Nokea
What types of orders for drug therapy might the nurse expect to find in a client's medical record? Select all that apply.
- A. Standing order
- B. STAT order
- C. Single order
- D. Alternate order
- E. PRN order
Correct Answer: A,B,C,E
Rationale: Common orders given by health care providers for drug therapy include the standing order, the single order, the PRN order, and the STAT order.
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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 actions can nurses take to help prevent drug errors? Select all that apply.
- A. Rechecking all calculations
- B. Always administering the drug before answering any of the client's questions
- C. Avoiding distractions and concentrating on only one task at a time
- D. Confirming any questionable orders
- E. Practicing the five+ 1 rights of drug administration
Correct Answer: A,C,D,E
Rationale: In addition to following the five+ 1 rights of drug administration, a nurse can employ the following strategies to aid in the prevention of drug errors: confirm any questionable orders; when calculations are necessary, verify them with another nurse; listen to the client when he or she questions a drug, the dosage, or the drug regimen; never administer the drug until the client's questions have been adequately researched; and avoid distractions and concentrate on only one task at a time.
What action is most important to minimize tissue damage when administering subcutaneous heparin?
- A. Insert the needle at the appropriate angle
- B. Select the needle length based on the patient's weight
- C. Ensure that there is no hair on the injection site
- D. Rotate the injection site regularly
Correct Answer: D
Rationale: The nurse should rotate the injection sites to minimize the damage caused to the tissue. Inserting the needle at the proper angle and selecting the needle length based on the patient's weight will not significantly help in minimizing tissue damage if the same site is repeatedly injected. It is not necessary to avoid injection sites that have hair as long as the drug is administered in the upper arms, the upper abdomen, and the upper back.
When ensuring the right drug is being administered, what should the nurse compare? Select all that apply.
- A. Medication
- B. Container label
- C. Medication record
- D. MAR
- E. Nursing notes
Correct Answer: A,B,C,D
Rationale: The nurse compares the medication, container label, and medication record and then the MAR as the item is removed from the cart and before the actual administration of the drug.
What site is most appropriate for an IM injection in an 18-month-old toddler?
- A. Dorsogluteal site
- B. Deltoid muscle
- C. Vastus lateralis
- D. Ventrogluteal site
Correct Answer: C
Rationale: The vastus lateralis site is frequently used for infants and small children because it is more developed than the other intramuscular sites such as the dorsogluteal and deltoid muscle. Ventrogluteal sites may be used in children who have been ambulating for more than 2 years.