Test Bank of Basic Pharmacology for Nurses 16th Ed by Clayton – Willihnganz

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Basic Pharmacology for Nurses 16th Ed by Clayton – Willihnganz

Chapter 6: A Review of Arithmetic

Test Bank

 

MULTIPLE CHOICE

 

  1. Which medication consists of a liquid solvent that contains one or more dissolved substances?
a. Emulsion
b. Precipitate
c. Aliquot
d. Intravenous (IV) solution

 

 

ANS:  D

IV solutions consist of dissolved substances (solutes) in a liquid (solvent). An emulsion is a mixture of two immiscible (unblendable) substances. A precipitate is an insoluble product of a chemical reaction. An aliquot is a nonspecific small amount of a whole sample of a substance.

 

DIF:    Cognitive Level: Knowledge          REF:   p. 72              OBJ:   none

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. What is the most accurate way for the nurse to document the administration of two milligrams of a medication?
a. Two mg
b. 2.0 mg
c. 2 mg
d. II mg

 

 

ANS:  C

“2 mg” is the correct documentation. It is not appropriate to write out the word “two,” to include a trailing zero to the right of the decimal point, or to use Roman numerals to write metric doses.

 

DIF:    Cognitive Level: Application          REF:   p. 63              OBJ:   none

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

COMPLETION

 

  1. 1/7 + 3/7 = _____

 

ANS:  4/7

 

DIF:    Cognitive Level: Comprehension   REF:   p. 59              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 2 1/2 + 1 1/3 = _____

 

ANS:  3 5/6

 

DIF:    Cognitive Level: Comprehension   REF:   p. 59              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 7/30 + 9/30 + 1/30 = _____

 

ANS:  17/30

 

DIF:    Cognitive Level: Comprehension   REF:   p. 59              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1/18 + 1/9 + 1/12 + 1/4 = _____

 

ANS:  1/2

 

DIF:    Cognitive Level: Comprehension   REF:   p. 59              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 5/18 – 2/9 = _____

 

ANS:  1/18

 

DIF:    Cognitive Level: Comprehension   REF:   p. 60              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 10 7/9 – 6 1/6 = _____

 

ANS:  4 11/18

 

DIF:    Cognitive Level: Comprehension   REF:   p. 60              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1 1/2 – 7/11 = _____

 

ANS:  19/22

 

DIF:    Cognitive Level: Comprehension   REF:   p. 60              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 11/15 – 1/4 = _____

 

ANS:  29/60

 

DIF:    Cognitive Level: Comprehension   REF:   p. 60              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1/2 ´ 1/3 = _____

 

ANS:  1/6

 

DIF:    Cognitive Level: Comprehension   REF:   p. 61              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 5/12 ´ 3/4 = _____

 

ANS:  5/16

 

DIF:    Cognitive Level: Comprehension   REF:   p. 61              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 75/20 ´ 5 = _____

 

ANS:  18 3/4

 

DIF:    Cognitive Level: Comprehension   REF:   p. 61              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 300/125 ´ 5/1 = _____

 

ANS:  12

 

DIF:    Cognitive Level: Comprehension   REF:   p. 61              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 3/32 ÷ 1/8 = _____

 

ANS:  3/4

 

DIF:    Cognitive Level: Comprehension   REF:   p. 62              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 7/10 ÷ 3/5 = _____

 

ANS:  1 1/6

 

DIF:    Cognitive Level: Comprehension   REF:   p. 62              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1/200 ÷ 1/150 = _____

 

ANS:  3/4

 

DIF:    Cognitive Level: Comprehension   REF:   p. 62              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 3/4 ÷ 3 = _____

 

ANS:  1/4

 

DIF:    Cognitive Level: Comprehension   REF:   p. 62              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.5 + 0.05 = _____

 

ANS:  0.55

 

DIF:    Cognitive Level: Comprehension   REF:   pp. 62-63       OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1.5 + 0.75 = _____

 

ANS:  2.25

 

DIF:    Cognitive Level: Comprehension   REF:   pp. 62-63       OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.125 + 0.25 = _____

 

ANS:  0.375

 

DIF:    Cognitive Level: Comprehension   REF:   pp. 62-63       OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 4.302 + 1.88 + 0.009 = _____

