Bmc Pharmacology And The Nursing Process

Front 1

When calculating pediatric dosages, what will the nurse take into consideration?

A. Utilization of drug reference recommendations based on mg/kg of body weight is the preferred method.
B. Calculated doses based on body weight need to be increased by 10% due to immature renal and hepatic function.
C. Dosage calculation according to body weight is the most accurate method because it takes into account differences in maturational development.
D. Dosage calculation by body surface area is the most accurate method because it takes into account the difference in size of the child and/or neonate.

Back 1

D. Dosage calculation by body surface area is the most accurate method because it takes into account the difference in size of the child and/or neonate.

The body surface area takes into account not only the child's weight, but also the relationship with height and is therefore both the most accurate and most preferred method.

Immature renal and hepatic function would necessitate a decrease in dose, not an increase.

Front 2

When teaching a pregnant mother about the effects of medication on the fetus,
the nurse recognizes that the greatest harm from maternally ingested medications occurs during which time period?

A. First trimester.
B. Second trimester.
C. Third trimester.
D. Birthing process.

Back 2

A. First trimester.

During the first trimester of pregnancy, the fetus is at the greatest risk for drug-induced developmental defects.

During this period, the fetus undergoes rapid cell proliferation, and the skeleton, muscles, limbs, and visceral organs are developing at their most rapid rate.

Front 3

Knowing that the albumin in neonates and infants has a lower binding capacity for medications,
a health care provider would do which of the following to minimize the risk of toxicity?

A. Decrease the amount of drug given.
B. Increase the amount of drug given.
C. Shorten the time interval between doses.
D. Administer the medication intravenously.

Back 3

A. Decrease the amount of drug given.

A lower binding capacity leaves more drug available for action;
thus a lower dose would be required to prevent toxicity.

Front 4

The physiologic changes that normally occur in the older adult have which of the following implications for the nurse who is assessing drug response in this patient?

A. Drug metabolism is faster.
B. Drug half-life is lengthened.
C. Drug elimination is faster.
D. Protein binding is more efficient.

Back 4

B. Drug half-life is lengthened.

Drug half-life is extended secondary to diminished liver and renal function in the elderly.

Front 5

The nurse is admitting an 82-year-old patient for treatment of heart failure.

During assessment of the patient's history, the nurse notes a subjective complaint of chronic constipation.

Of the prescribed medications the patient was taking prior to admission,
which would the nurse suspect might contribute to this gastrointestinal complaint?

A. naproxen (Aleve), a nonsteroidal antiinflammatory drug.
B. warfarin sodium (Coumadin), an anticoagulant.
C. verapamil (Calan), a calcium channel-blocking drug.
D. spironolactone (Aldactone), a potassium-sparing diuretic.

Back 5

C. verapamil (Calan), a calcium channel-blocking drug.

Calcium channel-blocking drugs may worsen constipation in the elderly population and thus should be avoided.

Front 6

The nurse working in a prenatal clinic recognizes that the safety or potential harm of drug therapy during pregnancy relates to which factor?

A. Maternal blood type.
B. Fetal sex.
C. Drug properties.
D. Diet of the mother.

Back 6

C. Drug properties.

Drug properties have a direct correlation to the safety or potential harm of drug therapy during pregnancy,
and nurses working in prenatal settings need to be aware of information related to drug properties.

Front 7

A mother of a 1-month-old infant calls the clinic and asks the nurse if the medication she is taking can be passed to her infant during breast-feeding.

What is the appropriate response for this patient?

A. "You should not take any medication while breast-feeding."
B. "Only certain medications pass to infants while breast-feeding."
C. "I will leave the doctor a message to return your call."
D. "Drugs can cross from mother to infant in breast milk, so it will depend on the drug you are taking."

Back 7

D. "Drugs can cross from mother to infant in breast milk, so it will depend on the drug you are taking."

The nurse is aware that medications can pass in breast milk, but each medication is different.

Women who take medication while breast-feeding should be assessed on a case-by-case basis, including assessment of the medication the client is taking.

Front 8

A nurse working with elderly patients is concerned with the number of medications each patient is taking.

Which will the nurse assess as highest priority for her patients related to polypharmacy?

