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When a primary health care provider phones in a medication order, what should the nurse do? Select all that apply.
- A. Write down the order
- B. Record the order as soon as the MAR is retrieved
- C. Repeat back the information exactly as written
- D. Clarify any unclear information
- E. Obtain verbal confirmation that the information is correct
Correct Answer: A,C,D,E
Rationale: If a verbal order is given over the telephone, the nurse writes down the order immediately, repeats back the information exactly as written, and then asks for a verbal confirmation that it is correct. Any order that is unclear should be questioned and clarified.
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What sites are appropriate for subcutaneous injection? Select all that apply.
- A. Upper arm
- B. Inner forearm
- C. Upper abdomen
- D. Gluteus maximus
- E. Upper thigh
Correct Answer: A,C,E
Rationale: The sites for subcutaneous injection are the upper arms, the upper abdomen, and the upper thighs.
What is considered a unit dose system? Select all that apply.
- A. Floor stock bottle of aspirin 81 mg
- B. A prefilled Lovenox syringe
- C. One Phenergan suppository
- D. Floor stock bottle of ibuprofen suspension
- E. Single-dose cup of Maalox
Correct Answer: B,C,E
Rationale: Examples of unit dose medications include a package that contains one tablet or capsule, a premeasured amount of a liquid drug, a prefilled syringe, or one suppository.
When are drug errors most likely to occur? Select all that apply.
- A. When transcribing the drug order
- B. When verifying the client
- C. When dispensing the drug
- D. When charting after drug administration
- E. When administering the drug
Correct Answer: A,C,E
Rationale: Drug errors may occur in transcribing drug orders, when the drug is dispensed, or in administration of the drug. Nurses, as the drug administrators, serve as the last defense against drug errors. Verifying the client and charting after administration are two important areas to help prevent medication errors.
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 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.