 

ANS:  6.191

 

DIF:    Cognitive Level: Comprehension   REF:   pp. 62-63       OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 19.83 – 4.51 = _____

 

ANS:  15.32

 

DIF:    Cognitive Level: Comprehension   REF:   pp. 62-63       OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 3.75 – 1.5 = _____

 

ANS:  2.25

 

DIF:    Cognitive Level: Comprehension   REF:   pp. 62-63       OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 4 – 0.8 = _____

 

ANS:  3.2

 

DIF:    Cognitive Level: Comprehension   REF:   pp. 62-63       OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 3.7 – 1.9 = _____

 

ANS:  1.8

 

DIF:    Cognitive Level: Comprehension   REF:   pp. 62-63       OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.125 ´ 10 = _____

 

ANS:  1.25

 

DIF:    Cognitive Level: Comprehension   REF:   p. 63              OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 10,000 ´ 0.75 = _____

 

ANS:  7500

 

DIF:    Cognitive Level: Comprehension   REF:   p. 63              OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1.5 ´ 8.04 = _____

 

ANS:  12.06

 

DIF:    Cognitive Level: Comprehension   REF:   p. 63              OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.25 ´ 1/2 = _____

 

ANS:  0.125, 1/8

 

DIF:    Cognitive Level: Comprehension   REF:   p. 63              OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.6 ÷ 2 = _____

 

ANS:  0.3

 

DIF:    Cognitive Level: Comprehension   REF:   p. 64              OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.5 ÷ 4 = _____

 

ANS:  0.125

 

DIF:    Cognitive Level: Comprehension   REF:   p. 64              OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 5.5 ÷ 10 = _____

 

ANS:  0.55

 

DIF:    Cognitive Level: Comprehension   REF:   p. 64              OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.100 ÷ 1000 = _____

 

ANS:  0.0001

 

DIF:    Cognitive Level: Comprehension   REF:   p. 64              OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.305 = _____

 

ANS:  305/100, 61/200

 

DIF:    Cognitive Level: Comprehension   REF:   p. 65              OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.5 = _____

 

ANS:  5/10, 1/2

 

DIF:    Cognitive Level: Comprehension   REF:   p. 65              OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.13 = _____

 

ANS:  13/100

 

DIF:    Cognitive Level: Comprehension   REF:   p. 65              OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.00007 = _____

 

ANS:  7/100,000

 

DIF:    Cognitive Level: Comprehension   REF:   p. 65              OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 2/5 = _____

 

ANS:  0.4

 

DIF:    Cognitive Level: Comprehension   REF:   p. 65              OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1 3/4 = _____

 

ANS:  1.75

 

DIF:    Cognitive Level: Comprehension   REF:   p. 65              OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.125/0.25 = _____

 

ANS:  0.5

 

DIF:    Cognitive Level: Comprehension   REF:   p. 65              OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1/0.5 = _____

 

ANS:  2.0

 

DIF:    Cognitive Level: Comprehension   REF:   p. 65              OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 32% = _____ (ratio), _____ (fraction), _____ (decimal)

 

ANS:  8:25, 8/25, 0.32

 

DIF:    Cognitive Level: Comprehension   REF:   p. 66              OBJ:   5

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1:45 = _____ (%), _____ (fraction), _____ (decimal [round to the nearest thousandth])

 

ANS:  2.2, 1/45, 0.022

 

DIF:    Cognitive Level: Comprehension   REF:   p. 66              OBJ:   5

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 5/7 = _____ (%), _____ (ratio), _____ (decimal [round to the nearest thousandth])

 

ANS:  71.4, 5:7, 0.714

 

DIF:    Cognitive Level: Comprehension   REF:   p. 66              OBJ:   5

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 0.62 = _____ (%), _____ (ratio), _____ (fraction)

 

ANS:  62, 31:50, 31/50

 

DIF:    Cognitive Level: Comprehension   REF:   p. 66              OBJ:   5

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1 mg = _____ mcg

 

ANS:  1000

 

DIF:    Cognitive Level: Application          REF:   p. 68              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1 kg = _____ pounds

 

ANS:  2.2

 

