the most common one - ANSWER Sudafed (pseudoephedrine HCL)/ Sudafed What is an anticonvulsant/what is the most common type - ANSWER Stops or prevents seizure activity/ Depakene (valproic acid) Metamucil is what kind of laxative - ANSWER A bulk laxative What is a drug for Parkinson's disease - ANSWER Larodopa (Levodopa) What are psychoactive drugs - ANSWER Substances that, when taken in or administered into one's system, affect mental processes What is an anticoagulant/ what is the most common type - ANSWER Medicines to prevent formation of clots which may cause damage to the brain, heart, or lungs/coumadin (warfarin) What is the time frame for giving medications if scheduled at 9:00am - ANSWER 8:00am-10:00am Timoptic - ANSWER Eye medication for glaucoma and intraocular hypertension SE - Burning, irritation, rash, confusion, night blindness, increased saliva, blurred vision NC - Provide adequate lighting, especially at night, pain in eye may be a symptom of increasing pressure, monitor for increased blood pressure and heartrate, place inside lower lid, not directly on eye, best given at HS, wait 5 min between eye meds Nitroglycerin - ANSWER Vasodilator, dilate blood vessels and improve blood supply to the heart, treat angina pectoris and decreased circulation to the brain and extremities, treat hypertension SE - Hypotension, tachycardia, flushing, palpitations NC - Elderly residents may be more sensitive to medication's effects, sublingual tablets are placed under the tongue when pain begins. The physician's orders will usually allow the medication to be repeated every 5 min until relief occurs, taking no more than 3

tablets in 15 min, elderly residents with coronary artery disease and associated chest pain, may have NTG as a PRN Tenormin - ANSWER Anti-arrhythmics/ antihypertensives(beta blockers), blocks effects of epinephrine, causing heart to beat slowly and with less force, lowering B/P, treats arrhythmias, angina, hypertension and migraine headaches SE - Fatigue, hypotension, bronchospasm, lethargy, bradycardia, heart failure NC - Check apical pulse before administering medication, can mask common signs of shock or hypoglycemia Prednisone - ANSWER Anti-inflammatory steroids, decreases inflammation, used to treat arthritis, dermatitis, chronic respiratory conditions SE - Weight gain from increased appetite and edema, mood swings, night sweats, increased blood sugars, masks symptoms of infection, slows healing, elevates blood pressure, muscle weakness, hair loss, prolonged bleeding, insomnia, increased bruising NC - Observe for signs of infection, monitor for change in urine glucose or blood sugars, withdrawal symptoms occur if stopped abruptly, administer with food, elderly may be more susceptible to osteoporosis Lasix - ANSWER Diuretics, increases urine production, treat edema associated with CHF, liver or kidney disease SE - Excessive potassium loss, weakness, dry mouth, orthostatic hypotension, headache NC - Give early in the day in an effort to decrease nocturia, give with plenty of fluids unless on fluid restriction, monitor weight and edema (daily wt change 2 pounds is significant) potassium depletion may result in confusion, encourage resident to rise slowly from a lying or sitting position to decrease dizziness Elimite - ANSWER Scabicides and pediculocides, destroy parasites, treat scabies, mites, lice and other parasites SE - Skin irritation NC - Wear gloves when applying, may apply to skin or hair, may require repeat applications in 7-10 days, follow physician's orders and refer to manufacturer's instructions Dalmane - ANSWER Sedatives/hypnotics, increase inhibition of nerve cell excitability, reduce physical and mental activity, control seizures, produce relaxation and sleep SE - Rash, nausea, morning after drowsiness, short term memory loss, some elderly may become excited rather than sedated NC - May become dependent/addicted, try non-medication measures first to promote sleep, ensure medication is swallowed completely, monitor for cumulative effect Amoxil - ANSWER Antibiotics, kill or prevent growth and reproduction of specific bacteria, treatment of various SE - Nausea and vomiting, hives, rash, anaphylactic reaction, sensitivity to the sun, vaginitis, diarrhea, urinary tract infection (UTI)

