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 patient experiencing chest pain asks the nurse why a nitroglycerin tablet must be placed under their tongue instead of swallowed. Which answer by the nurse is appropriate?
Correct Answer: B
Rationale: Drugs with extensive or variable first-pass effects, such as nitroglycerin, are not given orally because most of the drug would be destroyed by the liver, with little or no drug left to work in the body. Sublingual medications should not be swallowed, but rather held in place so that complete absorption can occur. Before administering a sublingual or buccal drug, offer the patient water (if permitted) or oral care (if NPO). Placing a tablet between the cheek and gum is consistent with the buccal route of administration, not sublingual. Enteric-coated tablets are designed to dissolve after passing through the stomach.
Question 2 of 5
A nurse in the pediatric unit of an acute care hospital is awaiting a prescription for antibiotics for a toddler with a severe infection. Which information about the child is essential to document immediately?
Correct Answer: C
Rationale: Drug doses for children are calculated by weight in kilograms or BSA. The weight is needed for the provider to write the prescription.
Question 3 of 5
A nurse in a pediatric practice teaches the mother of a toddler to administer antibiotic ear drops. What education by the nurse is correct?
Correct Answer: C
Rationale: For children ages 3 years and younger, the nurse teaches the parent or caregiver to pull the pinna down and back to straighten the auditory canal, then instill the medication. For adults, the pinna is pulled up and back; for school-age children, the pinna is pulled straight back. The nurse does not insert cotton swabs in the ear; rather, the nurse can wipe the external ear of drainage, if necessary.
Question 4 of 5
A nurse is planning to administer digoxin to a patient. After reviewing the medical record, what action will the nurse take? Electronic Health Record Prescriptions - 11/22/2025 digoxin loading dose 0.25 mg IV twice today only - 11/23/2025 begin digoxin 0.125 mg orally daily Laboratory Studies - Digoxin level: 2.7 ng/mL (reference range 0.5-2 ng/mL)
Correct Answer: B
Rationale: The nurse is responsible for safe medication administration, including interpreting therapeutic serum drug levels. The nurse withholds the medication based on the toxic (high) drug level. Next, the nurse collaborates with the health care provider to determine if a dose adjustment is indicated. Prescribing is outside the nurse's scope of practice; determining a half dose is needed is a prescription. The patient's renal function will be evaluated periodically, but it is most important not to give a medication when the blood level demonstrates toxicity.
Question 5 of 5
A nurse notices that an older adult patient is malnourished, and blood tests reveal reduced plasma protein levels. For which of these pharmacodynamic effects will the nurse observe?
Correct Answer: A
Rationale: Lowered protein levels in the body means less drug bound to plasma proteins, which leads to a higher concentration of free (unbound) drug in the body. This higher drug concentration increases the risk for adverse effects.