DIF:    Cognitive Level: Application          REF:   p. 70              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1 qt = _____ cups

 

ANS:  4

 

DIF:    Cognitive Level: Application          REF:   p. 67              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1 tsp = _____ mL

 

ANS:  5

 

DIF:    Cognitive Level: Application          REF:   p. 67              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1 L = _____ mL

 

ANS:  1000

 

DIF:    Cognitive Level: Application          REF:   p. 68              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 6.2 L = _____ mL

 

ANS:  6200

 

DIF:    Cognitive Level: Application          REF:   p. 68              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 55 g = _____ kg

 

ANS:  0.055

 

DIF:    Cognitive Level: Application          REF:   p. 67              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1 tbs = _____ tsp

 

ANS:  3

 

DIF:    Cognitive Level: Application          REF:   p. 67              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 75 lb = _____ kg

 

ANS:  34

 

DIF:    Cognitive Level: Application          REF:   p. 70              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1 c = _____ oz

 

ANS:  8

 

DIF:    Cognitive Level: Application          REF:   p. 67              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1 dL = _____ L

 

ANS:  1/10

 

DIF:    Cognitive Level: Application          REF:   p. 68              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 15 kg = _____ lb

 

ANS:  33

 

DIF:    Cognitive Level: Application          REF:   p. 70              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. The physician has ordered 3500 units of heparin subcutaneously q12h

Available: Heparin 5000 units/mL

What volume of heparin will you administer? _____

 

ANS:

0.7 mL

 

3500 units : x as 5000 units : 1 mL

Multiply means: (5000 units)(x) = 5000 units – x

Multiply extremes: (3500 units)(1 mL) = 3500 units – mL

Reduce = 0.7 mL

 

DIF:    Cognitive Level: Application          REF:   pp. 70-71       OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Health care provider’s order: Versapen 2.5 mg/kg qid (patient weighs 20.2 kg).

Available: Versapen 112.5 mg/5 mL

How many mL will you give? _____

 

ANS:

2.24

 

2.5 mg ´ 20.2 kg = 50.5 mg qid

x = 2.24 mL

 

DIF:    Cognitive Level: Application          REF:   p. 70              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Health care provider’s order: 0.75 g amoxicillin PO

Available: Amoxicillin 250 mg tablets

How many tablets will you give? _____

 

ANS:

3

 

750 mg(x) : 250(1)

250x = 750 ´ 1

x = 3 tablets

 

DIF:    Cognitive Level: Application          REF:   p. 70              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Infuse 150 mL gentamicin over 1 hour (set calibration is 10 gtt/mL).

Calculate the flow rate. _____ gtt/minute

 

ANS:

25

x = 25 gtt

 

DIF:    Cognitive Level: Application          REF:   pp. 72-73       OBJ:   8

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. An IV of 750 mL was ordered to run over 6 hours with a set calibration of 10 gtt/mL.

After 2 hours you notice that 300 mL has infused. Recalculate the flow rate in gtt/min. _____

 

ANS:

18.75, 19

 

750 mL to be infused

– 300 infused in 2 hours = 450 mL left to be infused over 4 hours.

(2 hours have passed)

Reduce 10 and 60 to 1 and 6.

450 divided by 24 = 18.75 (round to 19 gtt)

 

DIF:    Cognitive Level: Application          REF:   pp. 72-73       OBJ:   8

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Zephrin chloride solution 1:5000 is ordered for an irrigation. How much 1:2000 stock solution is needed to prepare 1000 mL? _____ mL

 

ANS:

400

 

1000 mL of a 1:5000 solution contains 1/5 g or 200 mg of pure zephrin chloride.

1/5000 :: x/1000

Each mL of a 1:2000 solution contains 1/2 mg or 0.0005 g of pure zephrin chloride.