NC - Must be administered at the same time in order to maintain a therapeutic level in blood stream, sensitivity to the sun can occur, some more effective when given with food; some more effective when given on empty stomach (follow instructions from pharmacy) Thorazine - ANSWER Anti-psychotics(Neuroleptics), regulate the functioning of brain circuits that control thinking, mood, and perception, used to treat schizophrenia, and as a short-term treatment for bipolar disorder to control psychotic symptoms such as hallucinations, delusions, or mania SE - May affect thirst awareness, drowsiness, dizziness, slowness, dry mouth, restlessness, weight gain, constipation NC - Abrupt withdrawal of antipsychotics may cause seizures, prolonged use may cause tardive dyskinesia (in and out movement of tongue, sucking and smacking of lips, lateral jaw movements; monitor for worsening symptoms) Atrovent - ANSWER Bronchodilators, relax bronchial muscles to open breathing passages, treat asthma, bronchitis and chronic lung disease SE - Restlessness, dizziness, palpitations, nausea, hypertension, anxiety NC - May experience withdrawal symptoms if med stopped abruptly, combination of oral and inhaled bronchodilators may result in increased side effects Milk of magnesia - ANSWER Antacids, neutralize stomach acid, decrease the rate of gastric emptying, treats hyperacidity SE - Constipation NC - Should not be given with other meds. Wait 1-2 hours after giving other meds, chart amount and consistency of stools, anti-flatulence tablets must be chewed well Metamucil - ANSWER Bulk laxative, absorbs water and expands to increase bulk and moisturize content of stool, used to promote regular bowel evacuation SE - Nausea, vomiting, diarrhea with excessive use, esophageal gastric, small intestine and rectal obstruction when medication is taken in dry form NC - Must be administered with at least 8oz of pleasant tasting liquid, encourage and additional glass of fluid, use sugar free formula for diabetics, acts within 12 hours to 3 days Nitro-bid - ANSWER Vasodilator, dilate blood vessels and improve blood supply to the heart, treat angina pectoris and decreased circulation to the brain and extremities, treat hypertension SE - Hypotension, tachycardia, flushing, palpitations NC - Elderly may be more sensitive to medication's effects, sublingual tablets are placed under tongue when pain begins, physician's orders will usually allow medication to be repeated every 5 min until relief occurs, taking no more than 3 tablets in 15 min Naprosyn - ANSWER NSAID'S, block enzymes and other substances that promote inflammation, treat arthritis, bursitis, tendonitis, gout

SE - Nausea, abdominal pain/cramps/diarrhea, prolonged bleeding/GI bleeding, increased bruising, change in renal function, decreased appetite, dizziness, heartburn, tinnitus, headache NC - May be better tolerated with food, handle residents requiring these medications gently to avoid causing more pain Nardil - ANSWER Antidepressants, decrease amount of enzyme which degrades norepinephrine, serotonin, and dopamine, treat severe depression SE - Muscle tremors, diarrhea, constipation, heart irregularities, sweating, tardive dyskinesia NC - Avoid foods that contain high amounts of tyramine (cheese, fish, liver, baked potatoes, yogurt, beer, wine) which may cause hypertensive crisis when taking MAO Inhibitors Synthroid - ANSWER Thyroid hormones, replacement therapy if the thyroid is not producing sufficient hormones, treat hypothyroidism SE - Nervousness, insomnia, palpitations, sweating, tremors, chest pains NC - Report chest pains to nurse, onset is gradual - full effect in about 3 weeks, administer 30 min before meal on empty stomach Robitussin - ANSWER Expectorants, thins and loosens mucous, breaking up congestion, promote a productive cough SE - Gastric irritation, nausea and vomiting NC - Should be taken with water, humidified air may promote expectoration, increased activity may promote movement of mucous and productive cough Schedule V, lowest potential for abuse Theragran - ANSWER Multivitamin, source of multiple vitamins in one dose, supplement diet, often ordered to promote wound healing SE - Itching, diarrhea, nausea