ATI RN
Medication Administration Test Questions and Answers Questions
Question 1 of 5
A 45-year-old patient is diagnosed with lumbar radiculopathy. The patient's pain is not well controlled by an opioid medication. Which medication class does the pain management nurse identify as being the first-line, adjuvant medication for this diagnosis?
Correct Answer: B
Rationale: Anticonvulsants (e.g., gabapentin) are first-line adjuvants for neuropathic pain like radiculopathy, targeting nerve-related pain.
Question 2 of 5
Which part of a syringe is pushed to move the fluid out?
Correct Answer: D
Rationale: The plunger is pushed to expel fluid from the syringe, creating pressure to move the medication through the needle.
Question 3 of 5
Your patient has just recently been diagnosed with familial adenomatous polyposis (FAP). This disorder is chronic, progressive, and fatal. There is a genetic test that can tell whether children of parents with the disease will develop it. The test is very accurate. The patient has become divorced and refuses to give you his consent to inform his ex-wife who now has custody of their three children. He threatens to sue you if you reveal elements of his medical care to his ex-wife. What should you do?
Correct Answer: D
Rationale: The patient's right to confidentiality ends where it comes into conflict with the safety of other people. The right to confidentiality is extremely strong, but it is not universal and absolute. In this case, the children of the patient have a right to know whether their lives will be cut short by the disease of familial adenomatous polyposis (FAP) and colon cancer. The most important element is that screening for polyps should begin at the age of 12 with screening sigmoidoscopy every year. Colectomy needs to be done if polyps are found. Hence, in FAP there is a very specific intervention that can prevent colon cancer and a very specific screening that can be done. In addition, the mother has a right to know whether her children will become ill and how to plan for that. If a child falls and breaks his leg, one parent cannot claim confidentiality as a reason to withhold this critical health information from the other parent. As a part of divorce, the stipulation that each parent must inform the other parent of health-care issues for the children as they arise is a standard part of the agreement. Although, in this case, the health-care issue involves the private health of one parent, the issue is still pertinent to the other parent as the caregiver of the children. The right to one person's to privacy is not as important as the right of another person to safety. This is established standard and does not require a court order. You will have more liability from the mother of the children if she is NOT informed than from violating the confidentiality of the patient to inform. She can successfully pursue a legal action stating you, the physician, did not inform her that her children were at risk of the 'injury' of the genetic disease. The health department does not do notification for genetic diseases. The health department notifies partners and the population at risk of transmissible diseases such as tuberculosis, HIV, STDs, and food- or water-borne diseases.
Question 4 of 5
You have a patient who is an HIV-positive physician. He has recently found out that he is HIV-positive. He is very concerned about confidentiality and you are the only one who knows he is HIV-positive. He asks you who you are legally obligated to inform. What should you tell him?
Correct Answer: D
Rationale: Patients with HIV have a right to privacy as long as they are not putting others at risk. You have no mandatory obligation to inform the state, his insurance, or his employer. You and the patient do not have a mandatory obligation to inform his patients of his HIV status even if he is a surgeon. This is because an HIV-positive physician poses no significant risk of transmission to a patient. Universal precautions are supposed to prevail in order to prevent transmission. Every patient requires management as if he were HIV-positive in order to interrupt transmission. This is the meaning of 'universal' precautions.
Question 5 of 5
Mr. Sakiewiec is a 32-year-old man with severe mental retardation who has been institutionalized since childhood. He is noncommunicative and has never been able to verbalize his preferences on any decision. His parents are dead and the institution and a court-appointed guardian manages him. He has developed leukemia that is severe and incurable. Chemotherapy involves significant risk and discomfort and only a small chance of prolonging his survival. What should be done in terms of his medical treatment?
Correct Answer: D
Rationale: This patient has never been competent so there is no possibility of trying to determine what he had wanted for himself. There is no family to act in his best interests. You cannot substitute judgment for a person that has never had judgment. This case involves decision making on the least accurate of the decision-making standard, which is to determine what would be in the best interests of the patient. The reason this is the least accurate method of giving or withholding consent is that there is no way to be sure what the patient would have wanted for himself. With a best interests standard we have the difficult problem of determining whether the guardian is basing their decision on what the patient would need, or the guardian's own subjective standard of what they would want for themselves. In this case, the burden of therapy for no chance of cure is worse than the option of simply deferring therapy. If there is a court-appointed guardian, then there is no point of an 'expert panel.' The question here is not one of what the best medical therapy is, but what is in the best interests of a patient too mentally impaired to make his own decisions.