A. Drug interactions.
B. Cost of medications.
C. Schedule of medications.
D. Nonadherence to drug regimen.

Back 8

A. Drug interactions.

The highest priority for patients with multiple medications, polypharmacy, is the assessment for drug interactions.

The more medications a patient takes, the higher the risk for drug interactions.

Front 9

Which of the following is of highest priority when obtaining a pharmacologic history from a patient?

A. Allergies.
B. Use of over-the-counter medications.
C. Home remedy use.
D. Alcohol intake.

Back 9

A. Allergies.

The key to this question is the phrase "of highest priority".

Identification of allergies is of highest priority.\
Although the other answers are important, giving a patient a medication to which he or she is allergic can be life-threatening.

Front 10

When administering medications to a patient, which action will the nurse perform?

A. Switch the route of administration based on shortage in drug stock.
B. Call the patient by name when entering the room in order to verify right person.
C. Check the patient's armband before administering the mediation.
D. Prepare medications for all patients first, then administer by room in order to manage time appropriately.

Back 10

C. Check the patient's armband before administering the mediation.

Checking the patient's armband is the most accurate method of determining identity.

All the other answers leave room for error.

Front 11

For which of the following activities is the nurse responsible during the evaluation phase of drug administration?

A. Preparing and administering medications safely and as ordered.
B. Planning measurable outcomes for the patient related to drug therapy.
C. Monitoring the patient continuously for therapeutic as well as adverse effects.
D. Gathering data in a drug and dietary history.

Back 11

C. Monitoring the patient continuously for therapeutic as well as adverse effects.

Ongoing monitoring of the patient evaluates the effect of the drug on the patient.

All the other answers refer to different steps in the nursing process.

Front 12

The nurse is caring for Mrs Smith, a 72-year-old woman.
Assuming all of the following statements are true, which documented nursing note is appropriate?

A. Mrs Smith's roommate, Mrs Jones, states that Mrs Smith did not eat her meal after the insulin injection.
B. Mrs Smith received regular insulin 2 units SQ at 0730 in the right lower abdomen.
C. Mrs Smith accidently received NPH insulin instead of the ordered regular insulin.
D. Mrs Smith received 4 units of regular insulin to treat a morning capillary blood glucose level of 210 mg/dL.

Back 12

D. Mrs Smith received 4 units of regular insulin to treat a morning capillary blood glucose level of 210 mg/dL.


The note, "Mrs Smith received 4 units of regular insulin to treat a morning capillary blood glucose level of 210 mg/dL, " is the only statement that does not violate the "Charting Don'ts" noted in Chapter 1 of the textbook.

The nurse should not chart other patients' names because this is a violation in confidentiality.

Abbreviations and terms such as "by mistake", "by accident", "accidentally", "unintentional", or "miscalculated" should also be avoided.

Front 13

The nurse should include which information when evaluating the outcome after a patient's medication has been administered?

A. Dose of medication administer.
B. Time medication administered.
C. Patient allergies to medications.
D. Medication effect on patient.

Back 13

D. Medication effect on patient.


The effect of the medication on the patient is part of the evaluation process after a medication is administered.

Front 14

The nurse has an order for administering a medication to her patient.
Which providers have legal authority to prescribe medications for patients? (Select all that apply.)

A. Physician.
B. Physical therapist.
C. Pharmacist.
D. Dentist.
E. Physician Assistant.
F. Nurse Practitioner.

Back 14

A. Physician.
D. Dentist.
E. Physician Assistant.
F. Nurse Practitioner.

The providers who have privileges to prescribe medications for patients include physicians, dentists, physician assistants, and nurse practitioners.

The exact medications that can be prescribed by non-physicians may vary from state to state as well as the type of agreement for prescriptive authority.

Front 15

The nurse should check a medication how many times prior to administration of a medication under the "right drug" part of the Six Rights?

A. One time.
B. Three times.
C. Five times.
D. Depends on the drug being administered.

Back 15

B. Three times.

The nurse should check the medication three times and confirm each time that the medication is the right drug prior to administration of the medication.

Front 16

The nurse notes that a medication was scheduled to be administered at 0900.
A medication error has occurred if the medication was administered at which time?