NC - DO NOT CRUSH MEDICATION, administer with food to avoid GI upset Dilantin - ANSWER Anticonvulsant, depress abnormal electrical discharges in brain, to stop or prevent seizure activity SE - Swelling and redness of gums, drowsiness, dizziness, double vision, tremors, confusion NC - Observe the resident's mouth for red, swollen, bleeding gums, encourage good oral hygiene due to potential for overgrowth of gum tissue Tinactin - ANSWER Local antifungals, inhibits production of substance that maintains fungal cell membranes, treat athlete's foot or other fungal infections and ring worm SE - Itching, rash NC - Wear gloves when applying, area should be cleaned and dried thoroughly before application of ointment, ensure resident wears clean socks daily if being treated for athlete's foot

Micronase - ANSWER Sulfonylureas, treats high blood sugar levels caused by type 2 diabetes, may be used alone or with another oral medicine such as metformin SE - Difficulty with swallowing, dizziness, fast heartbeat, hives, itching, skin rash, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, tightness in the chest, trouble breathing, unusual tiredness or weakness, abdominal or stomach pain, chills, clay-colored stools, dark urine, diarrhea, fever, headache, light colored stools, loss of appetite, nausea and vomiting, unpleasant breath odor, upper right abdominal or stomach pain, vomiting of blood, yellow eyes and skin NC - Make sure doctor knows if you are taking more than one medicine for diabetes, too much micronase can cause low blood sugar Surfak - ANSWER Stool softeners, softens stool, increases moisture in stool making evacuation easier, used to promote regular bowel evacuation SE - Mild abdominal cramping, can cause diarrhea NC - Takes 1-3 days to soften stools if a resident has diarrhea, consult nurse as to whether the medication should be given Debrox - ANSWER Ear medications (wax control agents), soften and dissolve ear wax, treat wax build up SE - Redness, itching NC - Do not use without physician's permission if the ear is draining, use with caution for more than 3 continuous days, the ear often requires irrigation to remove the wax, irrigation must be done by a licensed nurse and is not within the scope of practice of the QMA Pyridium - ANSWER Urinary analgesics, treat symptoms (frequency, urgency, discomfort) caused by irritation of urinary tract during UTI SE - Diminished urination, dizziness, GI discomfort, N/V, confusion, edema, weight gain, loss of appetite NC - Pyridium turns sweat, urine, tears red-orange color which can stain clothing, contact lenses, take after meals to avoid GI upset Lithotabs - ANSWER Mood stabilizers, alters chemicals in brain that influence mood, treats bipolar disorder SE - Lethargy, toxicity symptoms like (nausea, tremors, muscle weakness) NC - Provide adequate salt and juice intake; unusual loss of salt or fluid from body may result in toxicity Privine - ANSWER A decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion. Privine is for temporary relief of stuffy nose caused by hay fever, allergies, or the common cold SE - Ongoing or worsening nasal stuffiness; chest pain, fast or uneven heart rate; or severe headache, buzzing in your ears, anxiety, confusion, or feeling short of breath; sneezing; or mild burning or stinging in your nose NC - Follow all directions on medicine label and packaging, ask a doctor if it is safe to take if you have any other medical conditions`

Sinemet - ANSWER Anti-parkinson drugs, restores balance dopamine and acetylcholine (neurotransmitters needed for proper motor functioning), treat symptoms of parkinson's disease, treat EPS and restless leg syndrome, relieve weakness SE - Postural hypotension, drowsiness, difficulty voiding, GI upset, dizziness, blurred vision, dry mouth NC - Encourage adequate hydration, administer with food to reduce GI upset Dulcolax - ANSWER Stimulant Laxative (Cathartics), stimulate intestinal peristalsis, treats constipation, given for colon prep SE - Abdominal cramping, nausea, diarrhea NC - Monitor for diarrhea/constipation, usually act in 6-8 hours when given in oral form, suppositories act within 15-30 minutes Xanax - ANSWER Anxiolytics (Anti-anxiety drugs), increases