NLN Medication Exam

Six Rights of Medication Administration

Right medication

Right patient

Right Time

Right Route

Right Dose

Right Documentation

Two patient identifiers

Name and DOB

Which medication is contraindicated for renal failure patients?

• Ampicillin sodium (Omnipien-N)

• Calcitriol (Rocaltrol)

• Diphenhydramine hydrochloride (Benadryl)

• Tobramycin sulfate (Nebcin)

Tobramycin sulfate (Nebcin)

What should a nurse do prior to administration of an initial dose of an antibiotic?

• Ensure culture and sensitivity specimens have been obtained

• Obtain the client's body temperature

• Measure the client's urine output

• Determine the client's weight

Ensure culture and sensitivity specimens have been obtained

Prior to administering the next dose of glyburide (Diabeta) which of the following signs and symptoms would alert the nurse to further assess the patient?

• Cool, wet skin

• Elevated blood pressure

• Frequent urination

• Blurred vision

Cool, wet skin

Which statement by a patient on warfarin sodium (Coumadin) would indicate that he/she is knowledgeable about the medication?

• I will shave with an electric razor.

• I will increase my intake of green vegetables.

• I will use unwaxed dental floss twice daily.

• I will decrease my daily dose if I feel fatigued.

I will shave with an electric razor

What is the appropriate teaching for a patient on fentanyl (Duragesic) for several weeks?

• Taper this medication slowly when discontinuing its use

• Increase the dosage when pain persists for several hours

• Limit physical activity while on this medication

• Vigorously rub medication into skin

Taper this medication slowly when discontinuing its use

An adverse effect of captopril (Capoten) is...?

• Dehydration

• Peripheral edema

• Hyperglycemia

• Persistent cough

Persistent cough

A therapeutic effect to amlodipine (Norvasc) is...?

• Greater flexibility

• Decreased blood pressure

• Improved cognition

• Decreased pain

Decreased blood pressure

What is a common side effect of a calcium channel blocker?

• Hypertension

• Urinary retention

• Weight loss

• Diplopia

Diplopia

Enoxaparin (Lovenox) is CONTRAINDICATED for patients with...?

• Congestive health failure

• Kidney stones

• Bleeding disorders

• Asthma

Bleeding disorders

A nurse should include which of these instructions for a patient on naproxen (Naprosyn)?

• Maximum effectiveness may take two to four weeks of continued therapy

• The medication may be taken with aspirin to improve pain relief.

• You will need to carefully monitor your blood sugar levels

• It is important that you avoid sun exposure

Maximum effectiveness may take two to four weeks of continued therapy

A nurse should monitor ________________ for a patient who is taking furosemide (Lasix)?

• Respiratory rate

• Blood pressure

• Pulse oximetry

• Babinski reflex

Blood pressure

An anti-hyperlipidemic medication is contraindicated for which patient?

• a 30-year-old client who has a history of heart disease

• a 44-year-old client who has recurrent urinary tract infections

• a 57-year-old client who has cirrhosis related to alcohol abuse

• a 79-year-old client who has bilateral cataracts

a 57-year-old client who has cirrhosis related to alcohol abuse

The side effect for cefotaxime sodium (Claforan) is...?

• Diarrhea

• Vertigo

• Tinnitus

• Insomnia

Diarrhea

The therapeutic effect of an angiotensin converting enzyme, ACE inhibitor is..?

• Increased cardiac workload

• Increased exercise tolerance

• Increased peripheral vascular resistance

• Increased respiratory effort

Increased exercise tolerance

The desired effect of epoetin alfa (Epogen) is...?

• Decreased lymphocytes

• Decreased neutrophils

• Increased platelet count

• Increased hematocrit level

Increased hematocrit level

Signs of renal toxicity for a patient on vancomycin hydrochloride (Vancocin) would include...

• Increased serum creatinine level

• Decreased blood urea nitrogen, BUN, level

• Increased blood pressure

• Intermittent flank pain

Increased serum creatinine level

Which emergency medication should the nurse have available for a patient in cholinergic crisis from bethanechol (Urecholine)?

• Atropine sulfate (Isopto Atropine)

• Epinephrine hydrochloride (Adrenalin chloride)

• Diphenhydramine hydrochloride (Benadryl)

• Acetaminophen (Tylenol)

Atropine sulfate (Isopto Atropine)

Cephradine (Velosef) is contraindicated in an elderly patient with a history of...

