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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.
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How can the nurse ensure correct patient identification for an unresponsive patient?
- A. By waking him up to ask him his name
- B. By identifying the patient's room number
- C. By checking the patient's wristband
- D. By asking the nursing assistant for the patient's location
Correct Answer: C
Rationale: The nurse should identify a patient by checking his wristband, which has the patient's name. The nurse should not ask the patient to confirm his name, because some patients, particularly those who are confused or have difficulty hearing, may respond by answering yes. Additionally, this patient is unresponsive. The nurse can obtain the patient's location by asking any other member of the health care staff, but should verify the patient's identity by checking the wristband. The nurse should not rely on the patient's room number alone.
What is most important for the nurse to do before giving a drug for the first time?
- A. Obtain the patient's allergy history
- B. Obtain information about the drug
- C. Inquire if the patient has any objections to syringes
- D. Discuss the dosage with other nurses
Correct Answer: A
Rationale: Before giving any drug for the first time, the nurse should ask the patient about any known allergies as well as any family history of allergies. The nurse need not particularly obtain information about the drug as it has been prescribed by the physician, but needs to be aware of the adverse effects it may cause. There is also no need to discuss the dosage with other nurses or to find out if the client has any objections to syringes. However, the nurse should help allay the patient's fears by reassuring him or her about the administration.
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 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.
The five+ 1 rights of drug administration include which of the following? Select all that apply.
- A. Right documentation
- B. Right patient
- C. Right route
- D. Right drug
- E. Right prescriber
Correct Answer: A,B,C,D
Rationale: The five+ 1 rights of drug administration include: right patient, right drug, right dose, right route, right time, and right documentation.