action of brain chemical used by nerve cells to communicate with each other, reducing brain activity which increases anxiety, treat various anxiety disorders and some mental health disorders characterized by hallucinations/delusions SE - Drowsiness, dry mouth, impaired coordination, dizziness, constipation, decreased respirations NC - Should not give with opioids, monitor for CNA depressant effects and suicidal ideation, do not use with alcohol Hemoccult test - ANSWER Test that checks for hidden blood in the stool CCMS - ANSWER Type of urine testing done to check for the presence of infection using a method that aims to prevent bacteria from the skin of the penis or vagina from contaminating the urine specimen Why wear gloves in the bathroom - ANSWER To prevent the spread of disease or infections What is the procedure for taking a pulse - ANSWER Perform initial steps, place resident's hands on comfortable surface, feel for pulse above wrist on thumb side with tips of first three fingers, count beat for 60 seconds, noting rate, rhythm and force. Apply light to moderate pressure (alter as needed), continue with fingers on pulse as though still counting. Memorize pulse rate, count each rise and fall of the chest as one respiration, count respirations for 60 seconds, noting rate, regularity and sound. Record both readings immediately, perform final steps What does documenting the medications mean - ANSWER Chart all doses of medication given on MAR according to facility policy, do not chart any medications not given personally, chart medications omitted or refused according to facility policy, record any pertinent observations made according to facility policy, and always chart AFTER medication has been given

Positions - supine, lateral, sim's, fowler's, semi-fowlers, prone, dorsal recumbent - ANSWER Supine - Laying flat on the back with arms and legs straight Lateral - Lying on either side with pillows to the back, under the arm on top of the body, and between the knees and ankles Sim's - Resident lays on his/her side with the right knee and thigh drawn up and the left arm along his/her back Fowler's - Lying on the back with head of the bed elevated 45 - 60 degrees. Semi-fowler's - Usually more comfortable than fowler's, resident is on the back with the head of the bed elevated 30 - 45 degrees Prone - Lying face down on the stomach Dorsal recumbent - Resident on his/her back with head and shoulder elevated at an angle of 30 degrees or more. Lower extremities are moderately flexed with legs apart and the soles of the feet resting on the bed Procedure for measuring oxygen saturations - ANSWER Make sure resident has warm hands or fingers, then put oximeter on finger. Measurements obtained by shining two wavelengths of lights from LED emitters set inside the device at one side of the fingertip. By measuring how much light has passed through the fingertip and determining how much has been absorbed by the oxygen in the blood, an oxygen saturation reading is established and displayed What do you do if respirations are shallow and rapid - ANSWER Check oxygen SATS before giving PRN oxygen What should you do before assisting a resident with a Sitz bath - ANSWER Instruct resident to void. Take his/her pulse to serve as a baseline in gauging response to treatment. What artery is used for taking BP - ANSWER Brachial artery What is a metered dose inhaler and how is it used - ANSWER An inhaler that the resident uses by spraying the medicine out so that it can be breathed into the lungs What do you do for a seizure/what position should the resident be placed in after the seizure - ANSWER Stay with the resident and have somebody get the nurse. Lay them on their side with something under their head just in case they aspirate, as you don't want them choking How do you apply a dressing to a skin tear - ANSWER If a layer of skin is torn but still attached, replace the skin over the wound. Cover as much of the original surface as possible. Label the dressing with the date, time and initials. Remove the dressing's backing paper and expose the adhesive surface. Place the dressing gently over the wound, allowing the film to also cover the approximately one inch of undamaged skin around the wound.