• Hypertension

• Penicillin allergy

• Drug dependence

• Depression

Penicillin allergy

What is the appropriate education for a patient who abruptly stops his hypertensive medications due to interference to sexual function?

• Serious hypertension is likely to result from stopping medications abruptly

• The side effects would have eventually disappeared with continued administration

• Alternative medication therapy that will not affect sexual function is available

• Stopping the medications now will cause a stroke

Alternative medication therapy that will not affect sexual function is available

The nurse knows that performance of a purified protein derivative (PPD) test for TB will include:

• Pointing the bevel of the needle downward

• Massaging the area after the injection

• Ensuring the wheal forms

• Using a 22 gauge, one-inch needle

Ensuring the wheal forms

What is a priority action for the nurse with a patient who is admitted with an international normalized ratio, (INR) of 1.2 after taking Coumadin for 3 months?

• Administer phytonadione (AquaMEPHYTON) to the client?

• Withhold the client's next dose of warfarin sodium (Coumadin)

• Encourage the client to increase intake of iron-rich foods

• Determine if the client is taking the medication as prescribed

Determine if the client is taking the medication as prescribed

How many hours after administration of isophane insulin suspension (Humulin N, NPH) should the patient be monitored for hypoglycemia?

• 1 to 1 1 ⁄ 2

• 2 to 3

• 4 to 12

• 16 to 18

4 to 12

The nurse notes that the patient understands teaching on nadolol (Corgard) when he states _______________as a side effect.

• Hypotension

• Migraine headache

• Tremors

• Urinary retention

Hypotension

A side effect of nitrate medication is:

• Joint pains

• Double vision

• Headache

• Sweating

headache

What should the nurse monitor daily for a patient receiving spironolactone (Aldactone)?

• Heart rate

• Urine, acetone, level

• Body weight

• Pulse oximetry

Body Weight

Nursing education for a patient who is taking phenytoin sodium (Dilantin) is

• Annual vision screening

• Regular dental check-ups

• Monthly hearing tests

• Weekly weight monitoring

Regular dental check-ups

Which of these instructions is priority for a patient who will take clarithromycin (Biaxin) at home?

• Avoid citrus juice

• Stop this medication if you develop nausea

• Finish taking all of these pills

• You may experience dizziness when changing positions

Finish taking all of these pills

What is the appropriate patient education for a patient who is receiving sublingual nitroglycerin (Nitrostat)

• Do not take this medication if you heart rate is irregular

• Chew the tablet well to increase the therapeutic effects

• Take a minimum of four tablets for chest pain before going to the emergency department

• Discard unused pills if the bottle has been opened for six months

Discard unused pills if the bottle has been opened for six months

What is the most important assessment for a patient receiving nalbuphine hydrochloride (Nubain)?

• Respiratory status

• Pupillary reaction

• Pulse rate

• Blood sugar

respiratory status

Education for a patient prior to their initial dose of nitroglycerin for acute angina attacks should include:

• Wait five minutes before taking the medication, if experiencing pain

• Discontinue the medication if the client experiences a headache

• Take a second dose ten minutes after the first dose, if no relief is felt after the initial dose

• Allow the medication to dissolve under the tongue

Allow the medication to dissolve under the tongue

Which of these laboratory values should be monitored for a patient who is receiving digoxin (Lanoxin)?

• Blood urea nitrogen, BUN

• Serum glucose

• Serum potassium

• Complete blood count

Serum potassium

__________________ should be measured prior to the administration of potassium chloride (K-lor) intravenously.

• Blood pressure

• Respiratory rate

• Pulse deficit

• Urine output

Urine output

Further nursing assessment is indicated for a patient on vancomycin (Vancocin) who states __________________.

• I have a headache

• I can't hear the television

• I have not had a bowel movement in 2 days

• I feel drowsy

I can't hear the television

Which of the following is a side effect of nifedipine (Adalat)?

• Peripheral edema

• Hypertension

• Tinnitus

• Sexual dysfunction

Peripheral edema

Theophylline (Slo-Bid) is generally administered__________________.

• On a pm basis

• On an empty stomach

• With antiacids

• Every 4 hours

On an empty stomach

Recommended pediatric dosages for acetaminophen (Tylenol).

10-15 mg/kg at 4-hour intervals

What should be measured Prior to the administration of each dose of metoprolol tartate (Lopressor)?

