The client is taking an 800 mg dose of a medication with a half-life of 4 hours. How much medication will be available in the body after 12 hours?
400 mg
50 mg
100 mg
✓
200 mg
Correct Answer
100 mg
The amount of the drug would halve every 4 hours. In 4 hours, 400 mg of the drug would be available. In 8 hours, 200 mg would be available, and in 12 hours, 100 mg of the drug would be available
Question 2
Which laboratory test should the nurse check prior to administering a drug that can cause harm to the kidneys?
Aspartate transaminase
Serum creatinine
✓
Hemoglobin
Alanine transaminase
Correct Answer
Serum creatinine
The serum creatinine level is an indicator of kidney function.
Question 3
The nurse is preparing to administer an intramuscular injection in the deltoid muscle. At which site will the nurse inject the medication?
Between the acromion process and the scapula
1 inch in front of the acromion process
1.5 inches below the acromion process
✓
At the level of the axilla
Correct Answer
1.5 inches below the acromion process
An intramuscular injection in the deltoid muscle is administered approximately 1.5 inches below the acromion process in the upside-down triangle formed by the acromion process and the axilla.
Question 4
The nurse is teaching a client about self-administering a fentanyl transdermal patch. Which statement indicates an understanding of client teaching?
"I will remove the old patch before applying a new one."
✓
"I will cleanse the application site with alcohol before applying."
"I will cut the patch in half when my pain is not severe."
"I will rotate the patch application site every 7 days."
Correct Answer
"I will remove the old patch before applying a new one."
The old patch should be removed before applying a new one to avoid a drug overdose.
Question 5
Which action will the nurse take when administering a subcutaneous enoxaparin injection?
Massage the site after injection.
Aspirate for blood return.
Administer the injection in the deltoid area.
Administer the injection at a 90-degree angle.
✓
Correct Answer
Administer the injection at a 90-degree angle.
The nurse should insert the needle at a 90-degree angle when administering enoxaparin.
Question 6
When administering an oral medication to a client with renal insufficiency, which potential complication is of greatest concern to the nurse?
Decreased drug absorption
Increased risk of drug toxicity
✓
Increased risk of an allergic reaction
Decreased therapeutic drug effects
Correct Answer
Increased risk of drug toxicity
Drugs are excreted through the kidneys, so drug toxicity can develop in the client with renal insufficiency as drug levels rise because they are not properly eliminated from the body.
Question 7
When administering digoxin, a drug with a narrow therapeutic index, the nurse should assess for which effect?
Increased toxicity
✓
Reduced first-pass effect
Reduced dependence
Increased tolerance
Correct Answer
Increased toxicity
A narrow therapeutic index indicates that it has a narrow safety margin, thus requiring frequent monitoring for drug toxicity.
Question 8
The health care provider has changed the order for a medication from an IV dose to an oral dose of the same medication. The oral medication has a high first-pass effect through the liver. What does the nurse expect to see when checking the order for the oral medication to achieve similar concentrations?
The oral medication dose will be higher than the IV dose.
✓
The oral medication dose will be lower than the IV dose.
The oral medication dose will be the same as the IV dose.
The oral medication dose has no relation to the IV dose.
Correct Answer
The oral medication dose will be higher than the IV dose.
Because a portion of an oral dose of a medication is inactivated by the first-pass effect in the liver, a drug that has been administered IV may now require a larger oral dose to achieve a therapeutic effect.
Question 9
A client has been prescribed an oral medication that is supplied as a large unscored caplet. The client refuses to take the medication with the statement, "I cannot swallow such a large pill." What is the nurse's best action?
Call the provider to request an IV form of the drug.
Convince the client to go ahead and take the medication.
Break the caplet in half so it is easier to swallow.
Call the pharmacy and request an oral solution of the drug.
✓
Correct Answer
Call the pharmacy and request an oral solution of the drug.
The best course of action is to request the pharmacy to send up a liquid form of the medicine because that does not change the route. A caplet that is not scored should not be split by the nurse.
Question 10
A client is complaining of severe pain and has an order for morphine sulfate. Which route would give the client the fastest pain relief?
Subcutaneous
PO
IM
IV
✓
Correct Answer
IV
IV is the fastest route because the medication is 100% bioavailable and has immediate onset.
Question 11
The provider has ordered dofetilide 0.5 mg orally every 12 hours. The pharmacy supplies dofetilide 125 mcg tablets. How many tablets will the nurse administer?
0.5 tablets
3 tablets
2 tablets
4 tablets
✓
Correct Answer
4 tablets
The nurse determines that 0.5 mg is equal to 500 mcg and sets up the following equation: . represents the desired dose (the dose ordered), the amount on hand or available, the quantity or volume of the drug form (tablet, capsule, liquid), and the amount calculated to be administered to the client. Therefore, .
