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When using a bar-code point-of-care medication system, which items should the nurse scan prior to drug administration? Select all that apply.
- A. Client's hospital chart
- B. Client's identification band
- C. Drug unit dose package
- D. Nurse's identification badge
- E. Client's medication administration record
Correct Answer: B,C,D
Rationale: The bar-code point-of-care medication system requires that the client's identification band, the drug unit dose package, and the nurse's identification badge are all scanned prior to drug administration.
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Prior to administering a prescribed drug, how should the nurse correctly identify the client? Select all that apply.
- A. Checking a client's name on his or her wristband
- B. Checking a client's chart
- C. Asking the client to identify himself or herself and give his or her birth date
- D. Using a current picture of the client if available
Correct Answer: A,C,E
Rationale: Client identifiers can include visual and verbal methods. Visual methods include use of a recent picture of the client or client wristband. Verbal methods include asking the client for his or her name and another unique identifier, such as his or her birth date. Never ask a client, 'Are you Mr. Jones?' because some clients may respond by answering 'yes' even though that is not their name due to confusion or difficulty hearing. Checking the client's chart would be inappropriate to use for identifying the client.
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.
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.
What action is most appropriate immediately after administering an opioid drug?
- A. Monitoring the vital signs of the patient
- B. Documenting administration of the drug
- C. Informing the patient about the type of drug
- D. Updating the physician regarding the patient's condition
Correct Answer: B
Rationale: After administration of any drug, the nurse should immediately document the administration. After the documentation is complete, the nurse can record the patient's vital signs. The patient needs to be informed about the drug before the administration. The physician need not be immediately informed, unless the client develops severe adverse reactions.
How many times should the student compare the drug label with the MAR when preparing an oral drug for administration?
- A. 2
- B. 3
- C. 4
- D. 5
Correct Answer: B
Rationale: The proper procedure is to compare the drug label with the MAR three times: (a) when the drug is taken from its storage area, (b) immediately before removing the drug from the container, and (c) before administering the drug to the patient.