ATI LPN
Fundamentals of Nursing: The Art and Science of Person-Centered Care Tenth, North American Edition
Chapter 30 : Medications Questions
Question 1 of 5
A nurse caring for a group of patients uses measures to reduce discomfort for the patients during injections. Which technique is recommended?
Correct Answer: C
Rationale: The nurse should use the Z-track technique for intramuscular injections to prevent medication from leaking into the needle track, minimizing discomfort. The nurse should select a needle of the smallest gauge that is appropriate for the site and solution to be injected, and select the correct needle length for the type of injection and patient size. The nurse should inject the medication into relaxed muscles since more pressure (causing discomfort) will be required to injected into contracted muscles. The nurse should apply gentle pressure after injection, unless this technique is contraindicated.
Question 2 of 5
A nurse is preparing medications for patients in the ICU. The nurse is aware that patient variables may affect the absorption of these medications. Which statements accurately describe these variables the nurse will use as a basis for practice? Select all that apply.
Correct Answer: A,B,D,F
Rationale: Nurses are responsible for applying pharmacologic knowledge during medication administration, including varied responses in patients from different ethnic groups (ethnopharmacology). The patient's expectations of the medication may affect the response to the medication; for example, when a placebo is given and a patient has a therapeutic effect. Environment may also influence the patient's response to medications; for example, sensory deprivation and overload may affect drug responses. Circadian rhythms and cycles may also influence drug action. The liver is the primary organ for drug breakdown, thus pathologic conditions that involve the liver may slow metabolism and alter the dosage of the drug needed to reach a therapeutic level. The presence of food in the stomach can delay the absorption of orally administered medications. Alternatively, some medications should be given with food to prevent gastric irritation, which the nurse should consider when establishing a patient's medication schedule. Other medications may have enhanced absorption if taken with certain foods.
Question 3 of 5
A nurse is administering a pain medication to a patient. In addition to checking the identification bracelet, which active identification strategy reflects best practice?
Correct Answer: A
Rationale: The nurse should ask the patient to state their name and birthdate based on facility policy. A sign over the patient's bed may not be current or correct. The roommate is an unsafe source of information. The patient may not hear their name or may reply in the affirmative regardless of accuracy (e.g., a person with a hearing deficit).
Question 4 of 5
A nurse is administering a medication to a patient via an enteral feeding tube. Which are accurate guidelines related to this procedure? Select all that apply.
Correct Answer: C,D,F
Rationale: The nurse should use the facility policy for checking tube placement prior to administering medications. The nurse should also give each medication separately and flush with water between each drug, adjusting the amount of water used if fluids are restricted. Enteric-coated medications should not be crushed, the tube should be flushed with 15 to 30 mL of water, and the head of the bed should be elevated to prevent reflux and aspiration.
Question 5 of 5
A medication prescription reads: 'Hydromorphone, 2 mg IV every 3 to 4 hours PRN pain.' The prefilled cartridge is available with a label reading 'Hydromorphone 2 mg/1 mL' and a statement that the cartridge contains 1.2 mL of hydromorphone. How should the nurse proceed?
Correct Answer: D
Rationale: Many prefilled medication cartridges are overfilled, requiring some medication to be discarded to prevent adverse effects. Always check correct dose compared to the volume in the syringe for accuracy. As this is a prefilled syringe, it is not necessary to call the pharmacy or refuse to give the medication. Wasting narcotics typically requires a second RN to witness the waste and verify the amount of narcotic discarded.