Review Ati nurs 180 phamacology

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Ati nurs 180 phamacology

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Total Questions : 25

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Question 1:

The nurse is preparing to administer medications to a 38-year-old client. Before administering the medications, the nurse understands which components make up the Five Rights of Medication Administration?
(Select All that Apply.)

A. Right to education B. Right Dose C. Right Drug D. Right Patient E. Right Assessment F. Right Evaluation

Answer and Explanation

Choice A:

Right to education: While educating patients about their medications is important, it is not one of the traditional Five Rights of Medication Administration. Education ensures that patients understand their treatment, potential side effects, and the importance of adherence, but it is not a core component of the Five Rights.

Choice B:

Right Dose: Ensuring the correct dose is administered is crucial to avoid underdosing or overdosing, which can lead to ineffective treatment or adverse effects. The right dose is determined based on factors such as the patient’s age, weight, and medical condition.

Choice C:

Right Drug: Administering the correct drug is essential to ensure the patient receives the intended therapeutic effect. This involves verifying the medication name, checking for potential drug interactions, and confirming the prescription details.

Choice D:

Right Patient: Verifying the patient’s identity before administering medication is critical to prevent medication errors. This typically involves checking the patient’s wristband, asking for their name and date of birth, and cross-referencing with the medication order.

Choice E:

Right Assessment: While assessing the patient before medication administration is important, it is not one of the traditional Five Rights. Assessment involves evaluating the patient’s condition, allergies, and potential contraindications to ensure safe medication administration.

Choice F:

Right Evaluation: Evaluating the patient’s response to medication is important for ongoing care, but it is not one of the traditional Five Rights. Evaluation helps determine the effectiveness of the medication and identify any adverse reactions or need for dosage adjustments.

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Question 2:

A nurse is preparing an in-service program about preventing medication errors when transcribing a prescription. The nurse is using a dosage example of two tenths of a milligram. Which of the following examples should the nurse use to show appropriate transcription of this dosage?

A. 2 mg B. 0.20 mg C. 0.2 mg D. 2.0 mg

Answer and Explanation

Choice A:

2 mg: This dosage is incorrect because it represents two milligrams, which is ten times the intended amount of two-tenths of a milligram (0.2 mg). The intended dosage is much smaller, so this option does not accurately represent the prescribed amount.

Choice B:

0.20 mg: Although this representation is correct, the trailing zero is not necessary and can lead to potential confusion or errors. Standard practice often omits the trailing zero to simplify and clarify dosage instructions.

Choice C:

0.2 mg: This is the most appropriate and clear way to write two-tenths of a milligram. It includes a leading zero before the decimal point, which is important for clarity and reducing the risk of misinterpretation. This format adheres to best practices in medication transcription.

Choice D:

2.0 mg: This option is incorrect because it represents two milligrams, not two-tenths of a milligram. The decimal point and trailing zero do not change the fact that the dosage is significantly larger than what is intended.

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Question 3:

The nurse is assigned a 49-year-old female client in the primary care office for a wellness visit. The nurse assesses the client, documents nurses notes, and reviews the medication administration record for potential interactions. The nurse should be most concern with the potential interaction between __________and _________.
Complete the sentence by choosing one answer from each option in the drop-down list below:
Medication Reconciliation:

A. St. John's wort 450 mg by mouth twice daily B. Gabapentin 400 mg by mouth twice daily C. Aspirin 81 mg by mouth daily D. Atorvastatin 80 mg by mouth daily E. Lisinopril 5 mg by mouth daily F. Warfarin 5 mg by mouth daily G. Ginger 5mg by mouth daily H. Valerian 10mg by mouth daily

Answer and Explanation

Choice A:

St. John's wort 450 mg by mouth twice daily: St. John's wort is known to be a potent inducer of cytochrome P450 enzymes and can significantly reduce the effectiveness of warfarin by increasing its metabolism. This interaction can lead to subtherapeutic levels of warfarin and an increased risk of thromboembolic events.

Choice B:

Gabapentin 400 mg by mouth twice daily: While gabapentin can interact with other medications, its interactions with warfarin or St. John's wort are generally not as significant as those between warfarin and St. John's wort.

