Medication Exam

1. The most dangerous side effect of morphine sulfate is its:

Ability to disorient patients

Ability to induce sleep

Effect on inducing seizure

Depressing effect on the respiratory center

2. The nurse gives a patient's routine medicines and the patient states, "I had fewer capsules than this yesterday." Which of the following responses is most appropriate?

"I am certain this dose is the amount the doctor feels is best."

"This is the number of capsules the doctor ordered."

"Let me recheck the doctor's orders."

"Well, this is probably just a new order."

3. During administration of Heparin via an IV drip, which of the following labs may be ordered as frequently as q6 hrs:

H/H

Partial thromboplastin time (PTT)

Serum fibrinogen

Sedimentation rate

4. Which of the following are appropriate patient education instructions to the patient taking a medication sublingually?

Drink a full glass of water after swallowing it

Rinse your mouth with medication, but do not swallow it

Chew the medication thoroughly before swallowing it

Hold the medication under your tongue until it is dissolved

5. The physician orders 100 mg of Demerol PO every 4 hours PRN incision pain. Demerol 50 mg tablets are available. The nurse should administer:

2 tablets

3 tablets

4 tablets

½ tablet

6. A client who takes 4 tablets of buffered aspirin 4 times a day complains of dizziness and ringing in the ears. The nurse should recognize that the client is probably experiencing:

Aspirin toxicity

A dermatitis reaction

Withdrawal symptoms

Acetaminophen overdose

7. The physician orders 8 mg of Morphine Sulfate to be given by injection. The vial on hand is labeled 10 mg/1 ml. The nurse should administer:

0.8 ml

1.0 ml

0.5 ml

2.0 ml

8. A client is admitted to the hospital for abdominal surgery for cancer of the Pancreas. Before surgery, Demerol is ordered for pain. The nurse recognizes that Morphine would be contraindicated for this client because it:

Causes respiratory excitement

Stimulates kidney activity

Causes spasm of the pancreatic ducts

Stimulates the sympathetic nervous system

9. Laboratory values have indicated an overdosage of Coumadin in a patient. What drug is the antidote?

Heparin

Protamine sulfate

Epogen

Vitamin K

10. Two serious side effects of Gentamycin or Tobramycin are:

Yeast and fungal infections

Ototoxicity and nephrotoxicity

Alopecia and epistaxis

Leukopenia and thrombocytopenia

11. The chief danger in giving an IM injection in the wrong area of the buttock is:

Poor absorption

Formation of an abscess secondary to fecal contamination

Damage to the sciatic nerve or penetration of a large blood vessel

Damage to underlying bony tissue

12. The antihypertensive Tenormin (atenolol) 50 mg q.d. has been previously ordered for a patient. Today, the physician increased the order to 100 mg q.d. Which is the most appropriate action for the nurse before administering this medication?

Monitor the patient's PT/PTT

Monitor the I/O

Monitor the serum creatinine

Monitor the blood pressure

13. Which of the following are patient symptoms reflecting a potential drug allergy requiring immediate treatment?

Extreme muscular tremors

Edema of face and hands

Difficulty breathing and falling blood pressure

Diaphoretic and shaking

14. The physician has ordered atropine sulfate 0.4 mg IM before surgery. The medication is supplied in 0.8 mg per milliliter. The nurse should administer how many milliliters of the medication?

0.25 ml

0.5 ml

1.0 ml

1.25 ml

15. What drug is contraindicated for the patient receiving anticoagulant therapy?

Phenergan

Tylenol

Aspirin

Demerol

16. Symptoms of digitalis toxicity include:

Abdominal pain, constipation, anorexia

N/V, visual disturbances

Tachypnea, hematuria

Leg cramps, anorexia, drowsiness

17. Which of the following drugs may never be given via an IV push?

Morphine

Demerol

Epinephrine

Potassium Chloride

18. The patient is receiving heparin for thrombophlebitis of the left lower extremity. Which of the following drugs reverses the effects of heparin?

Cyanocobalamine

Protamine sulfate

Streptokinase

Sodium warfarin

19. The physician has ordered Percocet (Oxycodone) for a patient following abdominal surgery. The primary objective of nursing care for the patient receiving an opiate analgesic is:

Preventing addiction

Alleviating pain

Facilitating mobility

Preventing nausea

20. Which of the following is not a medication error?

Failure to give a drug within the prescribed time frame

Failure to give a drug when you know it is contraindicated

Giving the wrong drug to a patient

Giving an unordered drug to a patient

21. The physician prescribes Cimetidine (Tagamet) and Maalox for a client with a peptic ulcer. The nurse should teach the client to take these drugs:

At the same time

At least 1 hour apart

One immediately before the other

Together with milk or orange juice

22. Many drugs are metabolized or eliminated via the liver or kidney. When a particular drug is nephrotoxic, what laboratory test should be monitored for the safety of the patient?

Na+, CL-, K+

WBC

Platelets

Serum creatinine

23. Some oral medications may upset the stomach and should be given:

Before meals on an empty stomach

At least four hours after meals

After meals on a full stomach

At bedtime

24. A client is to be discharged. When discussing pain management, the nurse should advise the client to take the prescribed PRN Tylenol with Codeine:

Just as a last resort

Before going to sleep

When the discomfort begins

As the pain becomes intense

25. Colestid 1 G is ordered BID, a.c. This means to administer it:

With meals

Before meals

After meals

Without regard to meals

26. Your patient is receiving IV therapy via a triple-lumen central line including Total Parenteral Nutrition (TPN) at 75 ml/hr, an IV of NS at 20 ml/hr, and two antibiotics, one ordered q8 hr and another q6 hr. Which of the following symptoms could suggest your patient has fluid overload?

