Nokea
Which patient is most likely to have a drug reaction?
- A. A patient with kidney failure who is on dialysis
- B. A patient who is more physically active than the average person
- C. A patient with no known drug allergies (NKDA)
- D. A patient who has never had a reaction to a medicine in the past
Correct Answer: A
Rationale: Patients with kidney failure have impaired drug clearance, increasing the risk of drug accumulation and reactions.
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Before administering any antihypertensive medication, you will first
- A. Ask the patient if he or she is allergic to any antibiotics.
- B. Check the chart for the most recent temperature readings.
- C. Ensure that any ordered blood cultures have already been drawn.
- D. Check the patient's blood pressure to ensure that it is not too low.
Correct Answer: D
Rationale: Checking blood pressure before administering antihypertensives prevents giving the medication if the pressure is too low, avoiding hypotension.
Which is true of the PDR?
- A. It contains only one index, so you must know the generic name of a drug to look it up.
- B. It is written specifically for nurses and includes topics for patient teaching.
- C. It contains colored pictures of many drugs in the Product Identification Section.
- D. It contains medication chemical composition, indications for use, contraindications, warnings, routes, and administration guidelines.
Correct Answer: C,D
Rationale: The PDR includes a Product Identification Section with colored pictures and detailed drug information, but it is not nurse-specific or limited to one index.
Which of the following is an example of an over-the-counter medication?
- A. Hydrocodone (Lortab)
- B. Amoxicillin (Amoxil)
- C. Acetaminophen (Tylenol)
- D. Cefazolin (Ancef)
Correct Answer: C
Rationale: Acetaminophen (Tylenol) is available without a prescription, making it an over-the-counter medication, unlike the others, which require prescriptions.
A patient with pneumonia is allergic to cephalosporin antibiotics. He tells you that he breaks out in a rash and itches if he takes it. The health-care provider has prescribed cefazolin (Ancef) for him because it is one of the few antibiotics that will kill the bacteria cultured from his sputum. What will you do?
- A. Hold the medication and notify the health-care provider.
- B. Give the medication and administer oral diphenhydramine (Benadryl) without an order because it is an OTC medication.
- C. Ask the supervising nurse to give the medication because the patient may have an allergic reaction.
- D. Give the medication and watch the patient closely for any signs of anaphylaxis.
Correct Answer: A
Rationale: Due to the patient's known allergy, administering cefazolin risks a severe reaction. Holding the medication and notifying the provider is the safest action.
Identify the three times to check the medication, dose, route, and patient to ensure that you are administering the medication safely.
- A. When removing the medication from the storage area
- B. When preparing the medication
- C. When administering the medication to the patient
- D. When documenting the administration
- E. When reviewing the patient's chart
- F. When consulting the pharmacist
- G. When checking the medication order
Correct Answer: A,B,C
Rationale: Checking the medication, dose, route, and patient at removal, preparation, and administration ensures safety by catching errors at multiple points.