1/2000 :: x/2000

Therefore, 0.5 mg/1 mL :: 200 mg/x mL

x = 400 mL

 

DIF:    Cognitive Level: Application          REF:   pp. 65-66       OBJ:   5

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 1000 mL of solution containing 50 g glucose in water: _____

 

ANS:

1:20, 5%

 

1000:50 reduced is 1:20

1/20 :: x/100

100 = 20x

5 = x

 

DIF:    Cognitive Level: Application          REF:   pp. 65-66       OBJ:   5

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 500 mL of solution containing 350 mL alcohol in water: _____

 

ANS:

7:10, 70%

 

500:350 reduced is 7:10

7/10 :: x/100

700 = 10x

7 = x

 

DIF:    Cognitive Level: Application          REF:   pp. 65-66       OBJ:   5

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. 200 mL of solution containing 2 g of boric acid in water: _____

 

ANS:

1:100, 1%

 

2:200 = 1:100 reduced or 1%

 

DIF:    Cognitive Level: Application          REF:   pp. 65-66       OBJ:   5

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Convert 1 tablespoon to milliliters (mL): _____

 

ANS:

15

 

1 tbs = 3 tsp; 1 tsp = 5 mL; 3 tsp ´ 5 mL = 15 mL

 

DIF:    Cognitive Level: Application          REF:   pp. 67-68       OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Convert 2 tsp to milliliters (mL): _____

 

ANS:

10

 

1 tsp = 5 mL; 5 mL ´ 2 = 10

 

DIF:    Cognitive Level: Application          REF:   pp. 67-68       OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Convert 400 mcg to mg: _____

 

ANS:

0.4

 

Move decimal three places to left (1000 mcg = 1 mg); = 0.4 mg

 

DIF:    Cognitive Level: Application          REF:   pp. 67-68       OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Convert 25 g to mg: _____

 

ANS:

25,000

 

1 g = 1000 mg; 25 g ´ 1000 mg = 25,000 mg

 

DIF:    Cognitive Level: Application          REF:   pp. 67-68       OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Convert 0.2 mg to mcg: _____

 

ANS:

200

 

1 mg = 1000 mcg; move decimal place three places to the right; = 200 mcg

 

DIF:    Cognitive Level: Application          REF:   pp. 67-68       OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

Chapter 7: Principles of Medication Administration and Medication Safety

Test Bank

 

MULTIPLE CHOICE

 

  1. Where would the procedures and treatments directed by the health care provider be found?
a. Summary sheet
b. Physician’s order form
c. Physician’s progress notes
d. History and physical examination form

 

 

ANS:  B

The physician’s order form contains all procedures and treatments ordered by the health care provider. A summary sheet provides a brief overview of the hospital course at discharge. Physician’s progress notes provide regular observations on the patient’s course of treatment and response. A history and physical examination form provides information about baseline information from the patient.

 

DIF:    Cognitive Level: Knowledge          REF:   p. 80              OBJ:   2

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment

 

  1. Which action will the nurse take when it is determined that the narcotic count is incorrect while obtaining a medication from the narcotic area?
a. Determine the cause of the discrepancy at the end of the shift.
b. Notify the health care provider stat.
c. Call the nurse from the previous shift to determine if there was a discrepancy earlier.
d. Report the discrepancy to the charge nurse immediately.

 

 

ANS:  D

Reporting the discrepancy to the charge nurse immediately enables the supervisory staff to narrow the time frame during which a medication was taken and not documented. The discrepancy needs to be addressed immediately, and therefore determining the cause of the discrepancy at the end of the shift is not the most appropriate action for the nurse to take. It is not appropriate to contact the health care provider for an incorrect narcotic count. The count would have been verified at shift change; calling the nurse from the previous shift is not an appropriate action for the nurse to take.

 

DIF:    Cognitive Level: Analysis               REF:   p. 95              OBJ:   3

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment

 

  1. Which action will the nurse take if a dosage is unclear on a health care provider’s order?
a. Ask the patient what dosage was given in the past.
b. Ask another physician to determine the correct dosage.
c. Tell the patient that the medication will not be given.
d. Contact the health care provider to verify the correct dosage.

 

 

ANS:  D

Any questionable orders should be verified by the health care provider who wrote the orders. The patient is not a reliable source of verification. The physician who wrote the order should verify it. It would be a medication error to withhold the dose instead of verifying it.

