NUR 239 Final Exam SP 2026

What are the components of a medication prescription?

Patient name, date/time order written, medication name, dose, route, frequency, prescriber signature.

What is the purpose of including the medication indication on a prescription?

Helps verify the medication is appropriate for the patient's condition and reduces medication errors.

What precautions should be taken when administering medications to children?

Use weight-based dosing, verify calculations carefully, use appropriate measuring devices, and confirm dose ranges for pediatric patients.

Why are children at higher risk for medication errors?

Doses must be calculated based on weight and organ systems are still developing.

What is an incident report in medication administration?

A report documenting a medication error or unusual event used to improve patient safety and prevent recurrence.

What should be documented in the patient chart after a medication error?

Patient assessment, medication given, provider notification, interventions, and patient response.

What information should NOT be documented in the chart after a medication error?

That an incident report was completed.

What is cell adaptation?

Structural or functional changes cells make to survive environmental stress.

What is hypertrophy?

Increase in cell size due to increased workload.

What is hyperplasia?

Increase in number of cells due to increased cell division.

What is atrophy?

Decrease in cell size due to decreased demand or nutrient supply.

What is metaplasia?

Replacement of one differentiated cell type with another due to chronic irritation.

What is pain?

An unpleasant sensory and emotional experience associated with tissue damage.

What is pain tolerance?

The maximum level of pain a person is able to tolerate.

What factors influence pain perception and tolerance?

Culture, anxiety, previous experiences, emotional state, fatigue, and support systems.

What is opioid abstinence syndrome?

Withdrawal symptoms that occur when opioid use is abruptly stopped.

What are clinical manifestations of opioid withdrawal?

Anxiety, sweating, irritability, abdominal cramps, diarrhea, nausea, vomiting, tremors.

What are nursing implications for epidural analgesia?

Monitor respiratory rate, blood pressure, pain relief, level of consciousness, and motor function.

Why is respiratory monitoring essential with epidural analgesia?

Opioids can cause respiratory depression.

What are Schedule II controlled substances?

Drugs with high potential for abuse but accepted medical use.

What are nursing responsibilities for Schedule II medications?

Locked storage, accurate documentation, double-counting with another nurse, and strict administration records.

What is the action of morphine?

Binds to opioid receptors in the CNS to relieve moderate to severe pain.

What are the major adverse effects of morphine?

Respiratory depression, sedation, hypotension, constipation, nausea.

What is the antidote for opioid overdose?

Naloxone.

What nursing assessment is required before giving morphine?

Respiratory rate, level of consciousness, and pain level.

What patient teaching is required for opioids?

Avoid alcohol, avoid driving, increase fiber and fluids to prevent constipation.

What is the action of NSAIDs like aspirin and naproxen?

Inhibit prostaglandin synthesis to reduce pain, inflammation, and fever.

Why is enteric-coated aspirin used?

To reduce stomach irritation and protect the gastric lining.

What are major adverse effects of NSAIDs?

Gastrointestinal bleeding, ulcers, kidney impairment.

What nursing teaching is important for NSAIDs?

Take with food and report signs of GI bleeding.

What is the purpose of the inflammatory response?

To eliminate pathogens and initiate tissue repair.

What are the clinical manifestations of an allergic reaction?

Rash, itching, hives, swelling, wheezing, shortness of breath.

What is anaphylaxis?

A severe systemic allergic reaction causing airway swelling and hypotension.

What is a culture and sensitivity test?

A lab test identifying microorganisms and determining which antibiotics are effective.

What is a serum drug level?

Measurement of medication concentration in the blood.

What is a peak drug level?

Highest concentration of a drug in the bloodstream after administration.

What is a trough drug level?

Lowest concentration of a drug in the bloodstream before the next dose.

What is the action of penicillin/ampicillin?

Inhibit bacterial cell wall synthesis leading to bacterial death.

What is the major adverse effect of penicillin?

Allergic reactions including anaphylaxis.

What is the action of cefazolin?

A cephalosporin antibiotic that disrupts bacterial cell wall synthesis.

What is cefazolin used to treat?

Skin infections and surgical prophylaxis.

What are major adverse effects of gentamicin?

Nephrotoxicity and ototoxicity.

What monitoring is required with gentamicin?

Kidney function and peak/trough drug levels.

What is the action of ciprofloxacin?

Inhibits bacterial DNA replication.

What patient teaching is required with ciprofloxacin?

Avoid antacids and excessive sunlight.

What is the action of clindamycin?

Inhibits bacterial protein synthesis.

What serious complication can occur with clindamycin?

