The nurse knows the seven rights of medication administration are which of the following?
- A. Right patient
- B. Right route
- C. Right indication
- D. Right dosage
- E. Right documentation
- F. Right medication
- G. Right date and time
Correct Answer: A,B,C,D,E,F,G
Rationale: The seven rights of medication administration are right patient, right medication, right dose, right route, right time, right indication, and right documentation.
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A patient on birth control pills tells you that she is also taking St. John's wort as an herbal supplement for mild depression. Which response will you make?
- A. You need to be on a prescription drug for depression, not treat yourself.'
- B. St. John's wort increases estrogen breakdown, so it can decrease the effectiveness of your birth control pills.'
- C. St. John's wort decreases the rate of excretion of estrogen, so it can increase the side effects of birth control pills.'
- D. Have you looked up the medications you are taking to see if it interacts with any of them?'
Correct Answer: B
Rationale: St. John's wort induces liver enzymes, increasing the metabolism of estrogen and reducing the effectiveness of birth control pills. Choice C is incorrect as it does not increase estrogen side effects. Choices A and D are not specific enough.
You are preparing to administer a Schedule II drug. What special considerations are necessary?
- A. It is kept under double lock or with limited access in a computerized medication cabinet.
- B. It has a lower potential for abuse than Schedule III drugs.
- C. The remaining medications must be counted.
- D. The count must match the total in the record book.
- E. If kept in a computerized medication cabinet, the count is totaled by the nurse and the computer.
Correct Answer: A,C,D
Rationale: Schedule II drugs have a high potential for abuse and are tightly controlled, requiring secure storage (double lock or limited access), counting of remaining medications, and ensuring the count matches the record book. Schedule III drugs have a lower potential for abuse than Schedule II, making choice B incorrect. Computerized cabinets typically automate counts, so E is not universally required.
A patient is taking a medication to lower cholesterol. You know that the patient needs more teaching about the medication when he says:
- A. I will take my medicine each morning with grapefruit.'
- B. This medicine is to help lower my blood pressure.'
- C. If I experience any adverse effects or problems, I will contact my doctor.'
- D. I need to eat a low-fat diet and exercise as well as take this medication.'
Correct Answer: A,B
Rationale: Grapefruit can interact with many cholesterol-lowering medications (e.g., statins), affecting their metabolism and increasing side effects. The medication is for cholesterol, not blood pressure, indicating a misunderstanding. Choices C and D are correct behaviors.
A patient tells you that he is allergic to a muscle relaxer because it makes him sleep all day. You know that this is a common side effect of this medication. What action will you take?
- A. Record it as an allergy in the chart only
- B. Explain to the patient that he is not really allergic to the medication
- C. Record it as an allergy in the chart with an explanation of the reaction
- D. Notify the health-care provider immediately of the allergy and check for blood levels of the drug in the chart
Correct Answer: B,C
Rationale: The patient should be educated that excessive sleepiness is a side effect, not an allergy. However, it should still be documented in the chart with an explanation to clarify the reaction for future reference.
The drug name that is assigned and is not owned by the pharmaceutical company that develops the drug is the:
- A. chemical name
- B. proprietary name
- C. brand name
- D. generic name
Correct Answer: D
Rationale: The generic name is assigned to a drug and is not owned by the pharmaceutical company, unlike the proprietary or brand name, which is trademarked. The chemical name describes the drug's chemical composition.
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