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Fundamental Nursing 2

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Question 1:

Directions: Refer to the diagram of the syringe provided to answer the following question The nurse needs to withdraw 0.65 mL of medication into a syringe. The nurse fills the medication to which area on the syringe?

Explanation

Area 3 corresponds to 0.65 mL

Area 1 corresponds to 0.3 mL

Area 2 corresponds to 0.5 mL

Area 4 corresponds to 0.75 mL


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Question 2:

Which of the following is not considered a unique when establishing the identification of a client?

Explanation

Room number of the client is not considered unique when establishing the identification of a client.

While a room number may be used to identify the physical location of a client within a healthcare facility, it is not a unique identifier for the client themselves. The other options listed (medical record number, full name, date of

birth) are all considered unique identifiers and are commonly used in healthcare settings to establish a client's identity.


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Question 3:

A nurse is administering a medication at the bedside. Which of the following actions should be the first priority?

Explanation

Establish the identity of the client should be the first priority when a nurse is administering a medication at the bedside.

It is essential to verify the identity of the client before administering any medication to ensure that the medication is being given to the right person. This can be done by asking the client to state their name and verifying it with their medical record or identification band. Once the nurse has established the client's identity, they can proceed to administer the medication.

Documenting the administration of the medication is important but should not take priority over verifying the client's identity. Rechecking the medication label is also important but can be done after the nurse has established the client's identity and is preparing to administer the medication. Obtaining orange juice for the client to take with the medication is not a priority action and can be done after the medication has been administered.


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Question 4:

The "six rights” of medication administration are:

Explanation

These are important principles that nurses follow to ensure that medications are given safely and accurately to clients. The six rights are:

1. Right medication: ensuring that the medication being administered is the correct one prescribed for the client.

2. Right dose: ensuring that the correct amount of medication is given to the client.

3. Right route: ensuring that the medication is given via the correct route (oral, topical, intravenous, etc.). 4. Right time: ensuring that the medication is given at the correct time as per the prescribed schedule. 5. Right client: ensuring that the medication is given to the correct client/patient by verifying their identity. 6. Right documentation: ensuring that the medication administration is accurately documented, including themedication name, dose, route, time, and any adverse reactions or other pertinent information. The other answer choices do not accurately represent the six rights of medication administration.


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Question 5:

The generic name for this medication is:



 

Explanation

The generic name for a medication is the official or non-proprietary name of the drug, which is not owned by any specific drug manufacturer. It is a simple name given to a medication that describes its active ingredient and chemical structure, and is used worldwide by healthcare professionals.

The generic name for the medication Ancef is cefazolin. Ancef is a brand name for the antibiotic medication cefazolin, which is used to treat various bacterial infections.

For example, the generic name of Tylenol is acetaminophen, the generic name of Advil is ibuprofen, and the generic name of Aspirin is acetylsalicylic acid.


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Question 6:

When a verbal order is received by an authorized individual, the individual must do the following:

Explanation

The Joint Commission (TJC) requires healthcare organizations to use the read-back method when taking verbal or telephone orders to ensure accurate communication between healthcare professionals. The authorized individual receiving the order should first write it down, then read it back to the prescriber to confirm that it is accurate, and finally receive confirmation from the prescriber that the order has been received and recorded correctly. This process helps to prevent medication errors and ensure the safety of the clients receiving the prescribed treatment.


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Question 7:

What would be the appropriate interpretation for the following order? Demerol 50 mg IM stat

Explanation

The appropriate interpretation for the following order "Demerol 50 mg IM stat" is: Demerol 50 mg IM immediately.

The term "stat" means immediately or without delay. Therefore, the order is requesting the administration of Demerol 50 mg intramuscularly as soon as possible.


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Question 8:

Which of the following correctly indicates the order below:

Explanation

The correct way to indicate the order "Administer Colace 100mg by mouth three times a day" is:

A) Colace 100 mg p.o. t.i.d.

"p.o." means by mouth, "t.i.d." means three times a day, so the correct order is "Colace 100 mg by mouth three times a day."

B) Colace 100 mg p.o. b.i.d. - This would mean "Colace 100 mg by mouth twice a day." "b.i.d." stands for "bis in die," which is Latin for "twice a day."

C) Colace 100 mg p.o. q.i.d. - This would mean "Colace 100 mg by mouth four times a day." "q.i.d." stands for "quater in die," which is Latin for "four times a day."


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Question 9:

A nurse who administers a medication that is unsafe is liable for the error

Explanation

As a healthcare professional, a nurse has a legal and ethical responsibility to ensure that medication administration is safe and effective for the patient. If a nurse administers medication that is unsafe, they can be held liable for the error. It is important for nurses to follow medication administration protocols, verify medications before administering them, and report any errors or concerns to the appropriate parties.