 

DIF:    Cognitive Level: Application          REF:   p. 99              OBJ:   5

TOP:   Nursing Process Step: Planning

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. What is the most reliable method to calculate a pediatric patient’s medication dosage?
a. Age
b. Height
c. Body surface area (BSA)
d. Placement on a growth scale

 

 

ANS:  C

The most reliable method is by proportional amount of BSA or body weight. Because of the differences in weight among children, age is not a reliable method. Because of the differences in height among children, this is not a reliable method. Placement on a growth scale identifies how the child corresponds to other children on a percentile. Although it is determined by a specific measurement, the percentile identified would not be a specific measurement; therefore, this is not a reliable method.

 

DIF:    Cognitive Level: Comprehension   REF:   p. 101            OBJ:   10

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Which medication route provides the most rapid onset of a medication, but also poses the greatest risk of adverse effects?
a. Intradermal
b. Subcutaneous (subcut)
c. Intramuscular (IM)
d. Intravenous (IV)

 

 

ANS:  D

IV medications are delivered directly into the bloodstream and avoid the “first pass” effect of the liver. Intradermal, subcut, and IM administration have a slower absorption rate.

 

DIF:    Cognitive Level: Knowledge          REF:   p. 102            OBJ:   10

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Which is known as the “fifth vital sign”?
a. Temperature
b. Respirations
c. Pain
d. Pulse

 

 

ANS:  C

Pain is known as the “fifth vital sign.”

 

DIF:    Cognitive Level: Knowledge          REF:   p. 86              OBJ:   2

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Which is true regarding the unit dose drug distribution system?
a. The inventory is delivered to each nursing unit on a regular and recurring basis.
b. The system delivers one dose of each medication to be administered until the subsequent delivery of inventory.
c. The use of single dose packages of drugs dispensed to fill each dose requirement as it is ordered.
d. The amount of inventory needed to dose all patients on the unit for a 24 hour interval.

 

 

ANS:  C

The unit dose drug distribution system uses single unit packages of drugs dispensed to fill each dose requirement as it is ordered.

 

DIF:    Cognitive Level: Comprehension   REF:   p. 93              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. The nursing assessment identifies that the client is nauseated and cannot take acetaminophen (Tylenol) orally. Which is true regarding the substitution of this medication to suppository form?
a. It is standard practice when the patient is unable to take the ordered medication.
b. It is acceptable if the patient agrees to the altered route form.
c. It is preferable to having the patient miss a dose of the medication.
d. It is contraindicated without an order from the health care provider.

 

 

ANS:  D

One dosage form of medication should never be substituted for another unless the prescriber is consulted; there can be a great variation in the absorption rate of the medication through different routes of administration. The substitution of one form for another is not standard practice, and is not acceptable or preferable without the prescriber’s order.

 

DIF:    Cognitive Level: Application          REF:   p. 99              OBJ:   N/A

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Which medication order requires nursing judgment and means “administer if needed”?
a. Morphine 4 mg IV stat
b. Morphine 4 mg IV prior to procedure
c. Morphine 4 mg IV four times a day
d. Morphine 4 mg IV every 4 hours PRN

 

 

ANS:  D

PRN indicates for the nurse to administer morphine every 4 hours if needed and requires nursing judgment. Stat means the dose of morphine would be given immediately, not as needed. The orders for the dose of morphine to be given prior to the patient’s scheduled procedure and four times a day, do not indicate to give the dose as needed.

 

DIF:    Cognitive Level: Comprehension   REF:   p. 89 | p. 97    OBJ:   2

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. What is medication reconciliation?
a. Comparing the patient’s current medication orders to all of the medications actually being taken
b. The administration of high alert medications that have been ordered on admission to an acute care facility
c. The completion of an incident report following a variance that resulted in a serious complication
d. A printout of computerized patient data that identifies the times that all of the ordered medications are to be administered

 

 

ANS:  A

Medication reconciliation is the process of comparing a patient’s current medication orders to all of the medications that the patient is actually taking. Administering high alert medications and completing an incident report are not the same as medication reconciliation. A printout of computerized patient data that identifies the times that all of the ordered medications are to be administered is a description of the medication administration record (MAR), not a description of medication reconciliation.

