Review Causes and risk factors

Medication Safety and Error Prevention > Pharmacology

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Causes and risk factors

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Total Questions : 7

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Question 1:

A nurse is preparing to administer medication to a client who has a history of medication errors. Which of the following actions should the nurse take to prevent medication errors? (Select all that apply.)

A. Check the medication label against the medication administration record (MAR) three times. B. Use two client identifiers before giving the medication. C. Ask the client to state their name and date of birth before giving the medication. D. Document the medication administration after completing other tasks. E. Follow the six rights of medication administration.

Answer and Explanation

Choice A:

This is correct as checking the medication label against the MAR three times is one of the six rights of medication administration and helps to ensure accuracy and safety.

Choice B:

This is correct as using two client identifiers is another one of the six rights of medication administration and helps to verify the identity of the client.

Choice C:

This is correct as asking the client to state their name and date of birth is another way of verifying the identity of the client and can also help to engage them in their care.

Choice D:

This is incorrect as documenting the medication administration should be done as soon as possible after giving the medication to avoid errors and omissions.

Choice E:

This is correct as following the six rights of medication administration (right client, right medication, right dose, right route, right time, right documentation) is a standard practice that helps to prevent medication errors.

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Question 2:

A nurse is reviewing a client's medication list and notices that the client is taking warfarin, a blood thinner. Which of the following factors should the nurse assess as potential risk factors for bleeding? (Select all that apply.)

A. The client's international normalized ratio (INR) level B. The client's use of herbal supplements C. The client's intake of vitamin K-rich foods D. The client's history of peptic ulcer disease E. The client's blood pressure

Answer and Explanation

Choice A:

This is correct as the INR level measures how long it takes for blood to clot and is used to monitor the effectiveness and safety of warfarin therapy. A high INR level indicates a higher risk of bleeding.

Choice B:

This is correct as some herbal supplements, such as garlic, ginger, ginkgo, and ginseng, can interact with warfarin and increase the risk of bleeding.

Choice C:

This is incorrect as vitamin K-rich foods, such as green leafy vegetables, can interfere with warfarin and decrease its effectiveness, leading to a lower risk of bleeding. However, clients taking warfarin should maintain a consistent intake of vitamin K-rich foods and avoid sudden changes in their diet.

Choice D:

This is correct as peptic ulcer disease is a condition that causes erosion and inflammation of the lining of the stomach or duodenum and can lead to bleeding complications, especially when taking warfarin.

Choice E:

This is incorrect as blood pressure does not directly affect the risk of bleeding from warfarin therapy. However, clients taking warfarin should monitor their blood pressure regularly and report any signs of hypertension or hypotension to their provider.

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Question 3:

A nurse is administering medication to a client who has dysphagia, or difficulty swallowing. Which of the following strategies should the nurse use to prevent medication errors and ensure safety? (Select all that apply.)

A. Crush or dissolve tablets and capsules before giving them to the client. B. Mix medications with food or liquids that are easy to swallow. C. Give one medication at a time and allow time for swallowing. D. Encourage the client to drink water before and after taking medications. E. Assess the client's mouth for pocketing of medications.

Answer and Explanation

Choice A:

This is incorrect as crushing or dissolving tablets and capsules before giving them to the client can alter their effectiveness, absorption, or bioavailability and cause medication errors or adverse effects. Some tablets and capsules are designed to be swallowed whole, such as enteric-coated, extended-release, or sublingual formulations. The nurse should check with the pharmacist before crushing or dissolving any tablets or capsules.

Choice B:

This is correct as mixing medications with food or liquids that are easy to swallow can help to prevent choking and aspiration and improve compliance. However, some medications may interact with certain foods or liquids, so the nurse should check with the pharmacist before mixing them.

Choice C:

This is correct as giving one medication at a time and allowing time for swallowing can help to prevent choking and aspiration and ensure that each medication is taken correctly. The nurse should also monitor the client for signs of difficulty swallowing, such as coughing, gagging, drooling, or regurgitation.

Choice D:

This is incorrect as encouraging the client to drink water before and after taking medications can help to prevent choking and aspiration and ensure adequate hydration, but it may not be appropriate for some clients who have dysphagia or who are on fluid restrictions. The nurse should assess the client's ability to drink water safely and follow their individualized plan of care.

Choice E:

This is correct as assessing the client's mouth for pocketing of medications can help to prevent medication errors and ensure that each medication is taken correctly. Pocketing of medications occurs when the client holds medications in their cheeks or under their tongue instead of swallowing them. This can lead to ineffective therapy, toxicity, or adverse effects.

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Question 4:

A nurse is administering an intramuscular injection to a client who has a latex allergy. Which of the following precautions should the nurse take to prevent an allergic reaction? (Select all that apply.)