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Question 10:

The nurse can safely administer medications that are prepared by another nurse

Explanation

It is important for the nurse to personally prepare and verify the medication before administering it to the patient to ensure accuracy and safety. Nor is it acceptable practice to administer a medication that another has prepared. The reasons for this strict rule are numerous. First and foremost, because preparation and administration are fraught with potential for error, relying on another nurse to prepare a medication that you administer is dangerous at best. Ultimately, the responsibility for safe medication administration falls on the administering nurse, regardless of who prepared the medication.


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Question 11:

A prn order must indicate the minimum time between doses such as q4h

Explanation

A PRN order does not necessarily indicate the minimum time between doses. PRN stands for "pro re nata," which means "as needed." When a medication is ordered PRN, the healthcare provider should also indicate the frequency or the minimum time between doses, for example, "PRN every 4 hours" or "PRN up to 3 times a day." However, the specific frequency or time between doses may vary depending on the patient's condition and response to the medication, so it is important to follow the healthcare provider's instructions and assess the patient's response before administering the medication again.


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Question 12:

Directions: Refer to the diagram of the syringe provided to answer the following question The nurse needs to withdraw 1.7 mL of medication into a syringe. The nurse fills the medication to which area on the syringe?

Explanation

The correct answer is area 2 that corresponds to 1.7 mL

Area 1 corresponds to 1.2 mL

Area 3 corresponds to 2.1 mL

Area 4 corresponds to 2.7 mL


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Question 13:

The 30-minute rule refers to

Explanation

The 30-minute rule refers to the administration of medications within 30 minutes of the scheduled timeis important because it helps ensure that medications are administered at appropriate intervals to maintain theirtherapeutic effect. Medications are often ordered to be given at specific times or intervals to achieve maximum benefit and prevent adverse effects. The 30-minute rule allows for some flexibility in medication administration while still maintaining adherence to the ordered schedule.

For example, if a medication is ordered to be given at 8:00 AM, the 30-minute rule allows the nurse to administer the medication any time between 7:30 AM and 8:30 AM while still considering it given on time. This is important because patients often have complex medication schedules, and strict adherence to the ordered timing can be challenging. The 30-minute rule helps prevent missed doses, allows for adjustments in administration times, and reduces the risk of medication errors.


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Question 14:

A client refuses a po medication and provides the nurse with a reason for refusing the medication. What should the nurse’s action be?

Explanation

Document the refusal and inform the prescriber is the appropriate action for the nurse to take if a client refuses a medication and provides a reason for refusal. The nurse should document the refusal and reason in the client’s medical record, and notify the prescriber of the refusal and the reason given by the client. The prescriber may then choose to modify the medication or the administration method, or may provide additional education or counseling to the client regarding the medication. It is important to respect the client’s autonomy and right to refuse medication, and to work collaboratively with the prescriber to ensure that the client’s care needs are met in a safe and effective manner.


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Question 15:

Medication errors can result in prolonged hospitalization for a client.

Explanation

The correct answer is A True. Medication errors can result in adverse events and harm to the patient, which can lead to prolonged hospitalization or even death in some cases. It is important for healthcare professionals to take measures to prevent medication errors and ensure patient safety.


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Question 16:

Round dose and weight to the nearest tenth as indicated. Order. Albuterol 1.2 mg p.o. t.i.d. is ordered for a child weighing 27 lb. The recommended dose is 0.3 mg/kg/24 hr divided q8h. Available: 

Explanation

First, let's calculate the child's weight in kilograms:

27 lb ÷ 2.205 lb/kg = 12.25 kg

Next, we can calculate the total daily dose of albuterol that the child should receive:

0.3 mg/kg/24 hr x 12.25 kg = 3.675 mg/24 hr

We need to divide this total daily dose into three equal doses to be given every 8 hours: 3.675 mg/24 hr ÷ 3 doses = 1.225 mg/dose

The available Albuterol syrup is 2mg/5ml, which means each 5ml of syrup contains 2mg of albuterol. To administer 1.225 mg of albuterol, we need to calculate the volume of syrup required using the following formula:

Volume (ml) = (dose (mg) ÷ concentration (mg/ml))

Volume (ml) = (1.225 mg ÷ 2 mg/ml)

Volume (ml) = 0.6125 ml

Therefore, the child should receive 0.6 ml (rounded to the nearest tenth) of Albuterol syrup per dose, to be given orally three times a day.


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Question 17:

The correct abbreviation twice a day is: 

Explanation

The correct abbreviation for "twice a day" is "BID," which stands for "bis in die" in Latin.


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Question 18:

Round dose and weight to the nearest tenth as indicated Use labels where provided. 

Order: Ceclor (cefaclor) 100 mg p.o. q8h is ordered for a child weighing 32 lb. 

The recommended dose is 20 to 40 mg/kg/day divided q8h. 

Available:



 

Explanation

First, we need to convert the child's weight from pounds to kilograms:

32 lb ÷ 2.2 lb/kg = 14.54 kg (rounded to the nearest hundredth)

Next, we'll calculate the recommended daily dose range for this child:

20 mg/kg/day × 14.54 kg = 290.8 mg/day

40 mg/kg/day × 14.54 kg = 581.6 mg/day

So the recommended dose range for this child is 290.8 to 581.6 mg/day.