A. 0800.
B. 0830.
C. 0900.
D. 0930.

Back 16

A. 0800.

Medications must be given no more than 1/2 hour before or after the actual time specified in the prescriber's orders.

If the medication was administered at 0800 but had been scheduled for 0900, then a medication error has occurred.

Front 17

What is the study of the physiochemical properties of drugs and how they influence the body called?

A. Pharmacokinetics.
B. Pharmacotherapeutics.
C. Pharmacodynamics.
D. Pharmacology.

Back 17

C. Pharmacodynamics.

Pharmacodynamics is the study of the physiochemical properties of drugs and how they influence the body.

Front 18

Pharmacokinetics involves the study of:

A. physiologic interactions of drugs
B. distribution rates among various body compartments.
C. interactions between various drugs.
D. adverse reactions to medications.

Back 18

B. distribution rates among various body compartments.

Pharmacokinetics involves the study of how the drug moves through the body, including absorption, distribution, metabolism, and excretion.

Front 19

How can drugs exert their action on the body? (Select all that apply)

A. By interacting with receptors.
B. By making the cell perform a new function.
C. By inhibiting the action of a specific enzyme.
D. By altering metabolic chemical processes.

Back 19

A. By interacting with receptors.
C. By inhibiting the action of a specific enzyme.
D. By altering metabolic chemical processes.

Drugs cannot make a cell perform a new function;
they can only alter the way a cell performs its current function.

Front 20

What is an alternate name for biotransformation of a drug?

A. Absorption.
B. Dilution.
C. Excretion.
D. Metabolism.

Back 20

D. Metabolism.

Metabolism connotes a breakdown of a product.
Biotransformation is actually a more accurate term because some drugs are actually changed into an active form in the liver in contrast to being broken down for excretion.

Front 21

A drug given by which route is altered by the first-pass effect?

A. Sublingual.
B. Subcutaneous.
C. Oral.
D. Intravenous.

Back 21

C. Oral.

Medications absorbed i the stomach and small intestine travel through the portal system and are metabolized by the liver before they reach the general circulation.

Front 22

Drug half-life is defined as the amount of time required for 50% of a drug to:

A. be absorbed by the body.
B. exert a response.
C. be eliminated by the body.
D. reach a therapeutic level.

Back 22

C. be eliminated by the body.

Half-life refers to the time it takes to excrete a drug from the body.

Front 23

Which action will increase the absorption of a medication administered intramuscularly?

A. Applying cold packs to the injection site.
B. Lowering the extremity below the level of the heart.
C. Administering the medication via the Z-track method.
D. Massaging the site after injection.

Back 23

D. Massaging the site after injection.

Massaging the site increases circulation to the area and thus increases absorption.

Front 24

Highly protein-bound drugs:

A. increase the risk of drug-drug interactions.
B. typically provide a short duration of action.
C. must be administered with 8 ounces of water.
D. have a decreased effect in patients with a low albumin level.

Back 24

A. increase the risk of drug-drug interactions.

When administering two medications that are highly protein bound, the medications can compete for binding sites on plasma proteins.

This competition results in either less of both or less of one of the drugs binding to the proteins, thus increasing the risk of toxicity.

Front 25

To achieve the most rapid onset of action, by which route will the health care provider administer the medication?

A. Subcutaneously.
B. Intravenously.
C. Intramuscularly.
D. Intrathecally.

Back 25

B. Intravenously.

When a drug is administered intravenously, it does not need to be absorbed because it is placed directly into general circulation.

Front 26

Patients with renal failure would most likely have problems with drug:

A. excretion.
B. absorption.
C. metabolism.
D. distribution.

Back 26

A. excretion.

The kidneys are responsible for the majority of drug excretion.

Front 27

What is the ratio between a drug's therapeutic effects and toxic effects called?

A. Tolerance.
B. Cumulative effect.
C. Therapeutic index.
D. Affinity.

Back 27

C. Therapeutic index.

The ratio of a drug's therapeutic benefits to its toxic effects is referred to as the drug's therapeutic index.

Front 28

Which factors will affect the absorption of orally administered medications? (Select all that apply.)

A. Presence of food in the stomach.
B. pH of the stomach.
C. Patient position upon intake of medication.
D. Form of drug preparation.
E. Time of day.

Back 28

A. Presence of food in the stomach.
B. pH of the stomach.
D. Form of drug preparation.
E. Time of day.

Various factors affecting the rate of drug absorption include the administration route of the drug, presence of food or fluids administered with the drug, dosage formulation, status of the absorptive surface, rate of blood flow to the small intestine, acidity of the stomach, and status of gastrointestinal motility.

Time of day would affect the acidity of the stomach and would therefore affect the rate of drug absorption.

Front 29

When a patient asks the nurse why a lower dose of intravenous pain medication is being given that the previous oral dose, what knowledge will the nurse draw on for her response?

A. Medications given intravenously are not affected by the first-pass effect.
B. Medications given orally bypass the portal circulatory system.
C. A large percentage of an intravenously administered drug is metabolized into inactive metabolites in the liver.
D. Drugs administered intravenously enter the portal system prior to systemic distribution.

Back 29

A. Medications given intravenously are not affected by the first-pass effect.

When drugs with a high first-pass effect are administered orally, a large amount of drug may be metabolized before it reaches the systemic circulation. The same drug given intravenously will bypass the liver. This prevent the firs-pass effect from taking place, and therefore more of the drug reaches the circulation. Parenteral doses of drugs with a high first-pass effect are much smaller than oral doses, yet they produce the same pharmacologic response.

Front 30

What is the nurse's role in the development of new and investigational drugs?

A. Monitoring for and reporting any adverse effects noted during Phase IV studies.
B. Selecting patients to participate in Phase I studies.
C. Identifying patients who are receiving placebo drugs during Phase III studies.
D. Informing patients of the specific drug they are receiving within a blinded investigational study during Phase III.

Back 30

A. Monitoring for and reporting any adverse effects noted during Phase IV studies.

Phase IV studies rely on health care professionals to report adverse effects that may not have been apparent in previous phases.

In most studies, neither the health care providers nor the patients know which patients are being given the real drug versus the placebo.

Front 31

Ethically, a nurse has the responsibility to:

A. employ beneficence, the duty to do no harm to a patient.
B. withhold information from the patient as requested by the family.
C. impose his or her own values upon the patient when doing so would help the patient.
D. transfer care of a patient to another professional nurse if caring for the patient would violate personal ethical principles.

Back 31

D. transfer care of a patient to another professional nurse if caring for the patient would violate personal ethical principles.

Beneficence is the duty to do good; withholding information from a patient is not only unethical, but illegal, and imposing your values onto a patient is never appropriate.

However, if providing required care to a certain type of patient would violate your personal ethics, then it is your responsibility to transfer care of that patient to another professional nurse rather than not performing necessary care, which would be a form of abandonment.

Front 32

Which of the following statements best reflects the nurse's understanding of cultural influences on drug therapy and other health practices?

A. Administration of some drugs may elicit varied responses in specific racial-ethnic groups.
B. Regardless of one's cultural background, it is crucial to always adhere to recommended medical practices.
C. Most cultures are fairly standard in reference to the use of medications during illness.
D. Dietary habits and practices can be of little value to the care of an ill adult.

Back 32

A. Administration of some drugs may elicit varied responses in specific racial-ethnic groups.

Knowledge about drugs that may elicit varied responses in specific racial or ethnic groups must remain current.
For example, genetic changes in certain CYP enzymes affect the rate of drug metabolism and thus affect drug levels and dosage amounts.
Cultural practices vary among individuals and should be implemented as an integral part of holistic nursing care.
Dietary habits and practices can affect the pharmacokinetics of medications and are thus an important aspect of the patient's history.

Front 33

When teaching a patient about the legalities regarding a prescription for methylphenidate (Ritalin), which statement is most correct?

A. Methylphenidate (Ritalin) is a C-1 narcotic that can only be prescribed according to an approved protocol.
B. Methylphenidate (Ritalin) is a C-II narcot that cannot be refilled and can only be filled with a written prescription.
C. Methylphenidate (Ritalin) is a C-III narcotic for which a prescription will expire in 6 months.
D. Methylphenidate (Ritalin) is a C-IV narcotic that is only allowed to be refilled five times per prescription.

Back 33

B. Methylphenidate (Ritalin) is a C-II narcot that cannot be refilled and can only be filled with a written prescription.

