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Prior to administering a prescribed drug, how should the nurse correctly identify the client? Select all that apply.
- A. Checking a client's name on his or her wristband
- B. Checking a client's chart
- C. Asking the client to identify himself or herself and give his or her birth date
- D. Using a current picture of the client if available
Correct Answer: A,C,E
Rationale: Client identifiers can include visual and verbal methods. Visual methods include use of a recent picture of the client or client wristband. Verbal methods include asking the client for his or her name and another unique identifier, such as his or her birth date. Never ask a client, 'Are you Mr. Jones?' because some clients may respond by answering 'yes' even though that is not their name due to confusion or difficulty hearing. Checking the client's chart would be inappropriate to use for identifying the client.
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What action is most appropriate when a nurse receives a STAT medication order?
- A. Insist on obtaining a written report before administering any drug
- B. Administer the drug as ordered by the physician
- C. Forgo obtaining the physician's order after the drug has been administered
- D. Document the administration of the drug only after receiving the physician's order
Correct Answer: B
Rationale: The nurse should administer the drug as instructed without a written order as it is an emergency. The nurse should, however, ensure that the physician's order is obtained after the drug has been administered. Waiting for a written order during an emergency may exacerbate the patient's condition. The nurse should complete the documentation immediately after the administration of the drug and not wait until the physician's order is received.
What action is most appropriate when administering an oral medication through a nasogastric tube? Select all that apply.
- A. Not diluting liquids prior to administration
- B. Checking the tube for placement
- C. Dissolving crushed tablets in water prior to administration
- D. Flushing the tube with water after drugs are administered
- E. Clearing the tube with air prior to administration
Correct Answer: B,C,D
Rationale: Before administration of an oral drug through an NG tube or gastrostomy tube, the nurse should check the tube for placement, dilute and flush liquid drugs through the tube, crush tablets and dissolve them in water before administering them through the tube, and flush the tube with water after the drugs are placed in the tube to clear the tubing completely.
What are examples of topical drugs? Select all that apply.
- A. Eyedrops
- B. Suppository
- C. Nebulized bronchodilator
- D. Nicotine patch
- E. Capsule
Correct Answer: A,B
Rationale: Topical drugs are drugs that are applied to the outer layer of the skin but not absorbed through the skin, such as eyedrops and suppositories. A nebulized bronchodilator is an inhaled medication. A nicotine patch delivers the medication transdermally; that is, it is readily absorbed from the skin. A capsule is a form of oral medication.
What is the most appropriate response when a patient says, 'This doesn't look like my usual pill'?
- A. This is the same pill your doctor has been ordering.'
- B. It must be from a different manufacturer.'
- C. It looks different? Are you sure?'
- D. Let me double check with your doctor and the order.'
Correct Answer: D
Rationale: If the patient makes any statement about the drug, the nurse needs to hold the drug and investigate the patient's statement, double checking the chart and the order and obtaining clarification and/or confirmation from the prescriber. It may be that the dosage or manufacturer has changed and that is what makes the pill look different. It is always important to err on the side of caution. Telling the patient that the pill is the same or that it is from a different manufacturer may be true, but the nurse needs to confirm that before giving it to the patient. Repeating the patient's statement and then asking him if he is sure is inappropriate because it implies that the patient is incorrect.
When administering a prescribed drug, which actions are completely inappropriate? Select all that 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 without consulting a pharmacist
- E. Removing the drug's unit dose wrapper at the client's bedside
Correct Answer: B,C,D
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.