Choice C:

Aspirin 81 mg by mouth daily: Aspirin has anticoagulant properties and can have interactions with warfarin. However, the interaction with St. John's wort is less pronounced compared to the interaction between warfarin and St. John's wort.

Choice D:

Atorvastatin 80 mg by mouth daily: Atorvastatin primarily affects lipid levels and has different metabolic pathways compared to warfarin. It does not have a strong interaction with St. John's wort.

Choice E:

Lisinopril 5 mg by mouth daily: Lisinopril is an ACE inhibitor and does not have significant interactions with St. John's wort or warfarin.

Choice F:

Warfarin 5 mg by mouth daily. Warfarin is an anticoagulant that requires careful monitoring due to its interactions with various substances that can either increase the risk of bleeding or decrease its effectiveness.

Choice G:

Ginger 5 mg by mouth daily: Ginger can affect platelet function but is not as significant in interaction with warfarin as St. John's wort.

Choice H:

Valerian 10 mg by mouth daily: Valerian may have mild interactions with central nervous system depressants but does not have significant interactions with warfarin or St. John's wort.

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Question 4:

The healthcare provider orders azithromycin (Zithromax) 1000mg to be given as a loading dose. The nurse understands that the purpose of this loading dose is to:

A. Increase the duration of action of the medication B. Decrease the frequency of subsequent doses. C. Achieve therapeutic drug levels more rapidly D. Minimize the risk of adverse effects

Answer and Explanation

Choice A:

Increase the duration of action of the medication:A loading dose is not intended to increase the duration of action of a medication. Instead, it aims to rapidly achieve therapeutic levels in the bloodstream. The duration of action is primarily influenced by the drug's half-life and how it's metabolized and excreted, rather than the initial dose.

Choice B:

Decrease the frequency of subsequent doses:The primary goal of a loading dose is to reach therapeutic levels quickly, not necessarily to alter the frequency of future doses. While a loading dose can help achieve therapeutic levels faster, the dosing schedule is determined by the drug's pharmacokinetics and the condition being treated.

Choice C:

Achieve therapeutic drug levels more rapidly:The main purpose of a loading dose is to quickly achieve a concentration of the medication in the blood that is sufficient to be therapeutic. By giving a larger initial dose, the medication reaches effective levels faster compared to gradually reaching those levels with smaller, incremental doses.

Choice D:

Minimize the risk of adverse effects:Minimizing adverse effects is not the primary aim of a loading dose. While achieving therapeutic levels quickly may indirectly help in reducing symptoms and improving outcomes, the main purpose of a loading dose is to reach effective drug levels promptly, not specifically to reduce adverse effects.

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Question 5:

The nurse is caring for a client who needs to have a peak drug level drawn. The client was given an oral medication 30 minutes ago. What is the best action by the nurse?

A. Wait for at least another 30 minutes before calling to have the level drawn. B. Schedule the level to be drawn in 8 hours C. Call the lab to have the medication level drawn immediately D. Arrange for the level to be drawn tomorrow since the peak time has passed.

Answer and Explanation

Choice A:

Wait for at least another 30 minutes before calling to have the level drawn:For oral medications, peak drug levels are typically drawn 1 to 2 hours after administration, depending on the medication's pharmacokinetics. Since the client took the medication only 30 minutes ago, it is premature to draw the level now. Waiting an additional 30 minutes would align with the typical peak times for oral medications, ensuring that the drug level reflects its peak concentration.

Choice B:

Schedule the level to be drawn in 8 hours:Drawing the peak level 8 hours after administration would likely be too late, as most oral medications reach their peak concentration within 1 to 2 hours. Scheduling the level for 8 hours later may result in an inaccurate measurement of the peak drug level, leading to potentially misleading clinical information.

Choice C:

Call the lab to have the medication level drawn immediately:Drawing the level immediately after 30 minutes may not provide an accurate representation of the peak drug level. Oral medications generally reach peak levels later, and an early draw could result in a falsely low measurement that does not reflect the drug's maximum concentration.