Question 12
The provider has ordered meperidine 150 mg IM every 6 hours, as needed, for pain. The pharmacy supplies meperidine 100 mg/mL. How many mL should the nurse administer to the client?
3.5 mL
2 mL
1 mL
1.5 mL
✓
Correct Answer
1.5 mL
The nurse sets up the following equation: . represents the desired dose (the dose ordered), the amount on hand or available, the quantity or volume of the drug form (tablet, capsule, liquid), and the amount calculated to be administered to the client. Therefore, .
Question 13
The health care provider ordered heparin sodium 4000 units subcutaneously every 12 hours. The pharmacy supplies 5000 units/1 mL in a 10 mL vial. How many mL should the nurse administer to the client?
8 mL
0.8 mL
✓
2.5 mL
1.2 mL
Correct Answer
0.8 mL
The nurse sets up the following equation: . represents the desired dose (the dose ordered), the amount on hand or available, the quantity or volume of the drug form (tablet, capsule, liquid), and the amount calculated to be administered to the client. Therefore, .
Question 14
The health care provider ordered 10 mL of cough syrup for a client. How many teaspoons will the client take per dose?
7.5
2
✓
10
5
Correct Answer
2
When converting metric and household units, 4.93 mL (which rounds to 5 mL) is equal to 1 teaspoon; 2 teaspoons are equivalent to 10 mL.
Question 15
The health care provider ordered enoxaparin 1.5 mg/kg/day. The client weighs 176 lb. How many milligrams of enoxaparin should the client receive?
80 mg
120 mg
✓
150 mg
100 mg
Correct Answer
120 mg
First, convert the client's weight from pounds to kilograms ( therefore, the client weighs ). Next, calculate the amount of drug the client should receive: .
Question 16
The health care provider ordered 6 mg of dexamethasone sodium phosphate injection. The pharmacy provided a vial labeled 120 mg/30 mL. How many mL will be administered to the client? (Round to the nearest tenth.)
3.3 mL
2.3 mL
1.5 mL
✓
0.6 mL
Correct Answer
1.5 mL
The nurse sets up the following equation: . represents the desired dose (the dose ordered), the amount on hand or available, the quantity or volume of the drug form (tablet, capsule, liquid), and the amount calculated to be administered to the client. Therefore, .
Question 17
The provider ordered heparin sodium 1250 units/hour IV infusion. The pharmacy supplied heparin sodium 25,000 units in 500 mL of D5W. Calculate the infusion rate in mL/hour.
25 mL/hour
✓
20 mL/hour
12 mL/hour
6 mL/hour
Correct Answer
25 mL/hour
The nurse sets up the following equation: . represents the desired dose (the dose ordered), the amount on hand or available, the quantity or volume of the drug form (tablet, capsule, liquid), and the amount calculated to be administered to the client. Therefore, .
Question 18
The provider ordered fluoxetine hydrochloride 60 mg oral solution for a client who has difficulty swallowing. The pharmacy supplied fluoxetine hydrochloride oral solution 20 mg/5 mL in a 120 mL bottle. How many mL should the nurse administer?
30 mL
60 mL
15 mL
✓
20 mL
Correct Answer
15 mL
The nurse sets up the following equation: . represents the desired dose (the dose ordered), the amount on hand or available, the quantity or volume of the drug form (tablet, capsule, liquid), and the amount calculated to be administered to the client. Therefore, .
Question 19
The provider ordered moxifloxacin 400 mg IV piggyback daily. The pharmacy supplied moxifloxacin 400 mg in 250 mL normal saline. The instructions are to infuse over 60 minutes. At how many mL/hour will the infusion pump be set?
250 mL/hour
✓
400 mL/hour
100 mL/hour
200 mL/hour
Correct Answer
250 mL/hour
The nurse sets up the following equation: . represents the desired dose (the dose ordered), the amount on hand or available, the quantity or volume of the drug form (tablet, capsule, liquid), and the amount calculated to be administered to the client. Therefore, to be infused over 1 hour.
Question 20
The provider ordered dobutamine hydrochloride 5 mcg/kg/minute IV for a 132 lb client. The pharmacy supplied 250 mg in 250 mL of D5W. How many mL/hour should be infused?
12 mL/hour
23 mL/hour
18 mL/hour
✓
15 mL/hour
Correct Answer
18 mL/hour
First, convert the client's weight from pounds to kilograms ( ). Therefore, the client weighs 60 kg. Set the equation up in dimensional analysis: .