What are the side effects of a cold compress and what should you do - ANSWER Observe resident's skin beneath device frequently. If skin appears blanched or cyanotic, discontinue treatment immediately notify the nurse. What two categories of skin are checked - ANSWER The epidermis and dermis Symptoms of hypoglycemia and hyperglycemia - ANSWER Hypoglycemia - Jittery, anxious, irritable, skin pale, cold, clammy, confusion, tachycardia - fast heart rate, dizziness, nausea, fatigue, weakness, blurred vision/headache Hyperglycemia - Frequent/unusual thirst (polydipsia), frequent urination (polyuria) frequent/extreme hunger (polyphagia), unusual weight loss, blurred vision, fruity odor to breath, extreme fatigue What is the hand placement on the resident for when you assist them to sit on the edge of the bed/ for moving to the head of the bed - ANSWER On shoulders and underneath knees, or on a gait belt around the hips Procedure for a finger stick - ANSWER Cleanse chosen site with alcohol wipe, and let site dry, put on gloves, turn on the testing meter, check code on meter and make certain it matches code on test strip bottle. Change code on meter, if necessary. Perform a finger stick using lancet. Use side of fingertip, as it will hurt less and prevent tip of finger from becoming too sensitive. Squeeze finger gently to obtain large drop of blood, apply the blood carefully to pad on end of test strip. Many strips can only be touched once; blood should not be smeared on pad of test strip. Place strip in slot machine for reading. Wait for digital reading to appear. Apply pressure to resident's finger with a tissue. Discard lancet into sharps container. Avoid sticking yourself with used lancet. Discard test strip according to facility policy. What is a colostomy/when should the bag be emptied - ANSWER An opening of some portion of the colon to the abdominal surface. Bag should be emptied when 1/3 full. Procedure for giving meds through a g-tube/site care for the g-tube/position for tube feeding/what if abdomen is distended while tube feeding is going - ANSWER Raise head of bed to fowler's or semi-fowlers position, disconnect the tube feeding administration set, or uncap the Y connector, avoiding contamination, check for proper G-tube placement by inserting air and listening for gurgling, pull out stomach content, if more than 100 cc DO NOT give meds, flush with 30 cc of water before administering and after administering. When applying dressings, remove the old one, clear the skin with a cotton swab or Q-tip dipped in prescription cleansing solutions. Rinse and pat dry and then re-dress site with physician ordered dressing. What are the stages of a pressure sore/of burns - ANSWER Pressure sore: stage one - redness that doesn't go away after pressure is relieved stage two - broken, cracked, split, or blister-like area surrounded by redness stage three - skin over wound gone with underlying tissue expose; may be covered with necrotic tissue and/or purulent exudate

stage four - excessive tissue damage, exposing muscle and/or bone Burns: stage one - affects outer layer only. Skin may be red and painful, but long-term damage is rare stage two - affect both outer layer of skin and dermis. Bright red, swollen and may look shiny and wet with blisters. stage three - destroy two full layers of skin. May appear black, brown, pearly white, or yellow. Usually do not hurt, nerve endings may be damaged stage four - deepest and most severed of burns. All layers of skin are destroyed, as well as bones, muscles, and tendons. CHF - ANSWER Congestive heart failure occurs when the heart muscle doesn't pump blood as well as it should Hypertension - ANSWER High blood pressure. Normal: less than 120/80mm Hg Elevated: systolic between 120-129 and diastolic more than 80 Stage 1: systolic between 130-139 or diastolic between 80- 89 Stage 2: systolic at least 140 or diastolic at least 90 mm Hg Hypertensive crisis: Systolic over 180 and/or diastolic 120 Angina - ANSWER An imbalance between myocardial blood supply and oxygen demand. Signs include chest pain, usually describe as "crushing, smothering, pressing" with radiation down the left arm or up to the jaw, neck, and shoulder blade region. May be accompanied by flushing, diaphoresis, and a sudden attack of vertigo. Is a warning sign of a heart attack. Angina is usually relieved by vasodilators Glaucoma - ANSWER A group of diseases that damage the eye's optic nerve and can result in vision loss and blindness. Usually affects both eyes. COPD - ANSWER A chronic lung disease characterized by obstruction of lung air flow that interferes with normal breathing. Rheumatoid arthritis - ANSWER Causes inflammation of the lining of the joints. Body tissue is mistakenly attacked by its own immune system OBS - ANSWER Emotional disorders with a physical cause. These disorders are more commonly associated with the elderly but can affect younger people as well. Manic depressive - ANSWER Mood swings ranging from severe depression to mania; mood shifts may occur only a few times a year or as often as several times a day Anemia - ANSWER Condition marked by a deficiency of red blood cells or hemoglobin in the blood, resulting in pallor and fatigue Diabetes - ANSWER Condition caused by insufficient production of insulin, characterized by increased sugar in the blood and urine