Wheeze

Urine output < 30 ml/hr

Crackles in the lower lobes

S3 auscultated over the precordium

27. A client with hypertensive heart disease who had an acute episode of congestive heart failure is to be discharged on a regimen of Propranolol HCL (Inderal) and Digoxin (Lanoxin). The nurse should be aware that the Inderal, when administered with Lanoxin, may:

Produce headaches

Produce a slow heart rate

Increase blood pressure

Stimulate nodal conduction

28. A client is to continue to take Digoxin (Lanoxin) following discharge from the hospital. The nurse would know the teaching concerning Digoxin is understood when the client states, “I should:

Increase my intake of Vitamin K."

Not eat food high in potassium."

Check my pulse rate and rhythm daily."

Adjust my dosage according to my activities."

29. The liver usually metabolizes most drugs into compounds that are more easily excreted via the kidneys. Advancing age decreases both liver blood flow and levels of microsomal enzymes which decreases metabolism, causing the drug to accumulate to potentially high levels in the body. What laboratory values are used to monitor for hepatic function?

Albumin

SGOT(AST) or SGPT(ALT)

Total bilirubin

Total protein

30. Betagan eyedrops are ordered for a patient. Which of these abbreviations indicate the eyedrops are to be instilled into both of the patient's eyes?

O.u.

O.d.

O.s.

O.b.

31. When sodium warfarin (Coumadin) is given, the nurse should monitor the:

I & O

Prothrombin time (PT)

Partial thromboplastin time (PTT)

Serum potassium

32. The physician has prescribed aspirin 325 mg daily for a patient with transient ischemic attacks. The nurse explains that aspirin was prescribed to:

Prevent headaches

Boost coagulation

Prevent cerebral anoxia

Decrease platelet aggregation

33. All of the statements below are appropriate patient education for a patient starting on an antihypertensive EXCEPT:

"Rise slowly when getting up from a horizontal position."

"You may become lightheaded or dizzy if you take very hot baths or showers."

"Limit your fluid intake to only 6 glasses per day."

"Don't stand on one spot for a long period of time."

34. Before administering the first dose of an IV antibiotic, the nurse should:

Check the results of the WBC

Tell the patient what side effects could occur

Check for a patient IV

35. In what disease is the administration of acetaminophen (Tylenol) contraindicated?

Active peptic ulcer

Asthma

Deep vein thrombosis

Active Hepatitis C

36. Regulatory agencies specify that two patient identifiers are to be used before administering medications. Which method is best for identifying patients using two patient identifiers?

Compare the medication administration record (MAR) with the patient's room number and name on the armband

Request that a family member identify the patient and then ask the patient to state his name

Ask the patient to state his full name and then to write his full name

37. The physician has ordered a patient-controlled analgesia (PCA) pump for the patient with chronic pain. The patient asks the nurse if he can become overdosed with pain medication using this machine. The nurse demonstrates understanding of the PCA if she states:

"The machine will administer only the amount that you need to control your pain without any action from you."

"The machine has a locking device that prevents overdosing to occur."

"The machine will administer one large dose every 4 hours to relieve your pain."

"The machine is set to deliver medication only if you need it."

38. A hypokalemic patient is receiving an infusion of NS containing 60 meq potassium chloride at 100 ml/hr. Which of the following is most appropriate for the patient?

Blood pressure readings q 1 hr

Deep tendon reflexes checked q 1 hr

Serum potassium levels q 1 hr

Continuous cardiac monitoring

39. The most appropriate size needle for administering an IM injection to a 200 lb male with a non-viscous solution is:

1", 20 gauge

½", 25 gauge

1 ½", 18 gauge

1 ½", 22 or 23 gauge

40. The physician orders Amicar Elixir 4 grams PO. The bottle is labeled 250 mg/1 ml. The nurse should administer:

16 ml

1.6 ml

0.16 ml

0.016 ml

41. The physician orders a low dose of narcotic to relieve the pain of a client with deep partial thickness burns. The nurse recognizes that the preferred mode of administration is:

Oral

Rectal

Intravenous

Intramuscular

42. Which of the following are the most important considerations when administering a drug via IV push?

Use a medium gauge needle or needleless cannula

Check for blood return in the IV line

Consider the diluent that is used to reconstitute the medication

Check the recommended rate for administering each bolus medication

43. A client is admitted to the hospital for abdominal surgery for cancer of the Pancreas. Before surgery, Demerol is ordered for pain. The nurse recognizes that Morphine would be contraindicated for this client because it:

Causes respiratory excitement

Stimulates kidney activity

Causes spasm of the pancreatic ducts

Stimulates the sympathetic nervous system

44. The physician orders 1200 mg of an antibiotic QID IVPB via a Heplock. The vial contains a powdered antibiotic to which diluent is added. The resulting solution contains 1 gram of drug per 3 ml. When adding this solution to D5W IVPB, the nurse should use:

0.7 ml

1.2 ml

2.9 ml

3.6 ml

45. The nurse is caring for a patient with leukemia who is receiving the drug Doxorubicin (Adriamycin). Which toxic effects of this drug should be reported to the physician immediately?

Rales and distended neck veins

Red discoloration of the urine and output of 75mL the previous hour

Nausea and vomiting

Elevated BUN and dry, flaky skin

46. A patient is receiving Gentamycin 80 mg q 12 hrs. The patient is to receive the 4th dose today at 8 pm to infuse over 30 minutes. The physician has ordered peak and trough blood levels with the 4th dose. At which of these times should the peak blood level be drawn?

7:30 pm

7:55 pm

8:35 pm

9:00 pm

47. If a patient had an anaphylactic reaction to penicillin, which of the following drugs are contraindicated for this patient?

Erythromycin

Aminoglycosides

Tetracyclines

Cephalosporins