Chapter 21: Preparation for Safe Medication Administration

Chapter 21: Preparation for Safe Medication Administration

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient received a drug that caused an unpredictable and unusual effect. Which term does the nurse use to describe this effect?

a.	Toxic
b.	Allergic
c.	Therapeutic
d.	Idiosyncratic

 

 

ANS:  D

An unpredictable overreaction or underreaction  to a medication is an idosyncratic reaction. Toxic medication effects occur with prolonged therapy, excessive dosing, or impaired metabolism or systemic accumulation in the patient. They are adverse effects with the potential to cause patient injury and death. Allergic reactions are unpredictable, unless the patient has a history of a medication allergy, and result from an immunological patient response to the medication involving antibody formation. A therapeutic response is a desirable or intended patient response.

 

DIF:    Cognitive Level: Comprehend          REF:   Page 540

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Evaluation

 

2. The nurse administers sulfamethoxazole and trimethoprim (Bactrim) for a desirable patient response derived from the combination of agents. Which type of medication effect does the nurse anticipate?

a.	Tolerance
b.	Synergistic
c.	Dependence
d.	Subtherapeutic

 

 

ANS:  B

The nurse anticipates a synergistic effect because the two antibiotics, sulfamethoxazole and trimethoprim, work better in combination than either agent works alone. Drug tolerance means that a larger dose of medication is needed to produce the same therapeutic effect over time. Drug dependence is psychological or physical. The patient takes the medication for an effect other than the therapeutic effect, resulting in psychological dependence. Physical dependence involves physiological adaptation to the medication that results in severe adverse effects if withdrawn abruptly. A subtherapeutic effect is less than therapeutic; the therapy treats the disorder inadequately.

 

DIF:    Cognitive Level: Comprehend          REF:   Page 540

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Assessment

 

3. A male patient looks at the medication in the cup and tells the nurse that he does not take one of the tablets. Which action should the nurse take next?

a.	Tell the patient that the medications are correct.
b.	Recheck the medication and the medication order.
c.	Call the pharmacy to bring the correct medication.
d.	Remove the medication and document the incident.

 

 

ANS:  B

A safe nursing intervention is to recheck both the medication and the order because the drug in question may be a new prescription, a new strength of the same medication, or a different generic form of the same medication. Regardless of the cause, the problem needs clarification. Telling the patient that the medications are correct is premature and misleading and denies the patient the right to information. The nurse does not know if the medications are correct yet. After checking the medications against the medication administration record (MAR) and the original prescriptions, he or she can call the pharmacy for help. The nurse removes the entire cup of medications and rechecks all of them. Documenting the incident is premature because the nurse needs to complete the investigation first.

 

DIF:    Cognitive Level: Analyze                REF:   Page 544

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Planning

 

4. The nurse admits a patient who has an acute kidney infection but refuses to take any medication. Which is the best initial nursing intervention to implement the therapeutic regimen?

a.	Notify the healthcare provider of the situation.
b.	Inform the patient about the risk of renal failure.
c.	Talk with the patient about taking the antibiotics.
d.	Disguise the medications so the patient takes them.

 

 

ANS:  C

The basis of the patient’s refusal is unknown; discussing the situation with the patient provides the nurse with an opportunity to clarify misunderstandings, provide information, and gather valuable patient data to plan nursing care. Notifying the healthcare provider is premature. The nurse takes care of the situation initially by educating the patient. Emphasizing the risk of renal failure may be interpreted as an indirect threat by the patient. The patient has the right to refuse taking the medication, and disguising the medication is neither indicated nor appropriate.

 

DIF:    Cognitive Level: Analyze                REF:   Page 549

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Implementation