Choice D:

Arrange for the level to be drawn tomorrow since the peak time has passed:
The peak time has not passed, as the medication was only administered 30 minutes ago. Drawing the level tomorrow would be far too late to assess the peak concentration accurately, which is essential for evaluating the effectiveness and safety of the medication.

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Question 6:

A nurse is preparing to administer a medication to a client who states, "That looks different from the pill I usually take." Which is the best response by the nurse?

A. This hospital might use a different manufacturer, but the medication is the same." B. "What does your usual pill look like?" C. This is the medication prescribed by your provider." D. "This pill is probably from a different lot number than yours at home."

Answer and Explanation

Choice A:

This hospital might use a different manufacturer, but the medication is the same:While it is possible that different manufacturers might produce pills of varying appearances, this response does not directly address the client's concern or involve them in verifying the medication. It's important for the nurse to first understand what the client is accustomed to before providing reassurance about the medication.

Choice B:

What does your usual pill look like?:Asking the client to describe their usual pill is the best response. This approach allows the nurse to verify the medication in question by comparing it to the client’s known medication. It also reassures the client that their concerns are being taken seriously and provides an opportunity for the nurse to check if there has been an error or if the medication is indeed correct.

Choice C:

This is the medication prescribed by your provider:While this statement is factual, it does not directly address the client’s concern about the appearance of the medication. It's important to involve the client in verifying the medication to ensure they are receiving the correct drug and to maintain their trust.

Choice D:

This pill is probably from a different lot number than yours at home:This response assumes the issue is related to the lot number, which may not be the case. It does not involve the client in the verification process or address their specific concern about the appearance of the medication. Providing a more thorough and engaging response would be more appropriate.

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Question 7:

The nurse is caring for a client who is 21-weeks pregnant and requires the administration of various medications. The nurse understands that different medications are classified on their potential interaction with the mother's fetus. From the list of options below, match the correct medication category to its corresponding description.

A. Category A- indicate no risk to the human fetus. B. Category C- medications indicated possible risk in humans has been reported. C. Category X - medications have reportable fetal abnormalities associated with consumption. Positive evidence of fetal risk is available in both humans and animals D. Category B -Studies indicate no risk to the animal fetus, with no information on human fetuses available.

Answer and Explanation

Choice A:

Category A:Medications classified as Category A are considered the safest during pregnancy. They have been well-studied in pregnant humans, and no risk to the fetus has been demonstrated. This classification means that adequate and well-controlled studies have shown no evidence of harm to the fetus in the first trimester and no risk in later trimesters.

Choice B:

Category C:Category C medications have shown potential risks to the fetus in animal studies, and there are no well-controlled studies in humans. The benefits of the medication may outweigh the potential risks, but caution is advised. These medications are used when the potential benefits justify the potential risks to the fetus.

Choice C:

Category X:Category X medications are contraindicated in pregnancy due to evidence of fetal abnormalities or risks that outweigh any potential benefits. These medications have demonstrated clear evidence of harm to the fetus in both human and animal studies, and their use is not recommended during pregnancy.

Choice D:

Category B:Category B medications have shown no risk to animal fetuses, but there is a lack of adequate and well-controlled studies in pregnant humans. The absence of evidence of harm in animal studies suggests that these drugs are generally considered safe, though their effects on human fetuses are not well-documented.

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Question 8:

A nurse reads in a drug information guide that PO morphine has a high first-pass effect. Which of the following would the nurse expect?

A. The drug will be more effective when given in a nonenteral route. B. The drug will be most effective when given orally C. The drug is excreted by the kidneys at a slower rate than most medications D. The kidney will metabolize some of the drug before it reaches the blood stream

Answer and Explanation

Choice A:

The drug will be more effective when given in a nonenteral route:Morphine has a high first-pass effect when taken orally, meaning that a significant amount of the drug is metabolized in the liver before it reaches systemic circulation. This reduces the amount of active drug available in the bloodstream. To avoid this extensive metabolism, morphine is often administered through nonenteral routes, such as intravenous or subcutaneous, where it bypasses the digestive system and liver first-pass metabolism, resulting in higher systemic bioavailability and effectiveness.

