Nokea
Which of the following are included in the Rights of Medication Administration? Select all that apply. A. right dose, B. right time, C. right explanation, D. right client, E. right route
- A. B, C, D, E
- B. A, B, D, E
- C. A, B, D
- D. B, C, E
Correct Answer: B
Rationale: The Rights of Medication Administration include right client, right drug, right dose, right route, and right time. An additional right that is sometimes included is right documentation.
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A serious complication of a total hip replacement is displacement of the prosthesis. What is the primary sign of displacement?
- A. pain on movement and weight bearing
- B. hemorrhage
- C. affected leg appearing 1-2 inches longer
- D. edema in the area of the incision
Correct Answer: A
Rationale: Pain on movement and weight bearing indicates pressure on the nerves or muscles caused by the dislocation. Other symptoms of dislocation include an inability to bear weight and a shortening of the affected leg. Edema is not a primary sign of displacement.
The HCP prescribes risperidone to manage the hallucinations of the client diagnosed with paranoid schizophrenia. Which client statements reflect a need for further education regarding the medication's side effects? Select all that apply.
- A. Diarrhea may be a problem for me.
- B. I'll most likely develop high blood pressure.
- C. Being too nervous is a side effect of my medicine.
- D. I will need to watch what I eat so I won't gain weight.
- E. Getting up too quickly when I'm sitting can make me dizzy.
- F. I will need to be careful driving because this can make me drowsy.
Correct Answer: A,B
Rationale: Constipation, not diarrhea, and hypotension, not hypertension, are side effects of risperidone, indicating a need for further education.
The nurse is developing the plan of care for the 7-year-old with encopresis who has been started on lactulose. Which outcome would be most appropriate for the nurse to establish?
- A. 2-pound weight gain
- B. Nighttime continence
- C. Blood glucose 70-110 mg/dL
- D. Normal bowel movement daily
Correct Answer: D
Rationale: A: Weight gain is not expected with an osmotic laxative. B: Nighttime continence is not expected to be altered by an osmotic laxative. C: Blood glucose is not expected to be altered by an osmotic laxative. D: Lactulose (Constulose) is an osmotic laxative used in treating encopresis to prevent constipation; the nurse should establish an outcome of a normal daily bowel movement.
The nurse is to administer vancomycin to the client diagnosed with sepsis. The client is to have a peak and trough level completed on this dose of vancomycin. Which action should the nurse initiate first?
- A. Determine if the trough level has already been drawn on the client.
- B. Check drug compatibilities before infusing into an existing IV line.
- C. Evaluate the client's culture and sensitivity (C&S) report results.
- D. Calculate the rate at which the vancomycin should be infused.
Correct Answer: A
Rationale: A: A trough level must be drawn before vancomycin (Vancocin) is administered. This is the first action because if the trough level has not been drawn, it will delay the vancomycin dose and could result in a medication error. B: Checking medication compatibilities is important, but this can be completed while the laboratory is obtaining the trough level. C: Checking C&S report results is important, but this can be completed while the laboratory is obtaining the trough level. D: Calculating the administration rate is important, but this can be completed while the laboratory is obtaining the trough level.
The child, admitted to the ED, is experiencing nausea and vomiting, salivation, respiratory muscle weakness, and depressed reflexes an hour after exposure to pesticides. Which medications should the nurse anticipate administering to the child?
- A. Atropine and flumazenil
- B. Atropine and pralidoxime
- C. Epinephrine and naloxone
- D. Epinephrine and digoxin immune Fab
Correct Answer: B
Rationale: A: Flumazenil (Romazicon) antagonizes the effects of benzodiazepines on the CNS, such as sedation, impaired recall, and psychomotor impairment. B: An organophosphate base in pesticides causes acetylcholine to accumulate at neuromuscular junctions. Atropine (Atropine), an anticholinergic medication, and pralidoxime chloride (Protopam), a cholinesterase reactivator, are effective antidotes to reverse the symptoms. C: Epinephrine (EpiPen) is an alpha- and beta-adrenergic agonist and cardiac stimulant that strengthens myocardial contractions, increases systolic BP, increases cardiac rate and output, and constricts bronchial arterioles, inhibiting histamine release. Naloxone (Narcan) is a narcotic antagonist that reverses the effects of opiates. D: Digoxin immune Fab (Digibind) is the antidote for digoxin and digitoxin, which acts by complexing with circulating digoxin or digitoxin, preventing the drug from binding at receptor sites.