 

DIF:    Cognitive Level: Knowledge          REF:   p. 98              OBJ:   4 | 9 | 10

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Which example best demonstrates safe drug administration by the nurse?
a. Administering an oral medication with the patient sitting upright
b. Asking children to say their name before administering the medication
c. Leaving the medications on the bedside stand after verifying patient identification
d. Returning the unused portion of a medication to a stock supply bottle

 

 

ANS:  A

Sitting the patient upright for oral medications is safe medication practice. Children should never be asked their names as a means of positive identification. Remaining with a patient until the drug is swallowed is safe practice. Returning an unused portion of medication to the stock supply bottle is not safe medication practice.

 

DIF:    Cognitive Level: Application          REF:   p. 103            OBJ:   10

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. The nurse determines that a prescribed medication has not been administered as ordered on the previous shift. What action will the nurse take?
a. Administer the medication immediately.
b. Complete an incident report.
c. Notify the nurse responsible for the error.
d. Record the occurrence in the nurse’s notes.

 

 

ANS:  B

An incident report is completed when a medication error occurs. Depending on the medication and frequency of administration, the medication may not be given immediately. It is not the nurse’s responsibility to notify another nurse of the error. Medication errors are not recorded in the nurse’s notes.

 

DIF:    Cognitive Level: Application          REF:   p. 100            OBJ:   6 | 11

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. A patient’s liquid cough medicine has been discontinued with one half of the bottle remaining. The home health nurse is aware that according to the U.S. Food and Drug Administration (FDA) guidelines on prescription medication disposal, the next step should be to:
a. save the remainder for another patient with the same prescription.
b. flush the remainder down the toilet.
c. read the drug label for specific disposal instructions.
d. pour remaining medication into a hazardous waste container.

 

 

ANS:  C

The nurse must follow specific disposal instructions on the drug label or in the patient information leaflet that accompanies the medication. Prescription medications should not be shared among patients. Prescription drugs should not be flushed down the toilet unless specifically instructed to do so by the manufacturer. The first action to be taken is to follow disposal instructions on the label. If the drug label indicates it should be emptied into a hazardous waste container, measures should be taken to prevent leaking and/or accidental ingestion.

 

DIF:    Cognitive Level: Analysis               REF:   p. 96              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment; Physiological Integrity

 

MULTIPLE RESPONSE

 

  1. Who defines the standards of care for the practice of nursing? (Select all that apply.)
a. State boards of nursing
b. Hospital policy and procedures
c. Federal laws regulating health care facilities
d. The Joint Commission
e. Professional nursing associations

 

 

ANS:  A, C, D, E

Standards of care are defined by state boards of nursing, federal laws regulating health care facilities, The Joint Commission, and professional nursing associations such as the American Nurses Association. Individual hospital policies and procedures incorporate federal and state guidelines into their respective policies and procedures and are often more stringent than state and federal regulations.

 

DIF:    Cognitive Level: Knowledge          REF:   p. 79 | p. 91 | p. 92

OBJ:   1                    TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment

 

  1. What must the nurse have before administering any medication? (Select all that apply.)
a. A current license to practice
b. A medication order signed by a practitioner licensed with prescription privileges
c. Knowledge of the medication
d. Consultation with a pharmacist
e. Knowledge of the client’s diagnosis

 

 

ANS:  A, B, C, E

Physicians must be licensed to prescribe medications; nurses must be licensed to administer medications. Safe medication administration includes knowledge of the medication, pathophysiology of patient diagnoses, and pharmacodynamics of the ordered medication on the pathophysiology. It is not necessary for the nurse to consult with a pharmacist each time medication is to be administered to a patient.

 

DIF:    Cognitive Level: Comprehension   REF:   p. 80              OBJ:   1

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment

 

  1. Which advantage(s) does the unit dose drug distribution system include? (Select all that apply.)
a. There is decreased participation by the pharmacy.
b. The pharmacist is able to analyze prescribed medications for each client for drug interactions and contraindications.
c. There is less waste of medications.
d. The time spent by nursing personnel preparing these medications is increased.
e. Credit is given to the patient for unused medications.

 

 

ANS:  B, C, E

Because the pharmacist has a profile of all medications for each patient, he or she is able to analyze prescribed medications for each patient for drug interactions and contraindications. This is an advantage of the unit dose drug distribution system. Less waste of medications is an advantage of the unit dose drug distribution system. Because each dose is individually packaged, credit can be given to the patient for unused medications. There is increased pharmacist involvement and better use of his or her extensive drug knowledge and nursing personnel time is decreased with this method.