Methylphenidate (Ritalin) is classified as a C-II narcotic. C-II narcotics can only be dispensed with a written prescription and cannot be refilled.

Front 34

The nurse is assessing her patient's culture and race on admission to the hospital. Which is important for the nurse to understand regarding drug therapy as it relates to different races of individuals?

A. Polypharmacy.
B. Polymorphism.
C. Pharmacokinetics.
D. Pharmacodynamics.

Back 34

B. Polymorphism.

The nurse should ask the patient if she takes any herbs or other non-prescribed medications.
The patient is of Asian culture and may use herbal remedies that she does not consider medications.

Front 35

The nurse is documenting the history of a patient of Asian culture in the emergency room.
The patient states that she has not taken any medications,
but the nurse notes a bottle of capsules in the patient's purse.
What information should the nurse collect next?

A. Vital signs.
B. Primary care provider name.
C. Use of herbs or over-the-counter medications.
D. Insurance information.

Back 35

C. Use of herbs or over-the-counter medications.

The nurse should ask the patient if she takes any herbs or other non-prescribed medications.
The patient is of Asian culture and may use herbal remedies that she does not consider medications.

Front 36

New drugs must go through much research and testing prior to approval for use in humans.
The nurse is providing education to a patient on a new medication and will inform the patient that the average length of time a medication is researched before being used in humans is:

A. 2 to 4 years.
B. 6 to 8 years.
C. 10 to 12 years.
D. 14 to 16 years.

Back 36

C. 10 to 12 years.

The average length of time it takes for a drug to move from the application and research process to being prescribed for a patient is 10 to 12 years.

Front 37

A pharmaceutical company is voluntarily conducting a postmarketing study to obtain further proof of the therapeutic effects of a new drug.
What phase of drug study is this considered?

A. Phase I.
B. Phase II.
C. Phase III.
D. Phase IV.

Back 37

D. Phase IV.

Front 38

Which is the most appropriate example of an indirect form of gene therapy?

A. Stem cells.
B. Human insulin.
C. Antigen substitution.
D. Platelet inhibitors.

Back 38

B. Human insulin.

One of the most common examples is the use of the Escherichia coli bacterial genome to manufacture a recombinant form of human insulin. When the human insulin gene is inserted into the genome of the bacterial cells the resulting culture artificially generates human insulin on a large scale.
The general goal of gene therapy is to transfer exogenous genes to a patient to change the patient's own genetic functioning to treat a given disease, to improve drug metabolism, to prevent genetic disorders in the patient's future children, and to stimulate the growth of stem cells. Antigen substitution is a small dose of an allergen that can be used for treatment of seasonal or environmental allergens. Platelet inhibitors are used to keep blood from clotting or aggregating. Plavix is an example of a platelet inhibitor.

Front 39

The general goal of gene therapy is to transfer exogenous genes to a patient to:

A. change the patient's own genetic functioning to treat a given disease.
B. improve drug metabolism.
C. prevent genetic disorders i the patient's future children.
D. stimulate the growth of stem cells.

Back 39

A. change the patient's own genetic functioning to treat a given disease.

This therapy involves the treatment or prevention of disease by transferring exogenous (foreign) genetic material (DNA or RNA) into the body of an individual.

Front 40

The NIH Recombinant DNA Advisory Committee has the responsibility for which of the following?

A. Approving all forms of human clinical gene therapy.
B. Identifying all major risks to the human subjects in a specific research protocol.
C. Reviewing clinical trials involving human gene transfer and scheduling public forums.
D. Analyzing genomes and determining whether they appear mutagenic.

Back 40

B. Identifying all major risks to the human subjects in a specific research protocol.

In the 1980's, the NIH Recombinant DNA Advisory Committee was assigned responsibility for oversight of gene therapy research in the United States. The FDA must also review and approve all human clinical gene therapy. The FDA regulates gene transfer trials.

Front 41

The presence of certain factors in a person's genetic makeup that increase the likelihood of eventually developing one or more diseases is known as a:

A. genetic mutation.
B. genetic polymorphism.
C. genetic predisposition.
D. genotype.

Back 41

C. genetic predisposition.

The definition of genetic predisposition is the presence of certain factors in a person's genetic makeup, or genome, that increases the individual's likelihood of eventually developing one or more diseases.