• Urine output

• Heart rate

• Capillary refill

• Body weight

Heart Rate

What is the classification of buspirone (BuSpar)?

• Antidepressant

• Anti-anxiety agent

• Anti-seizure medication

• Antipsychotic

Anti-anxiety agent

At what time should a patient who is taking isophane insulin suspension (NPH, Humulin N), to eat a snack?

• One-half hour prior to the dose

• Immediately after the dose

• In the mid-afternoon

• Every two hours during the daytime

In the mid-afternoon

Norm range of WBC

4,000 - 11,000

Norm range of Hct

men - 40-50%

women - 36-45%

Norm range of Hgb

men 14-18,

women 12-16

Norm range of RBC

men 4.5-6.0

women

Norm range of Platelet

150,000 - 400,000

Meperidine hydrochloride (Demerol) is contraindicated for a client who is receiving ______________________?

• An anti-anxiety medication

• A monoamine oxidase inhibitor, MAOI

• An antihypertensive medication

• A diuretic

A monoamine oxidase inhibitor, MAOI

Fluoxetine hydrochloride (Prozac) is normally administered

• In the morning

• On an as needed basis

• At bedtime

• On an empty stomach

In the morning

A side effect of pravastatin (Pravachol) includes _____________________.

• Myalgia

• Hypertension

• Tremors

• Tachycardia

Myalgia

A nurse who is administering sodium polystyrene sulfonate (Kayexalate) to a patient with renal failure recognizes the purpose of this medication is to:

• Increase the serum sodium level

• Decrease phosphorous absorption

• Reduce serum potassium

• Prevent loss of calcium

Reduce serum potassium

An adverse effect of methylprednisolone sodium succinate (Solu-Medrol) includes:

• Sore throat

• Fatigue

• Diarrhea

• Weight loss

Sore throat

A therapeutic response to a prescribed antihyperlipidemic medication is indicated by:

• Decreased high density lipoprotein, HDL, cholesterol

• Increased triglyceride level

• Decreased low density lipoprotein, LDL, cholesterol

• Increased bilirubin level

Decreased low density lipoprotein, LDL, cholesterol

A patient who has cytomegalovirus, CMV, is taking ganciclovir (Cytovene) for retinitis. What side-effects should the nurse monitor for?

• Tinnitus

• Inflammation of the gallbladder

• Bone marrow depression

• Myalgia and muscle weakness

Bone marrow depression

Which of the following is an adverse effect of beta-adrenergic blocker?

• Congestive heart failure

• Hypothyroidism

• Phlebitis

• Hypertension

Congestive heart failure

Rh-immune globulin (RhoGAM) is indicated for __________________________.

• Rh-neg mother who has an Rh-neg infant

• Rh-neg mother who has an Rh-pos infant

• Rh-pos mother who has an Rh-pos infant

• Rh-pos mother who has an Rh-neg infant

Rh-neg mother who has an Rh-pos infant

Prior to administering terbutaline sodium (Brethine) subcutaneously the nurse assesses _____________.

• Urine output

• Body temperature

• Pulse oximetry

• Heart rate

Heart rate

Which of the following is a side effect of isoniazid (INH)?

• Peripheral neuropathy

• Hypertension

• Weight gain

• Elevated blood glucose levels

Peripheral neuropathy

IV heparin infusion

IV BOL 80 international units/kg, then maintenance IV INF 18 international units/kg/hr

• if aPTT <35 (1.2×normal), increase IV INF rate by 4 international units/kg/hr and rebolus with 80 international units/kg

• if aPTT 35-45 (1.2-1.5 × normal), increase IV INF by 2 international units/kg/hr and rebolus with 40 international units/kg;

• if aPTT 46-70 (1.5-2.3 × normal), maintain IV INF;

• if aPTT 71-90 (2.3-3 × normal), decrease IV INF by 2 international units/kg/hr

• if aPTT >90 (>3 × normal), hold IV INF for 1 hr, then decrease rate 3 international units/kg/hr

1 pound (lb) = ___g

453.6 grams (g)

1 pint (pt) = ___ ml

500 mL

2 tbsp = ___ oz or ___ ml

1 ounce or 30 ml

1 tablespoon = ___ml

15 ml

1 teaspoon = ___ml

5 ml

15 gtts = ___ml

1 ml

1000 ml = ___qt

1 quart

1kg = ___lbs

2.2lbs