QUESTION 10 The nurse is prioritizing what step to take first when beginning to
ID: 243115 • Letter: Q
Question
QUESTION 10
The nurse is prioritizing what step to take first when beginning to care for a client.
Which step should occur first?
Prepare the morning medications.
Introduce oneself and confirm the patient's identity.
Assess the patient and document the findings.
Check the patient's chart and last set of vital signs.
11.When entering the client's room for assessment purposes, which of these actions
would be questionable?
Asking the client to share his or her date of birth and name
Handwashing
The nurse sharing his or her date of birth with the patient
Knocking on the door
12.Which of these assessments is not considered essential prior to giving medications
to an acutely ill client?
Level of consciousness
b.Pain rating
Vital signs and oxygen saturation
Mood
13.When the nurse checks the MAR, pulls out the needed medication, inserts them in
a common cup, signs the medication off, then gives them to the patient after
checking name, date of birth and allergies what is that nurse doing?
a. Adhering to accepted guidelines for medication administration
b.Falsifying the record by signing off the medication before it was actually given
c. Completing the three required checks
Being over-cautious about medication administration
14. If a medication is ordered by its trade name but the pharmacy sends up a
medication that has a different, unfamiliar name, what should the nurse do?
Look up the generic name of the ordered drug to confirm that they are the same
medication.
b. Use the patient's supply of medication from home.
Use the patient's supply of medication from home.
Have a peer confirm that they are the same medication.
15. Which of these practices is most apt to contribute to time-related medication errors?
Allowing the nurse to give medications within one half-hour either before or
after a medication is scheduled
Giving hour of sleep (HS) medications at whatever time the patient wants to go
to sleep
Documenting in military time
Avoiding the use of abbreviations
16. Which of the statements made by the trained medication assistant reveals the need
for further teaching? (Select all that apply.)
Suspensions should never be shaken before they are measured."
"When a patient has difficulty swallowing, even long-acting medications should
be crushed."
"It is OK to crush medications in advance when batch prepping them at the
station."
"Disgarded medications should go into the sharps container."
17. Which of these statements regarding controlled substances made by the nurse
intern indicates the need for further teaching? (Select all that apply.)
"Controlled substances should be counted by the oncoming and offgoing nurse
each shift."
"The cart keys should be hidden in the MAR when the nurse goes to lunch."
"Controlled substances of deceased people should be flushed in the presence
of a witness."
"Patients should be asked to rate their pain on a scale of 1-10 prior to and after
giving analgesics."
18. Which of these statements made by the student nurse indicates the need for
further teaching? (Select all that apply.)
"Two patient identifiers should be used in both acute and long-term care
settings."
"Reasons for refusal do not need to be documented on the MAR. Refusal is
a basic right."
"Medications may be documented before giving them because they can be
circled if they are refused."
Pills can be hidden in food without physician and guardian consent
whenever necessary."
19.Which statements made by the nurse indicate the need for further
teaching? (Select all that apply.)
"Herbal remedies do not need to go through FDA efficacy trials before
being marketed."
"Class D medications can be safely taken when pregnant."
"Class X medications refer to illicit medications like cocaine."
"Class C medications are controlled substance medications."
20. The nurse is preparing to administer an oral medication and wants to ensure a rapid drug action. Which form of the medication will the nurse administer?
a. Enteric Coated pill
Tablet
Liquid Suspension
Capsule
a.Prepare the morning medications.
b.Introduce oneself and confirm the patient's identity.
c.Assess the patient and document the findings.
d.Check the patient's chart and last set of vital signs.
Explanation / Answer
Q10- answer
Introduce oneself and confirm patient identification
This is one of the IPSG goal.
Before starting care we should do this.
Q11 answer- The nurse sharing his or her date of birth with the patient is questionable because it is not the part of care in anyway.
This is against the nursing care.
Q12 answer - mood assessment is not essential before giving medication to actually ill client.
Q13 answer - nurse follow the guidelines of medications administration
Q14 answer- Look up the generic name of the ordered drug to confirm that they are the same
medication
Because trade name is changeable but the generic name will not change.
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