NCLEX Pharmacology Quiz 3 (10 Items)

1. The nursery nurse is putting erythromycin ointment in the newborn's eyes to prevent infection. She places it in the following area of the eye:

Under the eyelid

On the cornea.

In the lower conjunctival sac

By the optic disc.

The ointment is placed in the lower conjunctival sac so it will not scratch the eye itself and will get well distributed.

Explanation

The ointment is placed in the lower conjunctival sac so it will not scratch the eye itself and will get well distributed.

2. The nurse is administering an antibiotic to her pediatric patient. She checks the patient's armband and verifies the correct medication by checking the physician's order. medication kardex. and vial. Which of the following is not considered one of the five "rights" of drug administration?

Right dose

Right route

Right frequency

Right time

The five rights of medication administration are right drug. right dose. right route. right time. right patient. Frequency is not included.

Explanation

The five rights of medication administration are right drug. right dose. right route. right time. right patient. Frequency is not included.

3. The nurse is administering augmentin to her patient with a sinus infection. Which is the best way for her to insure that she is giving it to the right patient?

Call the patient by name

Read the name of the patient on the patient’s door

Check the patient’s wristband

Check the patient’s room number on the unit census list

The correct way to identify a patient before giving a medication is to check the name on the medication administration record with the patient’s identification band. The nurse should also ask the patient to state their name. The name on the door or the census list are not sufficient proof of identification. Calling the patient by name is not as effective as having the patient state their name; patients may not hear well or understand what the nurse is saying. and may respond to a name which is not their own.

Explanation

The correct way to identify a patient before giving a medication is to check the name on the medication administration record with the patient’s identification band. The nurse should also ask the patient to state their name. The name on the door or the census list are not sufficient proof of identification. Calling the patient by name is not as effective as having the patient state their name; patients may not hear well or understand what the nurse is saying. and may respond to a name which is not their own.

4. The physician orders an intramuscular injection of Demerol for the postoperativepatient's pain. When preparing to draw up the medication. the nurse is careful to remove the correct vial from the narcotics cabinet. It is labeled

Simethicone.

Albuterol.

Meperidine.

Ibuprofen.

The generic name for Demerol is meperidine.

Explanation

The generic name for Demerol is meperidine.

5. The physician orders penicillin for a patient with streptococcal pharyngitis. The nurse administers the drug as ordered. and the patient has an allergic reaction. The nurse checks the medication order sheet and finds that the patient is allergic to penicillin. Legal responsibility for the error is:

Only the nurse’s—she should have checked the allergies before administering the medication.

Only the physician’s—she gave the order. the nurse is obligated to follow it.

Only the pharmacist’s—he should alert the floor to possible allergic reactions.

The pharmacist. physician. and nurse are all liable for the mistake

The physician. nurse. and pharmacist all are licensed professionals and share responsibility for errors.

Explanation

The physician. nurse. and pharmacist all are licensed professionals and share responsibility for errors.

6. Mrs. Jane Gately has been dealing with uterine cancer for several months. Pain management is the primary focus of her current admission to your oncology unit. Her vital signs on admission are BP 110/64. pulse 78. respirations 18. and temperature 99.2 F. Morphine sulfate 6mg IV. q 4 hours. prn has been ordered. During your assessment after lunch. your findings are: BP 92/60. pulse 66. respirations 10. and temperature 98.8. Mrs. Gately is crying and tells you she is still experiencing severe pain. Your action should be to

Give her the next ordered dose of MS.

Give her a back rub. put on some light music. and dim the lights in the room.

Report your findings to the MD. requesting an alternate medication order

Be obtained from the physician.

Morphine sulfate depresses the respiratory center. When the rate is less than 10. the MD should be notified.

Explanation

Morphine sulfate depresses the respiratory center. When the rate is less than 10. the MD should be notified.

7. The most important instructions a nurse can give a patient regarding the use of the antibiotic ampicillin prescribed for her are to

Call the physician if she has any breathing difficulties.

Take it with meals so it doesn’t cause an upset stomach.

Take all of the medication prescribed even if the symptoms stop sooner.

Not share the pills with anyone else.

Frequently patients do not complete an entire course of antibiotic therapy. and the bacteria are not destroyed.

Explanation

Frequently patients do not complete an entire course of antibiotic therapy. and the bacteria are not destroyed.

8. When counseling a patient who is starting to take MAO (monoamine oxidase) inhibitors such as Nardil for depression. it is essential that they be warned not to eat foods containing tyramine. such as:

Roquefort. cheddar. or Camembert cheese.

Grape juice. orange juice. or raisins.

Onions. garlic. or scallions.

Ground beef. turkey. or pork.

Monoamine oxidase inhibitors react with foods high in the amino acid tyramine to cause dangerously high blood pressure. Aged cheeses are all high in this amino acid; the other foods are not.

Explanation

Monoamine oxidase inhibitors react with foods high in the amino acid tyramine to cause dangerously high blood pressure. Aged cheeses are all high in this amino acid; the other foods are not.

9. Mr. Jessie Ray. a newly admitted patient. has a seizure disorder which is being treated with medication. Which of the following drugs would the nurse question if ordered for him?

Phenobarbitol. 150 mg hs

Amitriptylene (Elavil). 10 mg QID.

Valproic acid (Depakote). 150 mg BID

Phenytoin (Dilantin). 100 mg TID

Elavil is an antidepressant that lowers the seizure threshold. so would not be appropriate for this patient. The other medications are anti-seizure drugs.

Explanation

Elavil is an antidepressant that lowers the seizure threshold. so would not be appropriate for this patient. The other medications are anti-seizure drugs.

10. James Perez. a nurse on a geriatric floor. is administering a dose of digoxin to one of his patients. The woman asks why she takes a different pill than her niece. who also has heart trouble. James replies that as people get older. liver and kidney function decline. and if the dose is as high as her niece's. the drug will tend to:

Have a shorter half-life.

Accumulate.

Have decreased distribution.

Have increased absorption.

The decreased circulation to the kidney and reduced liver function tend to allow drugs to accumulate and have toxic effects.

Explanation

The decreased circulation to the kidney and reduced liver function tend to allow drugs to accumulate and have toxic effects.