Clostridioides difficile infection.

What is the action of metronidazole?

Disrupts bacterial DNA causing cell death.

What patient teaching is required with metronidazole?

Avoid alcohol due to severe nausea and vomiting.

What is the action of vancomycin?

Inhibits bacterial cell wall synthesis.

What is Red Man Syndrome?

Flushing and hypotension caused by rapid vancomycin infusion.

What nursing action prevents Red Man Syndrome?

Infuse vancomycin slowly.

What is the action of diphenhydramine?

Blocks histamine receptors to reduce allergic symptoms.

What is the most common adverse effect of diphenhydramine?

Drowsiness.

What patient teaching is important for diphenhydramine?

Avoid driving and alcohol.

What is bronchoconstriction?

Narrowing of airway smooth muscle.

What is bronchospasm?

Sudden contraction of bronchial smooth muscle.

What diagnostic test monitors theophylline therapy?

Serum theophylline level.

What is the therapeutic serum level of theophylline?

10-20 mcg/mL.

What is the action of albuterol?

Short-acting beta2 agonist that causes bronchodilation.

What are major adverse effects of albuterol?

Tachycardia and tremors.

What is the action of inhaled corticosteroids such as beclomethasone or fluticasone?

Reduce airway inflammation.

What teaching is required with inhaled corticosteroids?

Rinse mouth after use to prevent oral candidiasis.

What is montelukast used for?

Prevents airway inflammation and bronchoconstriction in asthma.

What is the action of theophylline?

Relaxes bronchial smooth muscle causing bronchodilation.

What are signs of theophylline toxicity?

Tachycardia, nausea, seizures.

What is epinephrine used for in respiratory emergencies?

Treat severe bronchospasm and anaphylaxis.

What is rifampin used for?

Treatment of tuberculosis.

What unique side effect occurs with rifampin?

Orange discoloration of body fluids.

What is nystatin used for?

Treatment of oral candidiasis (thrush).

How should nystatin oral suspension be taken?

Swish in mouth and swallow.

What medication should be taken first when using multiple inhalers?

Bronchodilator.

Why should inhaled corticosteroids be taken after bronchodilators?

Bronchodilation allows deeper steroid penetration.

What is the purpose of a spacer with inhalers?

Improves medication delivery to the lungs.

What does BNP measure?

Severity of heart failure.

What does creatine kinase indicate?

Muscle damage including myocardial infarction.

What is an echocardiogram used for?

Evaluates heart structure and pumping ability.

Why is potassium important in cardiac patients?

Abnormal potassium levels can cause arrhythmias.

What is the therapeutic range for serum digoxin levels?

0.5-2 ng/mL.

What is the action of digoxin?

Increases cardiac contractility and slows heart rate.

What are signs of digoxin toxicity?

Nausea, vision changes (yellow halos), bradycardia.

What assessment is required before giving digoxin?

Apical pulse for 1 full minute.

What is furosemide used for?

Loop diuretic used to treat edema and heart failure.

What electrolyte imbalance can furosemide cause?

Hypokalemia.

What is potassium supplementation used for?

Prevent or treat hypokalemia.

What is lisinopril used for?

ACE inhibitor used for hypertension and heart failure.

What adverse effect is common with ACE inhibitors?

Persistent dry cough.

What are metoprolol and propranolol used for?

Beta blockers used for hypertension, angina, and heart failure.

What adverse effect is associated with beta blockers?

Bradycardia.

What is spironolactone?

Potassium-sparing diuretic used for heart failure and hypertension.

What is atorvastatin/lovastatin used for?

Lower cholesterol levels to reduce cardiovascular risk.

What serious adverse effect can occur with statins?

Muscle injury (rhabdomyolysis).

What is alteplase (tPA) used for?

Dissolves clots in acute ischemic stroke.

What is the time window for tPA administration?

Within 3-4.5 hours of stroke symptom onset.

What is low-dose aspirin used for in TIA or stroke risk?

Prevent platelet aggregation and reduce risk of clot formation.

How many mg should a 20-kg child receive per dose of ampicillin if the recommended dose is 25 mg/kg/day divided into 2 doses?

250 mg per dose

What should the nurse do if a pediatric dose calculation seems unusually high?

Hold the medication and verify the dose with the provider or pharmacist before administration.

Which medication error requires the MOST urgent nursing action?

Extra dose of morphine given.

What is the FIRST action if a nurse realizes a medication error occurred but the patient is asymptomatic?

Assess the patient for adverse effects before notifying the provider.

What is the most likely cause of severe itching in a patient receiving morphine?

Histamine release from opioids.