To calculate the dose for each individual dose, we'll divide the total daily dose by 3 (since it's divided into three equal doses per day):

290.8 mg/day ÷ 3 = 96.9 mg/dose (rounded to the nearest tenth)

581.6 mg/day ÷ 3 = 193.9 mg/dose (rounded to the nearest tenth)

Since the available cefaclor suspension is 125 mg per 5ml, we'll need to calculate how much volume of suspension to give for each dose:

96.9 mg/dose ÷ 125 mg/5ml = 2.46 ml/dose (rounded to the nearest hundredth)

193.9 mg/dose ÷ 125 mg/5ml = 3.10 ml/dose (rounded to the nearest hundredth)

Therefore, the child should receive 2.5 ml of cefaclor suspension for each dose of 100 mg and 3.1 ml of cefaclor suspension for each dose of 200 mg.


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Question 19:

The client is to receive phenytoin 100 mg q8h. 

What is the correct military time that the nurse should document in the chart for the last dose of the day if the  first dose was given at 0600? 

Explanation

If the first dose of phenytoin was given at 0600, the next dose should be given 8 hours later at 1400 (2:00 PM) and the third dose should be given 8 hours after that at 2200 (10:00 PM).

To convert these times to military time, we can add 12 to any time after 12:00 PM (noon). Therefore, the correct military times for administering the phenytoin doses would be:

1st dose = 0600 (6:00 AM)

2nd dose = 1400 (2:00 PM)

3rd dose = 2200 (10:00 PM)

The last dose of the day should be given at 2200 (10:00 PM).

To document the administration of the medication in military time, the nurse should record the time as 2200 in the client's chart.


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Question 20:

A medicine ordered q4h would be given how many times a day? 

Explanation

6 times a day . If a medication is ordered to be given "q4h," it means that it should be administered every 4 hours. Therefore, the medication would be given 6 times a day, as there are 24 hours in a day and 24 divided by 4 equals 6.


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Question 21:

The correct abbreviation for immediately is 

Explanation

“STAT”. The correct abbreviation for immediately in medicine is "stat".

Here are some similar abbreviations used in medicine:

stat: immediately (from Latin "statim")

qd: every day (from Latin "quaque die")

qid: four times a day (from Latin "quater in die")

qh: every hour (from Latin "quaque hora")

q2h: every 2 hours (from Latin "quaque secunda hora")

ac: before meals (from Latin "ante cibum")

pc: after meals (from Latin "post cibum")

tid: three times a day (from Latin "ter in die")

hs: at bedtime (from Latin "hora somni")

prn: as needed (from Latin "pro re nata")


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Question 22:

Enteric-coated tablets and time-released tablets should never be? 

Explanation

Enteric-coated tablets and time-released tablets should never be crushed or broken before administration. Here are reasons why enteric-coated tablets and time-released tablets should never be crushed: 1. Effectiveness: Enteric-coated tablets are designed to resist the acidic environment of the stomach and dissolve in the alkaline environment of the small intestine. Crushing these tablets will alter their absorption pattern and effectiveness.

2. Safety: Time-released tablets are designed to slowly release the medication over an extended period, which helps to maintain a consistent therapeutic level in the body. Crushing these tablets can result in an immediate release of the entire dose, which can cause an overdose or adverse reactions.

3. Irritation: Crushing enteric-coated or time-released tablets can cause irritation to the throat, mouth, and airways, leading to coughing, choking, or breathing difficulties.

4. Accuracy: When tablets are crushed, the amount of medication that is delivered may be inaccurate, which can lead to underdosing or overdosing.


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Question 23:

The nursing instructor is facilitating a clinical group discussion about the adrenal glands including the cortex and the medulla. The instructor asks about the physiological changes that happen when norepinephrine and epinephrine are released. The students show good understanding of physiological changes when they state they include: (select all that apply).

Explanation

Norepinephrine and epinephrine are catecholamines released by the adrenal medulla during the "fight or flight" response. They have several physiological effects, including increasing heart rate, pupil dilation, and blood pressure. Additionally, epinephrine causes bronchodilation, while norepinephrine causes vasoconstriction. Therefore, the nurse should monitor the client for signs of hypertension, tachycardia, and increased respiratory rate.


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Question 24:

Medication errors can result in prolonged hospitalization for a client.

Explanation

The correct answer is A True. Medication errors can result in adverse events and harm to the patient, which can lead to prolonged hospitalization or even death in some cases. It is important for healthcare professionals to take measures to prevent medication errors and ensure patient safety.


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Question 25:

The correct abbreviation for every 4 hours is 

Explanation

The correct abbreviation for every 4 hours is "q4h".

Here are some other similar medication administration abbreviations:

ac: before meals

pc: after meals

qd: once daily

qod: every other day

qh: every hour

qid: four times daily

tid: three times daily

hs: at bedtime

prn: as needed

stat: immediately

po: by mouth

IV: intravenous

IM: intramuscular


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