Front 42

Which of the following is a commonly studied adenovirus?

A. Hepatitis A and C virus.
B. Genovirum.
C. Human influenza virus.
D. Pallodium.

Back 42

C. Human influenza virus.

One commonly used group of viruses is the adenoviruses, which include the human influenza (flu) viruses. (Genovirum is NOT a word.)

Front 43

General responsibilities of the nurse regarding genetics may include which of the following? (Select all that apply.)

A. Assessing the patient's personal and family history.
B. Referring the patient to a genetic counselor or other genetics specialist.
C. Communicating the results of genetic tests to the patient and patient's family.
D. Maintaining privacy and confidentiality during the testing process.
E. Answering questions about the genetic test results.

Back 43

A. Assessing the patient's personal and family history.
B. Referring the patient to a genetic counselor or other genetics specialist.
D. Maintaining privacy and confidentiality during the testing process.

Assessing family history is an important piece of genetic therapy. Nurses and advanced practice nurses (APN) will need to refer patients that have genetic disorders or have a high risk of having a child with a genetic disorder for genetic counseling.
Privacy and confidentiality are considered a patient's rights and are addressed with HIPPA laws.
The results should be kept confidential. The role of the nurse is to answer questions about what the genetic specialist has reviewed with the patient; however, the genetic counselor is charged with the task of conveying and answering questions about the results of the test.

Front 44

When planning interventions aimed at reducing medication errors, the nurse recognizes that:

A. only 10% of all preventable adverse drug reactions (ADRs) begin at the medication ordering (prescribing) stage.
B. disciplinary action is necessary to increase the nurse's vigilance in preventing medication errors.
C. the majority of medication errors result from weaknesses within the system rather than individual shortcomings.
D. the use of trailing zeroes (i.e. 1.0 mg) and omission of leading zeroes (i.e. 0.25 mg) reduces transcription errors.

Back 44

C. the majority of medication errors result from weaknesses within the system rather than individual shortcomings.

It is widely recognized that the majority of medication errors result from weaknesses within the "system" structure of health care organizations, resulting less often from individual shortcomings.
Vindictive disciplinary action or "finger pointing" is now generally recognized as being counterproductive in the prevention of medication errors.
Studies have shown that one half of all preventable ADRs begin at the medication ordering (prescribing) stage.
The use of leading zeroes and omission of trailing zeroes will help prevent transcription errors.

Front 45

When receiving a patient transferred from another unit, which action is most useful to prevent medication errors?

A. Completing a medication reconciliation between units.
B. Participating in a verbal report from the transferring nurse.
C. Asking the patient what medications were received upon transfer.
D. Asking the physician to rewrite all medication orders upon transfer.

Back 45

A. Completing a medication reconciliation between units.

Medication reconciliation to verify all of the patient's correct medications at each point of care (i.e. transfer from ICU to the general nursing unit) is an important nursing action to prevent medication errors. Reports should be written for better documentation. Patients may not remember or be aware of specific medications they received. Asking a physician to rewrite medication orders can only prevent errors if the physician also performs a medication reconciliation to verify that the correct medications are reordered.

Front 46

When admitting an elderly patient to an acute care setting, which nursing strategy is most appropriate to prevent medication errors?

A. Call the primary care physician to verify current medications.
B. Ask the patient's family to verify medications the patient was taking at home.
C. Ask the patient to provide you with a written list of all medications being taken at home.
D. Ask the patient and/or family to bring in all medications the patient was taking at home.

Back 46

D. Ask the patient and/or family to bring in all medications the patient was taking at home.

The USP recommends the use of "brown bagging" sessions of medications to identify drugs that patients are taking. Patients, family, and/or the primary care physician may not always accurately report all medications a patient is using. Actual examination of the mediations and containers provides the most accurate assessment of current medications and allows for appropriate medication reconciliation.

Front 47

Why are specific medications classified as "high-alert" medications?

A. Potential for patient harm is higher with these medications.
B. Medications always cause certain adverse side effects.
C. States require that these medications be on the high-alert list.
D. Only RNs are allowed to administer these medications.

