Review NUAS 130 Medication proctored exam 3

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NUAS 130 Medication proctored exam 3

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Total Questions : 25

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Question 1:

The nurse is transcribing an order for Ampicillin 500 mg PO t.i.d ac. Which of the following administration schedules would be best for a medication ordered t.i.d ac, if mealtime was 0800, 1200 and 1700?

A. 0800, 1200, 1800, 2200 B. 0900, 1300, 1900 C. 0700, 1100, 1700, 2100 D. 0700, 1100, 1600

Answer and Explanation

Choice A:

0800, 1200, 1800, 2200: This schedule reflects four doses (q.i.d), not three, and includes administration during or after meals rather than before. “ac” (ante cibum) requires administration prior to meals to optimize absorption, especially for antibiotics like ampicillin.

Choice B:

0900, 1300, 1900: These times are after meals (postprandial), which can reduce absorption of ampicillin due to food interference in the gastrointestinal tract. This does not meet the “before meals” requirement and may decrease therapeutic effectiveness.

Choice C:

0700, 1100, 1700, 2100: This schedule again reflects four doses instead of three, making it inconsistent with “t.i.d.” Additionally, while some times are before meals, the extra dosing increases risk of toxicity and is not aligned with the prescription.

Choice D:

0700, 1100, 1600: This schedule provides three doses (t.i.d.) administered approximately one hour before meals at 0800, 1200, and 1700. Giving ampicillin on an empty stomach enhances absorption by minimizing competition with food, ensuring optimal serum drug concentrations.

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Question 2:

A client is ordered 500 mg of Augmentin orally three times a day. The pharmacy sends the following to administer the morning dose:

How many ml should the nurse administer

Answer and Explanation

Correct Answer: "0.7" mL

Explanation

Ordered Dose: 35 mg
Available Concentration: 50 mg/mL

Calculate the volume to administer using the Dose/Have method

Volume (mL) = (Ordered Dose ÷ Dose on Hand) × Quantity

Volume = (35 ÷ 50) × 1

Volume = 0.7 × 1

= 0.7 mL

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Question 3:

The nurse is evaluating the integrity of the vastus lateralis site. The nurse finds the site by locating the:

A. Greater trochanter, anterior superior iliac spine, and iliac crest B. Greater trochanter, iliac crest, and posterior superior iliac spine C. Anterior aspect of the upper thigh D. Middle third of the lateral thigh

Answer and Explanation

Choice A:

Greater trochanter, anterior superior iliac spine, and iliac crest: These landmarks are used to identify the ventrogluteal injection site, which is a separate intramuscular site located over the gluteus medius muscle. They do not correspond to the anatomical boundaries of the vastus lateralis muscle.

Choice B:

Greater trochanter, iliac crest, and posterior superior iliac spine: These landmarks are associated with the dorsogluteal region. This site is less preferred due to proximity to the sciatic nerve and does not relate to the vastus lateralis location.

Choice C:

Anterior aspect of the upper thigh: The vastus lateralis is located laterally, not anteriorly. The anterior thigh overlies the rectus femoris muscle, and injections here increase the risk of nerve and vascular injury.

Choice D:

Middle third of the lateral thigh: The vastus lateralis muscle lies along the lateral aspect of the thigh, and the safest injection zone is the middle third between the greater trochanter and the knee. This area provides a large, well-vascularized muscle mass with minimal risk of major nerve or vessel

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Question 4:

The physician orders hydromorphone 0.6 mg intramuscularly every 3 hours PRN for pain. The pharmacy sends the following bottle (Read the label below). How many mL will be needed to administer hydromorphone 0.6 mg? Round to the nearest tenth and label your answer.

Answer and Explanation

Correct Answer: "0.3" mL

Explanation

Identify the ordered dose and available concentration

Ordered Dose: 0.6 mg
Available Concentration: 2 mg/mL

Calculate the volume to administer using the Dose/Have method

Volume (mL) = (Ordered Dose ÷ Dose on Hand) × Quantity

Volume = (0.6 ÷ 2) × 1

Volume = 0.3 × 1

= 0.3 mL

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Question 5:

A client is ordered Phenergan 37.5 mg intramuscularly at 0930 for nausea following a colonoscopy. Available is Phenergan 25 mg per mL. What will the nurse give the client with each dose? Round to the nearest tenth if necessary and label your answer.

Answer and Explanation

Correct Answer: "1.5" mL

Explanation

Calculation:

Identify the ordered dose and available concentration

Ordered Dose: 37.5 mg

Available Concentration: 25 mg/mL

Calculate the volume to administer

Volume (mL) = Ordered Dose ÷ Concentration

Volume = 37.5 ÷ 25

= 1.5 mL

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Question 6:

A patient weighs 314lbs. What is the weight in kg (kilograms)? Round to the nearest tenth and label your answer.

