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What action is most appropriate when a nurse cannot read a healthcare provider's handwriting on a medication order?
- A. The nurse should question the order with the primary health care provider
- B. The nurse should try to interpret the handwriting
- C. The nurse should confirm the order with a nearby health care provider
- D. The nurse should obtain a verbal order
Correct Answer: A
Rationale: Any order that is unclear, particularly due to illegible handwriting, should be questioned. The nurse should not try to interpret the handwriting as it may lead to a misinterpretation. The nurse should also not confirm the order with any other physician who is nearby. Administering drugs based on verbal orders is permissible only during emergencies.
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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.
What information about the drug is most important for the nurse to know before administration? Select all that apply.
- A. Normal dosage range
- B. Special precautions in administration
- C. Drug's most common adverse effects
- D. Drug's general action
- E. Reason for use of the drug
Correct Answer: A,B,C,D,E
Rationale: The nurse must have factual knowledge of each drug given, the reason for use of the drug, the drug's general action, the more common adverse reactions associated with the drug, special precautions in administration (if any), and the normal dose ranges.
What gauge needles are appropriate for intradermal injections? Select all that apply.
- A. 26 gauge
- B. 28 gauge
- C. 29 gauge
- D. 25 gauge
- E. 27 gauge
Correct Answer: A,D,E
Rationale: A 1-mL syringe with a 25- to 27-gauge needle that is 1/4 to 5/8 inches long is best suited for intradermal injections.
What is most important for the nurse to do when preparing to administer a prescribed oral drug? Select all that apply.
- A. Making sure the client is in an upright position prior to administration
- B. Ensuring that a full glass of water is readily available
- C. Leaving PRN drugs at the bedside for ready access if needed
- D. Instructing the client to tilt his or her head back to swallow a capsule
- E. Having the client refrain from sipping on the water before placing the tablet in the mouth
Correct Answer: A,B
Rationale: Clients should always be in an upright position when receiving oral drugs and a glass of water should be readily available. They should be encouraged to take a few sips of water before placing the tablet or capsule in the mouth. Drugs should never be left at the client's bedside. Instruct clients to tilt their head back to swallow a tablet and slightly forward to swallow a capsule.
Where should a buccal medication be placed?
- A. Under the tongue
- B. Against the cheek mucous membrane
- C. Inside the rectum
- D. At the back of the tongue
Correct Answer: B
Rationale: Buccal drugs are placed in the mouth against the mucous membranes of the cheek in either the upper or lower jaw. Sublingual medications are placed under the tongue. Rectal suppositories are inserted into the rectum. Oral medications are placed at the back of the tongue.