Back 47

A. Potential for patient harm is higher with these medications.

Medications on the high-alert list of medications have been identified as such because of their potentially toxic nature and their need for special care when prescribing, dispensing, and administering.

Front 48

The nurse administers a medication to the wrong client. Which the appropriate nursing action following this error?

A. Assess the client for an adverse reaction and report if an adverse event occurs.
B. Document the medication error. No further action is required.
C. Report the error and document on the patient chart.
D. Notify the provider and document the error on an incident report.

Back 48

D. Notify the provider and document the error on an incident report.

All medication errors which involved a patient need to be called to the health care provider and documented on an incident report.

Front 49

Which action assists the nurse in prevention of a potential medication error?

A. Ask the patient what disease the medication is for before administering.
B. Encourage the patient to question medications if the medications are different than he/she expects.
C. Allow the patient to take home medications when desired.
D. Administer the patient's medications from his/her personal bottles while in the hospital.

Back 49

B. Encourage the patient to question medications if the medications are different than he/she expects.

The nurse should encourage patients to question any medication that they are not familiar with or are not expecting to take.

Front 50

In which step of the medication process can a medication error occur? (Select all that apply.)

A. Procurement.
B. Prescribing.
C. Transcribing.
D. Dispensing.
E. Administration.

Back 50

A. Procurement.
B. Prescribing.
C. Transcribing.
D. Dispensing.
E. Administration.

Medication errors can occur at any point in the medication process.

Front 51

The nurse knows that the medication reconciliation process involves which three steps?

A. Reporting.
B. Reconciliation.
C. Verification.
D. Administration.
E. Clarification.

Back 51

B. Reconciliation.
C. Verification.
E. Clarification.

The 3 steps of the medication reconciliation process are verification, clarification, and reconciliation.

Front 52

Which assessment findings bes support the nursing diagnosis of "Deficient knowledge related to medication therapy"?

A. Patient is not taking medication as directed.
B. Patient is not reporting side effects ad directed.
C. Patient is unwilling to comply with medication therapy.
D. Patient is unable to verbalize reason for taking the medication.

Back 52

D. Patient is unable to verbalize reason for taking the medication.

A nursing diagnosis of Deficient knowledge evolves from data collected that proves that the patient has a lack of or limited understanding about the medication; its action, side effects, or cautions; and any related administration techniques. Deficient knowledge differs from noncompliance in that the latter occurs when the patient does not take the medication as prescribed or at all; in other words, the patient does not adhere to the instructions given about the medication.

Front 53

When planning care for an assigned patient, the nurse identifies the outcome of "Patient will be able to safely self-administer enoxaparin (Lovenox) subcutaneously upon discharge."
Which of the following methods best evaluates the patient's achievement of this outcome?

A. Have the patient verbalize the correct procedure step-by-step.
B. Visually demonstrate the correct procedure to the patient.
C. Have the patient perform a return demonstration of the procedure.
D. Give the patient detailed written instructions illustrating the procedure.

Back 53

C. Have the patient perform a return demonstration of the procedure.

Nurses should always validate whether learning has occurred by asking the patient questions related to the teaching session and having the patient provide a return demonstratio of the skill.
Although the other 3 responses are part of the teaching process, they do not validate the actual ability of the patient performing the procedure.

Front 54

The nurse is providing discharge teaching to an elderly patient with short-term memory problems.
Which strategies will the nurse use in educating the patient? (Select all that apply.)

A. Repeat information frequently.
B. Provide written instructions for home us.
C. Instruct patient to take all medications in the morning.
D. Encourage use of daily medication containers with alarms.
E. Perform several short teaching-learning sessions.

Back 54

B. Provide written instructions for home us.
C. Instruct patient to take all medications in the morning.
D. Encourage use of daily medication containers with alarms.
E. Perform several short teaching-learning sessions.

Repeating instructions, providing written instructions, and encouraging use of daily medication containers (which will remind the patient to take the medication as well as enable the patient to know whether or not medication has been taken) are all appropriate interventions for a patient with short term memory difficulties.
The nuse may have to conduct several brief teaching-learning sessions for the patient to absorb the information. Having the patient take all the medications at once does not necessarily ensure they will be taken or prevent overdosage. Also, some medications may have adverse interactions if taken at the same time.