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A nurse is assessing the patient's home medication use. After listening to the patient list current medications, the nurse asks what priority question?
- A. Do you take any generic medications?
- B. Are any of these medications orphan drugs?
- C. Are these medications safe to take during pregnancy?
- D. Do you take any over-the-counter medications?
Correct Answer: D
Rationale: It is important for the nurse to specifically question use of over-the-counter medications because patients may not consider them important. The patient is unlikely to know the meaning of orphan drugs unless they too are health care providers. Safety during pregnancy, use of a generic medication, or classification of orphan drugs are things the patient would be unable to answer but could be found in reference books if the nurse wishes to research them.
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When administering a prescribed drug to a client, which action would be completely inappropriate? (Select one that does not apply.)
- A. Charting immediately on the MAR after drug administration
- B. Removing a drug from an unlabeled container
- C. Giving a drug that someone else prepared
- D. Crushing tablets or opening capsules
Correct Answer: A
Rationale: The nurse should always record immediately on the MAR after drug administration. The nurse should never remove a drug from an unlabeled container, give a drug that someone else prepared, or crush tablets or open capsules without consulting a pharmacist. The drug's unit dose wrapper should remain on until the nurse arrives at the client's bedside.
A 68-year-old patient who must take antihistamines for severe allergies is planning a vacation to Mexico. The nurse will encourage the patient to:
- A. Avoid sightseeing during the hottest part of the day
- B. Discontinue the antihistamines if he becomes extremely restless
- C. Decrease the dosage of the drugs if he experiences excessive thirst
- D. Continue taking the antihistamines even if he begins to hallucinate
Correct Answer: A
Rationale: Antihistamines can decrease sweating by blocking cholinergic receptors, placing the patient at high risk for heat stroke. Avoiding the hottest part of the day will help prevent dehydration and heat prostration. Extreme restlessness could indicate Parkinson-like syndrome not usually associated with antihistamines. Excessive thirst is characteristic of hyperglycemia, and hallucinations are associated with drugs that affect neurologic functioning. Nurses should never tell patients to decrease or discontinue a drug unless the prescriber has instructed them to do so.
The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?
- A. Constipation
- B. Abdominal pain
- C. An episode of diarrhea
- D. Hematest-positive nasogastric tube drainage
Correct Answer: C
Rationale: Loperamide is an antidiarrheal agent. It is used to manage acute and also chronic diarrhea in conditions such as inflammatory16inflammatory bowel disease. Loperamide also can be used to reduce the volume of drainage from an ileostomy. It is not used for the conditions in options 1, 2, and 4.
The nurse is reviewing the patient's medication orders and finds an order stating amoxicillin 250 mg every 8 hours. What would the nurse question regarding this order?
- A. Dose
- B. Route
- C. Frequency of administration
- D. Allowance for generic substitution
Correct Answer: B
Rationale: The order lacks the route (e.g., oral, IV), which is essential for safe administration.
The nurse explains that what drug resource book is compiled from package inserts?
- A. Nurse's Drug Guide
- B. Physicians Desk Reference (PDR)
- C. Drug Facts and Comparisons
- D. AMA Drug Evaluations
Correct Answer: B
Rationale: The PDR is a compilation of information found on package inserts. The Nurse's Drug Guide uses more easily understood language and incorporates nursing considerations and patient teaching points. Drug Facts and Comparisons includes cost comparison, often not found in other drug resource guides. The AMA Drug Evaluations is far less biased than the PDR and includes drugs still in the research stage of development.