Answer and Explanation

Correct Answer: "142.7" kg

Explanation

Calculation:

Identify the weight in pounds

Weight = 314 lbs

Use the conversion factor: 1 kg = 2.2 lbs

Weight in kg = Weight in lbs ÷ 2.2

Weight in kg = 314 ÷ 2.2

Weight in kg ≈ 142.727

Round to the nearest tenth

= 142.7 kg

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Question 7:

A client is ordered Enoxaparin subcutaneous for DVT prophylaxis. The physician orders 1.4 mg/kg subcutaneously once daily to be administered. The client weighs 215 pounds. Round to the nearest tenth and label your answer.

Answer and Explanation

Correct Answer: "136.8" mg

Explanation

Calculation:

Convert weight from pounds to kilograms

Weight in kg = 215 ÷ 2.2

≈ 97.7 kg

Multiply the weight in kg by the ordered dose per kg

Dose (mg) = 97.7 × 1.4

≈ 136.78 mg

Round to the nearest tenth

= 136.8 mg

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Question 8:

A student nurse is administering medications with the clinical instructor. The assigned client was started on a new medication this morning. You, as the student nurse, do not know the mechanism of action. In this scenario, which is the best action by the student?

A. Stop, verify, and look-up the medication. B. Administer the medication and look it up later. C. Ask the patient about the medication. D. Tell the instructor you have do not have time to look up the medication.

Answer and Explanation

Choice A:

Stop, verify, and look-up the medication: The nurse must have a thorough understanding of a medication’s mechanism of action, indications, and potential side effects before administration. Stopping to verify and research ensures patient safety, prevents medication errors, and supports professional accountability. This is the safest and most responsible action in clinical practice.

Choice B:

Administer the medication and look it up later: Administering a medication without understanding its action or potential adverse effects risks patient harm, including allergic reactions, interactions, or contraindications. This approach violates safe nursing practice and professional standards.

Choice C:

Ask the patient about the medication: While the patient may know why they are taking the medication, they are not a reliable source for pharmacologic knowledge or contraindications. Relying on the patient does not ensure safe administration.

Choice D:

Tell the instructor you do not have time to look up the medication: Time constraints are not an acceptable reason to compromise patient safety. Proper nursing practice prioritizes patient safety over convenience or schedule pressures.

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Question 9:

A client is ordered 0.25 grams of amoxicillin orally three times a day. Available is amoxicillin suspension 125 mg in 5 mL. How many teaspoons will the nurse administer for each dose? Round to the nearest tenth, if necessary, and label your answer.

Answer and Explanation

Correct Answer: "2" tsp

Explanation

Calculation:

Convert the ordered dose to mg

Ordered Dose: 0.25 g × 1,000

= 250 mg

Identify the concentration of the available suspension

Available: 125 mg/5 mL

Calculate the volume in mL to administer

Volume (mL) = Ordered Dose ÷ Concentration × Quantity

Volume = 250 ÷ 125 × 5

Volume = 2 × 5

Volume = 10 mL

Convert mL to teaspoons

1 tsp = 5 mL

Volume in tsp = 10 ÷ 5

= 2 tsp

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Question 10:

A clinic nurse is preparing for a tuberculosis screening. Knowing the injections will be administered intradermally, what size needles and syringes will the nurse prepare?

A. 1 mL syringe marked in units, 1-inch 16-gauge needle B. 1 mL syringe, 3/8-inch 27-gauge needle C. 5 mL syringe, 2-inch 20-gauge needle D. 10 mL syringe, 3-inch 18-gauge needle

Answer and Explanation

Choice A:

1 mL syringe marked in units, 1-inch 16-gauge needle: A 16-gauge needle is too large and would deliver the solution too deeply, potentially into subcutaneous tissue, which is inappropriate for intradermal injections like a tuberculosis (TB) skin test.

Choice B:

1 mL syringe, 3/8-inch 27-gauge needle: Intradermal injections require a small volume delivered just under the skin. A 3/8-inch, 27-gauge needle allows precise placement into the dermis, minimizing tissue trauma and ensuring accurate formation of a wheal for TB testing. The 1 mL syringe provides accurate measurement of the small dose, typically 0.1 mL.

Choice C:

5 mL syringe, 2-inch 20-gauge needle: This combination is designed for intramuscular or large-volume injections. The needle is too long and wide for intradermal administration, risking deep tissue injection and inaccurate test results.

Choice D:

10 mL syringe, 3-inch 18-gauge needle: This syringe and needle size are intended for large-volume intravenous or deep tissue injections. Using it intradermally would be unsafe, painful, and compromise the accuracy of the TB skin test.

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Total Questions : 25

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NUAS 130 Medication proctored exam 3

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