Choice B:

The drug will be most effective when given orally:Due to the high first-pass effect of oral morphine, a significant portion of the drug is metabolized by the liver before it reaches systemic circulation. This means that oral morphine is often less effective compared to other routes of administration, such as intravenous, because the bioavailability of the drug is reduced.

Choice C:

The drug is excreted by the kidneys at a slower rate than most medications:The high first-pass effect primarily affects the drug's absorption and systemic availability rather than its excretion rate. The rate at which a drug is excreted by the kidneys is generally unrelated to its first-pass effect. Morphine’s excretion is influenced by its metabolism and clearance, but not directly by the first-pass effect.

Choice D:

The kidney will metabolize some of the drug before it reaches the bloodstream:The first-pass effect occurs primarily in the liver, not the kidneys. It involves the metabolism of the drug by the liver before it reaches systemic circulation. Therefore, this option incorrectly attributes the first-pass effect to kidney metabolism.

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Question 9:

A nurse is planning to administer an IM injection into a client's deltoid muscle. Which action should the nurse take?

A. Inject a volume of less than 2 mL. B. Inject the medication at a 90 degree angle. C. Inject the medication 12.7 cm (5 in) below the client's acromion process. D. Use a 21-gauge needle for the injection.

Answer and Explanation

Choice A:

Inject a volume of less than 2 mL: While it is generally recommended to inject a volume of less than 2 mL into the deltoid muscle to avoid discomfort and ensure proper absorption, this is not the primary action to focus on when planning the injection.

Choice B:

Inject the medication at a 90 degree angle: This is the correct action. Administering an intramuscular (IM) injection at a 90-degree angle ensures that the medication is delivered deep into the muscle tissue, which is necessary for proper absorption and effectiveness.

Choice C:

Inject the medication 12.7 cm (5 in) below the client’s acromion process: The correct injection site for the deltoid muscle is typically 2-3 finger widths (approximately 2.5-5 cm) below the acromion process, not 12.7 cm. Injecting too far below the acromion process could result in an incorrect injection site.

Choice D:

Use a 21-gauge needle for the injection: While a 21-gauge needle can be used for IM injections, the gauge of the needle is not the primary focus in this context. The angle of injection is more critical to ensure proper delivery of the medication.

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Question 10:

A nurse is reviewing a client's prescribed medications. Which of the following situations represents a contraindication to medication administration?

A. An antibiotic medication that has a side effect of nausea when taken without food. B. Administering medications to a client under 4 months of age. C. A antihypertensive medication given for high-blood pressure that causes orthostatic hypotension. D. A medication with a Blackbox warning that the drug causes tendonitis and the patient has a history of tendonitis.

Answer and Explanation

Choice A:

An antibiotic medication that has a side effect of nausea when taken without food:Nausea is a common side effect of many medications, including antibiotics, when taken on an empty stomach. While this side effect may cause discomfort, it is generally not a contraindication to medication administration. Patients can often manage this side effect by taking the medication with food or as advised by their healthcare provider.

Choice B:

Administering medications to a client under 4 months of age:While administering medications to very young children requires special considerations and dosing adjustments, it is not inherently a contraindication. The key is to ensure that the medications are appropriate for the age and weight of the infant, and are prescribed and dosed correctly.

Choice C:

An antihypertensive medication given for high-blood pressure that causes orthostatic hypotension:Orthostatic hypotension is a known side effect of some antihypertensive medications. While this side effect needs to be managed carefully, it does not represent a contraindication to the medication. Adjusting the dose or changing medications may be required to manage this side effect.

Choice D:

A medication with a Blackbox warning that the drug causes tendonitis and the patient has a history of tendonitis:A Black Box warning is the strictest warning put in the labelling of a prescription drug by the FDA. It indicates that the drug has significant risk of serious or life-threatening adverse effects. If a medication with a Black Box warning indicates a risk of tendonitis and the patient has a history of tendonitis, this represents a contraindication, as the drug could exacerbate or trigger the condition, posing a serious risk to the patient.

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Total Questions : 25

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Ati nurs 180 phamacology

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