A. Use a latex-free syringe and needle. B. Wear non-latex gloves when handling the injection site. C. Apply a non-latex bandage over the injection site after giving the injection. D. Check the medication label for any latex components. E. Ask the client about any previous reactions to latex products.

Answer and Explanation

Choice A:

Using a latex-free syringe and needle, wearing non-latex gloves, and applying a non-latex bandage are not precautions, but rather standard practices for administering an intramuscular injection to any client.

Choice B:

Choice C:

Choice D:

Checking the medication label for any latex components and asking the client about any previous reactions to latex products are important precautions that can help prevent an allergic reaction. Some medications may contain latex in their packaging or formulation, and some clients may have more severe reactions than others.

Choice E:

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Question 5:

A nurse is teaching a client who has diabetes mellitus about how to prevent hypoglycemia when taking insulin. Which of the following statements by the client indicates an understanding of the teaching?

A. "I should eat a snack before exercising." B. "I should skip a meal if my blood sugar is high." C. "I should increase my insulin dose if I am stressed." D. "I should drink alcohol only on special occasions."

Answer and Explanation

Choice A:

This is correct as eating a snack before exercising can help to prevent hypoglycemia by providing glucose for energy and preventing a sudden drop in blood sugar levels.

Choice B:

This is incorrect as skipping a meal can cause hypoglycemia by depriving the body of glucose and creating an imbalance between insulin and glucose levels. Clients taking insulin should eat regular meals and snacks and monitor their blood sugar levels frequently.

Choice C:

This is incorrect as increasing the insulin dose without consulting with the provider can cause hypoglycemia by lowering the blood sugar levels too much. Stress can affect blood sugar levels in different ways depending on the type and duration of stress and the individual's response. Clients taking insulin should consult with their provider about how to adjust their insulin dose according to their stress level and blood sugar readings.

Choice D:

This is incorrect as drinking alcohol can cause hypoglycemia by inhibiting the liver's production of glucose and increasing the risk of insulin overdose. Clients taking insulin should avoid or limit alcohol intake and never drink alcohol on an empty stomach.

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Question 6:

A nurse is caring for a client who is receiving intravenous (IV) fluids. The nurse notices that the IV site is red, swollen, and painful. Which of the following actions should the nurse take first?

A. Apply a warm compress to the IV site. B. Discontinue the IV infusion and remove the catheter. C. Elevate the affected arm above the level of the heart. D. Notify the provider and document the findings.

Answer and Explanation

Choice A:

This is incorrect as applying a warm compress to the IV site can help to reduce inflammation and discomfort, but it is not the first action that the nurse should take. The nurse should apply a warm compress after discontinuing the IV infusion and removing the catheter.

Choice B:

This is correct as discontinuing the IV infusion and removing the catheter is the first action that the nurse should take when suspecting an IV site infection or phlebitis. This helps to prevent further complications and damage to the vein.

Choice C:

This is incorrect as elevating the affected arm above the level of the heart can help to reduce swelling and improve blood flow, but it is not the first action that the nurse should take. The nurse should elevate the affected arm after discontinuing the IV infusion and removing the catheter.

Choice D:

This is incorrect as notifying the provider and documenting the findings are important steps in managing an IV site infection or phlebitis, but they are not the first actions that the nurse should take. The nurse should notify the provider and document the findings after discontinuing the IV infusion and removing the catheter.

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Question 7:

A nurse is reviewing the medication administration record of a client who is receiving digoxin, a cardiac glycoside. The nurse notes that the client's apical pulse is 58 beats per minute. Which of the following actions should the nurse take?

A. Administer the medication as prescribed. B. Hold the medication and notify the provider. C. Check the client's blood pressure and oxygen saturation. D. Repeat the apical pulse measurement after 5 minutes.

Answer and Explanation

Choice A:

Administering the medication as prescribed or holding the medication and notifying the provider are not appropriate actions for the nurse to take without further assessment of the client's condition.

Choice B:

Digoxin can lower the heart rate, but it can also improve cardiac output and contractility in clients with heart failure. Therefore, the nurse should not withhold the medication based on one vital sign measurement alone.

Choice C:

Checking the client's blood pressure and oxygen saturation is an appropriate action for the nurse to take when the client's apical pulse is below 60 beats per minute, which is the lower limit of normal. This is because a low pulse rate can indicate bradycardia, which can affect the client's hemodynamic status and tissue perfusion.

Choice D:

Repeating the apical pulse measurement after 5 minutes is not an appropriate action for the nurse to take when the client's apical pulse is below 60 beats per minute, as it delays further assessment and intervention.

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Total Questions : 7

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Causes and risk factors

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