 

DIF:    Cognitive Level: Knowledge          REF:   p. 93              OBJ:   7

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment

 

  1. Which statement(s) is/are true regarding the types of medication orders? (Select all that apply.)
a. Stat orders are the same as single dose orders.
b. Standing orders indicate the number of specified doses of a medication to be given.
c. Renewal orders facilitate physician review before continuance of high risk medications.
d. PRN medications will designate a mandatory number of times the medication is to be administered.
e. Verbal orders should be used as much as possible.

 

 

ANS:  B, C

Standing orders state the frequency of medication dosages to be administered or indicate the time frame of administration. Renewal orders require the physician to review medications that have “expired orders,” as determined by facility policy. Renewal policies facilitate physician verification of the necessity to continue a medication beyond a “usual” time frame and help ensure patient safety. Single dose and stat orders are not the same. PRN medications are not ordered a mandatory number of times, although a maximum number might be specified. Verbal orders should be avoided whenever possible.

 

DIF:    Cognitive Level: Comprehension   REF:   p. 97              OBJ:   8

TOP:   Nursing Process Step: Planning

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. Which statement(s) is/are true regarding computerized prescriber order entry (CPOE)? (Select all that apply.)
a. Integrates the ordering system with the pharmacy, laboratory, and nurses’ stations
b. Provides instant access to online information to facilitate patient care needs
c. Facilitates review of ordered medications for potential drug interactions
d. Facilitates review of drugs for appropriateness of dosages
e. Alleviates the need to perform mathematical computations

 

 

ANS:  A, B, C, D

CPOE systems integrate patient information, provide instant access, facilitate review of ordered medications for potential drug interactions, and facilitate review of drugs for appropriateness of dosages. Alleviation of the need to perform mathematical computations is not a component of the CPOE system.

 

DIF:    Cognitive Level: Knowledge          REF:   p. 92              OBJ:   8

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity; Safe, Effective Care Environment

 

  1. Which lab test(s) would be used to assess liver and/or renal function before administering medications? (Select all that apply.)
a. CBC
b. LDH
c. ALT
d. Crs
e. BUN
f. aPTT

 

 

ANS:  B, C, D, E

Liver function tests include LDH (lactic dehydrogenase) and ALT (alanine aminotransferase). Renal function tests include Crs (serum creatinine) and BUN (blood urea nitrogen). Although a CBC (complete blood count) and an aPTT are useful in assessing the patient before administration of medication, they are not renal or hepatic function tests.

 

DIF:    Cognitive Level: Knowledge          REF:   p. 101            OBJ:   N/A

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

 

  1. The nurse is preparing to administer Lanoxin to a patient on the telemetry unit. In addition to understanding the patient’s diagnosis, the nurse must also know which characteristic(s) of the medication? (Select all that apply.)
a. Chemical composition
b. Adverse effects
c. Expected actions
d. Contraindications for use
e. Usual dosing

 

 

ANS:  B, C, D, E

The nurse must understand the individual patient’s diagnosis and symptoms that correlate with the rationale for drug use. The nurse should also know why a medication is ordered, expected actions, usual dosing, proper dilution, route and rate of administration, adverse effects, and contraindications for the use of a particular drug. It is not required that the nurse know the chemical composition of the medication prior to administration.

 

DIF:    Cognitive Level: Application          REF:   p. 80              OBJ:   5

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment; Physiological Integrity

 

  1. The nurse transcribes an order to administer Valium 10 mg IV stat. This order is correctly interpreted by the nurse to mean it should be provided how? (Select all that apply.)
a. As needed
b. Immediately
c. One time only
d. In divided doses
e. Intravenously

 

 

ANS:  B, C, E

The stat order is generally used on an emergency basis. It means that the drug is to be administered as soon as possible, but only once. IV indicates the route is intravenous. A PRN order means “administer if needed.” The order would specify “divided doses” and amount per dose if indicated.

 

DIF:    Cognitive Level: Analysis               REF:   p. 80              OBJ:   8

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity