Pharmacology for Nurses: A Pathophysiologic Approach 5th edition Adams Test Bank

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  • Published: 2016
  • ISBN-13: 978-0134255163
  • ISBN-10: 013425516X

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pharmacology for nurses adams 5th edition test bank

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 5/E
Chapter 7

Question 1

Type: MCMA

The nursing instructor teaches the student nurses about how medication errors can occur. What information will the nursing instructor include in the presentation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The nurse miscalculates the medication dose.
  2. The nurse does not check the patient’s identification band.
  3. The nurse does not validate an order with the physician.
  4. The nurse misinterprets a physician’s order.
  5. The nurse administers the incorrect drug.

Correct Answer: 1,2,4,5

Rationale 1: Medication errors may be related to misinterpretations, miscalculations, and misadministration. The nurse should always check the patient’s identification band. As long as the nurse understands the physician’s order, there is no need to validate the order with the physician.

Rationale 2: Medication errors may be related to misinterpretations, miscalculations, and misadministration. The nurse should always check the patient’s identification band. As long as the nurse understands the physician’s order, there is no need to validate the order with the physician.

Rationale 3: Medication errors may be related to misinterpretations, miscalculations, and misadministration. The nurse should always check the patient’s identification band. As long as the nurse understands the physician’s order, there is no need to validate the order with the physician.

Rationale 4: Medication errors may be related to misinterpretations, miscalculations, and misadministration. The nurse should always check the patient’s identification band. As long as the nurse understands the physician’s order, there is no need to validate the order with the physician.

Rationale 5: Medication errors may be related to misinterpretations, miscalculations, and misadministration. The nurse should always check the patient’s identification band. As long as the nurse understands the physician’s order, there is no need to validate the order with the physician.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7-1

 

Question 2

Type: MCSA

The nurse recognizes that agency system checks are in place to decrease medication errors. Who commonly collaborates with the nurse on checking the accuracy of the medication prior to administration?

  1. The nursing supervisor
  2. The nursing unit manager
  3. The pharmacist
  4. The physician

Correct Answer: 3

Rationale 1: Pharmacists and nurses must collaborate on checking the accuracy and appropriateness of drug orders prior to patient administration. The physician does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration. The nursing unit manager does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration. The nursing supervisor does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration.

Rationale 2: Pharmacists and nurses must collaborate on checking the accuracy and appropriateness of drug orders prior to patient administration. The physician does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration. The nursing unit manager does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration. The nursing supervisor does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration.

Rationale 3: Pharmacists and nurses must collaborate on checking the accuracy and appropriateness of drug orders prior to patient administration. The physician does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration. The nursing unit manager does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration. The nursing supervisor does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration.

Rationale 4: Pharmacists and nurses must collaborate on checking the accuracy and appropriateness of drug orders prior to patient administration. The physician does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration. The nursing unit manager does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration. The nursing supervisor does not commonly collaborate with the nurse on checking the accuracy of the medication prior to administration.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-2

 

Question 3

Type: MCSA

The nurse makes a medication error and a patient dies. In court, the attorney for the family of the deceased patient asks the nurse if she followed standards of care in administering the medication. How would the attorney phrase this question?

  1. “Did you follow agency guidelines as in previous circumstances?”
  2. “Did you follow the physician’s orders and double-check them before administration?”
  3. “Did you do the three checks and follow the five rights as taught in school?”
  4. “Did you do what another nurse would have done under similar circumstances?”

Correct Answer: 4

Rationale 1: Standards of care refer to the actions that a reasonable and prudent nurse with equivalent preparation would do under similar circumstances. Standards of care do not refer to following physician orders. Standards of care do not refer to following agency guidelines. Standards of care do not refer to doing three checks or five rights.

Rationale 2: Standards of care refer to the actions that a reasonable and prudent nurse with equivalent preparation would do under similar circumstances. Standards of care do not refer to following physician orders. Standards of care do not refer to following agency guidelines. Standards of care do not refer to doing three checks or five rights.

Rationale 3: Standards of care refer to the actions that a reasonable and prudent nurse with equivalent preparation would do under similar circumstances. Standards of care do not refer to following physician orders. Standards of care do not refer to following agency guidelines. Standards of care do not refer to doing three checks or five rights.

Rationale 4: Standards of care refer to the actions that a reasonable and prudent nurse with equivalent preparation would do under similar circumstances. Standards of care do not refer to following physician orders. Standards of care do not refer to following agency guidelines. Standards of care do not refer to doing three checks or five rights.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-3

 

Question 4

Type: MCSA

The nurse manager plans to teach the graduate nurse the reason why the nursing unit has policies and procedures. What best describes the reason for policies and procedures?

  1. The policies and procedures establish standards of care for the institution.
  2. The policies and procedures indicate how nursing personnel are to perform skills.
  3. The policies and procedures establish how the health care facility is to be run.
  4. The policies and procedures indicate the steps that must be taken when a medication error occurs.

Correct Answer: 1

Rationale 1: The reason health care facilities have policies and procedures is to establish standards of care for the facility; the performance of skills is included under standards of care. Steps to be taken when a medication error occurs are included under standards of care. Health care facilities have policies and procedures in place to establish standards of care for the facility, not to establish how the facility is to be run.

Rationale 2: The reason health care facilities have policies and procedures is to establish standards of care for the facility; the performance of skills is included under standards of care. Steps to be taken when a medication error occurs are included under standards of care. Health care facilities have policies and procedures in place to establish standards of care for the facility, not to establish how the facility is to be run.

Rationale 3: The reason health care facilities have policies and procedures is to establish standards of care for the facility; the performance of skills is included under standards of care. Steps to be taken when a medication error occurs are included under standards of care. Health care facilities have policies and procedures in place to establish standards of care for the facility, not to establish how the facility is to be run.

Rationale 4: The reason health care facilities have policies and procedures is to establish standards of care for the facility; the performance of skills is included under standards of care. Steps to be taken when a medication error occurs are included under standards of care. Health care facilities have policies and procedures in place to establish standards of care for the facility, not to establish how the facility is to be run.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7-6

 

Question 5

Type: MCSA

The nurse in the emergency department administers an adult dose of an antibiotic to a 3-month-old baby. As a result, the baby suffers permanent brain damage. What best describes the effect of this error on the health care facility?

  1. The professional license of the nurse will be lost.
  2. The morale of the staff involved will be depleted.
  3. The reputation of the health care facility will suffer.
  4. The health care facility will pay a very large settlement.

Correct Answer: 2

Rationale 1: Medication errors that result in permanent damage increase self-doubt and destroy the morale of all staff involved; some may choose to leave the nursing profession. Payment of a large settlement is not the primary concern; staff morale is the concern. The professional license of the nurse may or may not be lost depending on the circumstances of the case. The reputation of the facility will probably suffer, but this is not as important as the staff morale.

Rationale 2: Medication errors that result in permanent damage increase self-doubt and destroy the morale of all staff involved; some may choose to leave the nursing profession. Payment of a large settlement is not the primary concern; staff morale is the concern. The professional license of the nurse may or may not be lost depending on the circumstances of the case. The reputation of the facility will probably suffer, but this is not as important as the staff morale.

Rationale 3: Medication errors that result in permanent damage increase self-doubt and destroy the morale of all staff involved; some may choose to leave the nursing profession. Payment of a large settlement is not the primary concern; staff morale is the concern. The professional license of the nurse may or may not be lost depending on the circumstances of the case. The reputation of the facility will probably suffer, but this is not as important as the staff morale.

Rationale 4: Medication errors that result in permanent damage increase self-doubt and destroy the morale of all staff involved; some may choose to leave the nursing profession. Payment of a large settlement is not the primary concern; staff morale is the concern. The professional license of the nurse may or may not be lost depending on the circumstances of the case. The reputation of the facility will probably suffer, but this is not as important as the staff morale.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 7-7

 

Question 6

Type: MCSA

The nurse administers an evening medication to the patient in the morning. The medication did go to the correct patient. What is the nurse’s best course of action at this time?

  1. Change the medication administration time to the morning.
  2. Notify the physician about the error and complete an incident report.
  3. Tell the evening nurse to hold the evening dose just for tonight.
  4. Notify the physician and ask if any further action needs to be taken.

Correct Answer: 2

Rationale 1: Even though the medication went to the correct patient, this is still considered a medication error. The time of the medication cannot be changed without an order from the physician. Telling the evening nurse to hold the evening dose is unethical; an error has been committed. There is no need to ask the physician if any further action needs to be taken; an incident report needs to be completed.

Rationale 2: Even though the medication went to the correct patient, this is still considered a medication error. The time of the medication cannot be changed without an order from the physician. Telling the evening nurse to hold the evening dose is unethical; an error has been committed. There is no need to ask the physician if any further action needs to be taken; an incident report needs to be completed.

Rationale 3: Even though the medication went to the correct patient, this is still considered a medication error. The time of the medication cannot be changed without an order from the physician. Telling the evening nurse to hold the evening dose is unethical; an error has been committed. There is no need to ask the physician if any further action needs to be taken; an incident report needs to be completed.

Rationale 4: Even though the medication went to the correct patient, this is still considered a medication error. The time of the medication cannot be changed without an order from the physician. Telling the evening nurse to hold the evening dose is unethical; an error has been committed. There is no need to ask the physician if any further action needs to be taken; an incident report needs to be completed.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-8

 

Question 7

Type: MCSA

The nurse is preparing medications for a group of patients. Another nurse begins telling the nurse about her recent engagement. What is the best action by the first nurse?

  1. Ask the second nurse to help with administering medications so they can have more time to talk.
  2. Continue to prepare the medications for administration and pretend to listen to the first nurse.
  3. Stop preparing medications until the first nurse has finished talking about her engagement.
  4. Tell the second nurse that the conversation is distracting and must cease while medications are being prepared.

Correct Answer: 4

Rationale 1: When preparing medications, the nurse must focus entirely on the task at hand and instruct others who are talking to stop. It is inappropriate to ask another nurse to assist with medications so there is more time for the nurses to talk. The nurse cannot stop preparing medications; the patients must receive them on time. Pretending to listen to the second nurse’s conversation will also be distracting.

Rationale 2: When preparing medications, the nurse must focus entirely on the task at hand and instruct others who are talking to stop. It is inappropriate to ask another nurse to assist with medications so there is more time for the nurses to talk. The nurse cannot stop preparing medications; the patients must receive them on time. Pretending to listen to the second nurse’s conversation will also be distracting.

Rationale 3: When preparing medications, the nurse must focus entirely on the task at hand and instruct others who are talking to stop. It is inappropriate to ask another nurse to assist with medications so there is more time for the nurses to talk. The nurse cannot stop preparing medications; the patients must receive them on time. Pretending to listen to the second nurse’s conversation will also be distracting.

Rationale 4: When preparing medications, the nurse must focus entirely on the task at hand and instruct others who are talking to stop. It is inappropriate to ask another nurse to assist with medications so there is more time for the nurses to talk. The nurse cannot stop preparing medications; the patients must receive them on time. Pretending to listen to the second nurse’s conversation will also be distracting.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-9

 

Question 8

Type: MCSA

The nurse was very busy and unfamiliar with a new medication, but administered it anyway. Later the nurse looked up the medication. How does the nurse manager evaluate this behavior?

  1. This was acceptable as long as the nurse looked up the action and side effects of the drug later.
  2. An error could have occurred because the nurse was unfamiliar with the medication.
  3. The nurse manager was partially at fault because the nursing unit was understaffed and the nurse was too busy.
  4. An error did occur because the nurse could have administered the medication via the incorrect route.

Correct Answer: 2

Rationale 1: Nurses should never administer a medication unless they are familiar with its uses and side effects; an error could have occurred because the nurse was unfamiliar with the medication. It is not acceptable for a nurse to administer an unfamiliar medication and then look up the action and side effects later; an error could occur. An error did not occur, but could have because the nurse was unfamiliar with the medication. There is no information in the stem of the question that the nursing unit was understaffed, so the nurse manager is not partially at fault.

Rationale 2: Nurses should never administer a medication unless they are familiar with its uses and side effects; an error could have occurred because the nurse was unfamiliar with the medication. It is not acceptable for a nurse to administer an unfamiliar medication and then look up the action and side effects later; an error could occur. An error did not occur, but could have because the nurse was unfamiliar with the medication. There is no information in the stem of the question that the nursing unit was understaffed, so the nurse manager is not partially at fault.

Rationale 3: Nurses should never administer a medication unless they are familiar with its uses and side effects; an error could have occurred because the nurse was unfamiliar with the medication. It is not acceptable for a nurse to administer an unfamiliar medication and then look up the action and side effects later; an error could occur. An error did not occur, but could have because the nurse was unfamiliar with the medication. There is no information in the stem of the question that the nursing unit was understaffed, so the nurse manager is not partially at fault.

Rationale 4: Nurses should never administer a medication unless they are familiar with its uses and side effects; an error could have occurred because the nurse was unfamiliar with the medication. It is not acceptable for a nurse to administer an unfamiliar medication and then look up the action and side effects later; an error could occur. An error did not occur, but could have because the nurse was unfamiliar with the medication. There is no information in the stem of the question that the nursing unit was understaffed, so the nurse manager is not partially at fault.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7-2

 

Question 9

Type: MCSA

The nurse commits a medication error. The nurse documents the error in the patient’s record and completes the incident report. What does the nurse recognize as the primary reason for doing this?

  1. To verify that the patient’s safety was protected
  2. To protect the patient from further harm
  3. To protect the health care facility from litigation
  4. To protect the nurse from liability

Correct Answer: 1

Rationale 1: Documentation in the patient’s medical record and completion of an incident report verify that the patient’s safety was protected. Documentation of an error does not necessarily protect the health care facility from litigation. The patient has already been harmed; the documentation will not protect the patient from future harm. Documentation of an error does not necessarily protect the nurse from liability.

Rationale 2: Documentation in the patient’s medical record and completion of an incident report verify that the patient’s safety was protected. Documentation of an error does not necessarily protect the health care facility from litigation. The patient has already been harmed; the documentation will not protect the patient from future harm. Documentation of an error does not necessarily protect the nurse from liability.

Rationale 3: Documentation in the patient’s medical record and completion of an incident report verify that the patient’s safety was protected. Documentation of an error does not necessarily protect the health care facility from litigation. The patient has already been harmed; the documentation will not protect the patient from future harm. Documentation of an error does not necessarily protect the nurse from liability.

Rationale 4: Documentation in the patient’s medical record and completion of an incident report verify that the patient’s safety was protected. Documentation of an error does not necessarily protect the health care facility from litigation. The patient has already been harmed; the documentation will not protect the patient from future harm. Documentation of an error does not necessarily protect the nurse from liability.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7-8

 

Question 10

Type: MCMA

The nurse is working very hard to prevent medication errors. What plan(s) will assist the nurse in preventing most errors?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Plan to always check the patient’s identification band prior to administration of medications.
  2. Plan to open all of the medications immediately prior to administration.
  3. Plan to tell physicians that verbal orders will not be accepted.
  4. Plan to record the medication on the medication administration record (MAR) immediately prior to administration.
  5. Plan to validate all orders with another nurse prior to administration of medications.

Correct Answer: 1,2,3

Rationale 1: Ways to reduce medication errors include checking the patient’s identification band prior to administration of medications, telling physicians that verbal orders will not be accepted, and opening all of the medications immediately prior to administration. Medications should be documented on the medication administration record (MAR) after they have been administered. All orders do not need to be validated with another nurse, only the orders that the nurse is unsure about.

Rationale 2: Ways to reduce medication errors include checking the patient’s identification band prior to administration of medications, telling physicians that verbal orders will not be accepted, and opening all of the medications immediately prior to administration. Medications should be documented on the medication administration record (MAR) after they have been administered. All orders do not need to be validated with another nurse, only the orders that the nurse is unsure about.

Rationale 3: Ways to reduce medication errors include checking the patient’s identification band prior to administration of medications, telling physicians that verbal orders will not be accepted, and opening all of the medications immediately prior to administration. Medications should be documented on the medication administration record (MAR) after they have been administered. All orders do not need to be validated with another nurse, only the orders that the nurse is unsure about.

Rationale 4: Ways to reduce medication errors include checking the patient’s identification band prior to administration of medications, telling physicians that verbal orders will not be accepted, and opening all of the medications immediately prior to administration. Medications should be documented on the medication administration record (MAR) after they have been administered. All orders do not need to be validated with another nurse, only the orders that the nurse is unsure about.

Rationale 5: Ways to reduce medication errors include checking the patient’s identification band prior to administration of medications, telling physicians that verbal orders will not be accepted, and opening all of the medications immediately prior to administration. Medications should be documented on the medication administration record (MAR) after they have been administered. All orders do not need to be validated with another nurse, only the orders that the nurse is unsure about.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7-9

 

Question 11

Type: MCSA

The nurse teaches a class to patients about how to help prevent medication errors when in the hospital. What is a priority question for the nurse to ask the patients?

  1. “Do you know the names of all the medications you take?”
  2. “Do you trust your physician to order the correct medication?”
  3. “Do you have a friend to verify that you are receiving the correct medication?”
  4. “Do you know what your illness is, and if you will need surgery?”

Correct Answer: 1

Rationale 1: Knowing the names of all medications taken can reduce drug errors when a patient is admitted to the hospital. Knowing the illness and anticipating surgery do not necessarily help prevent medication errors. Asking the patients if they trust their physicians to order the correct medication is inappropriate. It is inappropriate for friends of patients to verify medications prior to administration.

Rationale 2: Knowing the names of all medications taken can reduce drug errors when a patient is admitted to the hospital. Knowing the illness and anticipating surgery do not necessarily help prevent medication errors. Asking the patients if they trust their physicians to order the correct medication is inappropriate. It is inappropriate for friends of patients to verify medications prior to administration.

Rationale 3: Knowing the names of all medications taken can reduce drug errors when a patient is admitted to the hospital. Knowing the illness and anticipating surgery do not necessarily help prevent medication errors. Asking the patients if they trust their physicians to order the correct medication is inappropriate. It is inappropriate for friends of patients to verify medications prior to administration.

Rationale 4: Knowing the names of all medications taken can reduce drug errors when a patient is admitted to the hospital. Knowing the illness and anticipating surgery do not necessarily help prevent medication errors. Asking the patients if they trust their physicians to order the correct medication is inappropriate. It is inappropriate for friends of patients to verify medications prior to administration.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 7-10

 

Question 12

Type: MCSA

The nurse assesses an adverse effect of a medication that has been administered. No medication error was committed. What is the best plan of the nurse at this time?

  1. Report the adverse effect to the Food and Drug Administration’s (FDA) MedWatch Website.
  2. Report the adverse effect to the Food and Drug Administration’s (FDA) Adverse Event Website.
  3. Report the adverse effect to the Food and Drug Administration’s (FDA) Safe Medicine Website.
  4. Report the adverse effect to the Food and Drug Administration’s (FDA) Med MARX Website.

Correct Answer: 1

Rationale 1: Adverse events with medication should be reported to the FDA’s Med Watch Website. There isn’t any Food and Drug Administration’s (FDA) Safe Medicine Website. There isn’t any Food and Drug Administration’s (FDA) Med MARX Website. There isn’t any Food and Drug Administration’s (FDA) Adverse Event Website.

Rationale 2: Adverse events with medication should be reported to the FDA’s Med Watch Website. There isn’t any Food and Drug Administration’s (FDA) Safe Medicine Website. There isn’t any Food and Drug Administration’s (FDA) Med MARX Website. There isn’t any Food and Drug Administration’s (FDA) Adverse Event Website.

Rationale 3: Adverse events with medication should be reported to the FDA’s Med Watch Website. There isn’t any Food and Drug Administration’s (FDA) Safe Medicine Website. There isn’t any Food and Drug Administration’s (FDA) Med MARX Website. There isn’t any Food and Drug Administration’s (FDA) Adverse Event Website.

Rationale 4: Adverse events with medication should be reported to the FDA’s Med Watch Website. There isn’t any Food and Drug Administration’s (FDA) Safe Medicine Website. There isn’t any Food and Drug Administration’s (FDA) Med MARX Website. There isn’t any Food and Drug Administration’s (FDA) Adverse Event Website.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-11

 

Question 13

Type: MCSA

The nurse is on a committee to reduce medication errors in a large health care facility. What is a recommendation the nurse proposes that will most likely help to reduce medication errors?

  1. Train medication technicians to administer medications.
  2. Use robots to prepare all medications for administration by the nurse.
  3. Use automated, computerized cabinets on all nursing units.
  4. Designate nurses whose only function is to administer medication.

Correct Answer: 3

Rationale 1: To help reduce medication errors, many health care agencies are using automated, computerized, locked cabinets for medication storage on patient-care units. Health care agencies are not planning to designate nurses who just do medication administration. Health care agencies are not planning to have medication technicians administer medications. Health care agencies are not planning to have robots prepare all medications for administration by the nurse.

Rationale 2: To help reduce medication errors, many health care agencies are using automated, computerized, locked cabinets for medication storage on patient-care units. Health care agencies are not planning to designate nurses who just do medication administration. Health care agencies are not planning to have medication technicians administer medications. Health care agencies are not planning to have robots prepare all medications for administration by the nurse.

Rationale 3: To help reduce medication errors, many health care agencies are using automated, computerized, locked cabinets for medication storage on patient-care units. Health care agencies are not planning to designate nurses who just do medication administration. Health care agencies are not planning to have medication technicians administer medications. Health care agencies are not planning to have robots prepare all medications for administration by the nurse.

Rationale 4: To help reduce medication errors, many health care agencies are using automated, computerized, locked cabinets for medication storage on patient-care units. Health care agencies are not planning to designate nurses who just do medication administration. Health care agencies are not planning to have medication technicians administer medications. Health care agencies are not planning to have robots prepare all medications for administration by the nurse.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-12

 

Question 14

Type: MCSA

Which of the following is an example of a medication error?

  1. The wrong dose of a medication is drawn up, but is caught and corrected prior to administration.
  2. A medication is administered to a patient with no allergies, yet an anaphylactic response occurs.
  3. A medication is administered in liquid form instead of tablet form due to the patient’s difficulty swallowing.
  4. A patient experiences unexpected hypotension as a result of medication administration.

Correct Answer: 1

Rationale 1: A medication error can occur even when it does not reach the patient. Unexpected reactions to medications are not preventable, and would be considered adverse effects, not medication errors. Altering the form from a tablet to a liquid does not constitute a medication error.

Rationale 2: A medication error can occur even when it does not reach the patient. Unexpected reactions to medications are not preventable, and would be considered adverse effects, not medication errors. Altering the form from a tablet to a liquid does not constitute a medication error.

Rationale 3: A medication error can occur even when it does not reach the patient. Unexpected reactions to medications are not preventable, and would be considered adverse effects, not medication errors. Altering the form from a tablet to a liquid does not constitute a medication error.

Rationale 4: A medication error can occur even when it does not reach the patient. Unexpected reactions to medications are not preventable, and would be considered adverse effects, not medication errors. Altering the form from a tablet to a liquid does not constitute a medication error.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7-1

 

Question 15

Type: MCSA

Which of the following statements correctly identifies factors that contribute to medication errors?

  1. A nurse who observes the five rights will prevent all medication errors from occurring.
  2. Nurses are always liable when a medication error occurs.
  3. Handwritten orders are more frequently associated with medication errors than are typed orders.
  4. An incorrect dose (based on weight) is ordered, dispensed, and administered to a patient. The administering nurse and ordering clinician would be the only parties held accountable.

Correct Answer: 3

Rationale 1: Handwritten orders can be illegible, leading to higher medication error rates. Although the nurse is a major player in medication safety, there are instances when medication errors occur that do not involve the nurse, such as when patients take medications at home. Observing the five rights is essential to avoiding medication errors, but will not prevent all medication errors from occurring. The clinician ordering the medication, the nurse administering the medication, and the pharmacist dispensing the medication would be held accountable.

Rationale 2: Handwritten orders can be illegible, leading to higher medication error rates. Although the nurse is a major player in medication safety, there are instances when medication errors occur that do not involve the nurse, such as when patients take medications at home. Observing the five rights is essential to avoiding medication errors, but will not prevent all medication errors from occurring. The clinician ordering the medication, the nurse administering the medication, and the pharmacist dispensing the medication would be held accountable.

Rationale 3: Handwritten orders can be illegible, leading to higher medication error rates. Although the nurse is a major player in medication safety, there are instances when medication errors occur that do not involve the nurse, such as when patients take medications at home. Observing the five rights is essential to avoiding medication errors, but will not prevent all medication errors from occurring. The clinician ordering the medication, the nurse administering the medication, and the pharmacist dispensing the medication would be held accountable.

Rationale 4: Handwritten orders can be illegible, leading to higher medication error rates. Although the nurse is a major player in medication safety, there are instances when medication errors occur that do not involve the nurse, such as when patients take medications at home. Observing the five rights is essential to avoiding medication errors, but will not prevent all medication errors from occurring. The clinician ordering the medication, the nurse administering the medication, and the pharmacist dispensing the medication would be held accountable.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7-2

 

Question 16

Type: MCSA

Which of the following best represents adherence to a standard of care?

  1. Administering a medication within the time frame specified by hospital policy
  2. Administering a medication intramuscularly when a patient refuses to take it orally
  3. Using abbreviations while charting to save time
  4. Discontinuing a medication at the request of a patient

Correct Answer: 1

Rationale 1: Administering medications as specified by agency policy is meeting the standard of care. Discontinuing medications is outside the scope of nursing. Changing the route of medication administration requires an order, and would not be appropriate, since the patient is refusing it. Using abbreviations might save time, but is not generally considered meeting a standard of care.

Rationale 2: Administering medications as specified by agency policy is meeting the standard of care. Discontinuing medications is outside the scope of nursing. Changing the route of medication administration requires an order, and would not be appropriate, since the patient is refusing it. Using abbreviations might save time, but is not generally considered meeting a standard of care.

Rationale 3: Administering medications as specified by agency policy is meeting the standard of care. Discontinuing medications is outside the scope of nursing. Changing the route of medication administration requires an order, and would not be appropriate, since the patient is refusing it. Using abbreviations might save time, but is not generally considered meeting a standard of care.

Rationale 4: Administering medications as specified by agency policy is meeting the standard of care. Discontinuing medications is outside the scope of nursing. Changing the route of medication administration requires an order, and would not be appropriate, since the patient is refusing it. Using abbreviations might save time, but is not generally considered meeting a standard of care.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7-6

 

Question 17

Type: MCSA

Which of the following statements regarding medication error rates is ethically accurate?

  1. Error rates are acceptable when well below the national average.
  2. Error rates are acceptable when associated costs exceed the costs necessary for preventative actions.
  3. Error rates are never acceptable.
  4. Error rates are only acceptable when associated costs are less than 5% of the facility’s yearly profit.

Correct Answer: 3

Rationale 1: The incidence of medication errors is never acceptable.

Rationale 2: The incidence of medication errors is never acceptable.

Rationale 3: The incidence of medication errors is never acceptable.

Rationale 4: The incidence of medication errors is never acceptable.

Global Rationale:

 

Cognitive Level: Remembering

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7-7

 

Question 18

Type: MCSA

Which of the following demonstrates ethical reporting of a medication error?

  1. The nurse does not report the error, because the error was caught and corrected prior to drug administration.
  2. The nurse does not report or document the error, since the error did not result in any harm to the patient.
  3. The nurse reports the error to the physician and the charge nurse but does not document the error due to possible legal action.
  4. The nurse informs the patient, documents the error as per hospital policy, and notifies the physician.

Correct Answer: 4

Rationale 1: The nurse should report and document all medication errors whether the patient was harmed or not. It is essential to report and document medication errors to identify possible system failures, even when the error is caught prior to administration or has potential for legal action.

Rationale 2: The nurse should report and document all medication errors whether the patient was harmed or not. It is essential to report and document medication errors to identify possible system failures, even when the error is caught prior to administration or has potential for legal action.

Rationale 3: The nurse should report and document all medication errors whether the patient was harmed or not. It is essential to report and document medication errors to identify possible system failures, even when the error is caught prior to administration or has potential for legal action.

Rationale 4: The nurse should report and document all medication errors whether the patient was harmed or not. It is essential to report and document medication errors to identify possible system failures, even when the error is caught prior to administration or has potential for legal action.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7-8

 

Question 19

Type: MCSA

Nurses should implement strategies to prevent medication errors. Which strategies would be the most beneficial for reducing common errors?

  1. Strategies to prevent wrong dosage errors
  2. Strategies to prevent wrong route errors
  3. Strategies to prevent wrong medication errors
  4. Strategies to prevent wrong patient errors

Correct Answer: 1

Rationale 1: The most common reported medication errors involve errors related to the wrong dose.

Rationale 2: The most common reported medication errors involve errors related to the wrong dose.

Rationale 3: The most common reported medication errors involve errors related to the wrong dose.

Rationale 4: The most common reported medication errors involve errors related to the wrong dose.

Global Rationale:

 

Cognitive Level: Remembering

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-9

 

Question 20

Type: MCSA

Patients who are discharged from the hospital on new medications should

  1. be advised that their local pharmacy will provide them with the drug information and instructions they need.
  2. be provided with oral and written drug information and instructions.
  3. be provided oral drug information and instructions as opposed to written.
  4. be provided with written drug information and instructions only.

Correct Answer: 2

Rationale 1: Patients should be provided with oral and written drug information and instructions prior to discharge. Patients may receive these oral and written materials from their pharmacy, but should be supplied initially by the hospital.

Rationale 2: Patients should be provided with oral and written drug information and instructions prior to discharge. Patients may receive these oral and written materials from their pharmacy, but should be supplied initially by the hospital.

Rationale 3: Patients should be provided with oral and written drug information and instructions prior to discharge. Patients may receive these oral and written materials from their pharmacy, but should be supplied initially by the hospital.

Rationale 4: Patients should be provided with oral and written drug information and instructions prior to discharge. Patients may receive these oral and written materials from their pharmacy, but should be supplied initially by the hospital.

Global Rationale:

 

Cognitive Level: Remembering

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-10

 

Question 21

Type: MCSA

Which statement is accurate regarding the Institute for Safe Medication Practices (ISMP)?

  1. It publishes a consumer newsletter regarding medication errors.
  2. It is a governmental agency.
  3. It accepts reports from anyone for a nominal fee.
  4. It only accepts reports from health care professionals.

Correct Answer: 1

Rationale 1: The ISMP is a non-profit organization that accepts reports from consumer and health care providers. It also publishes a newsletter titled Safe Medicine

Rationale 2: The ISMP is a non-profit organization that accepts reports from consumer and health care providers. It also publishes a newsletter titled Safe Medicine.

Rationale 3: The ISMP is a non-profit organization that accepts reports from consumer and health care providers. It also publishes a newsletter titled Safe Medicine.

Rationale 4: The ISMP is a non-profit organization that accepts reports from consumer and health care providers. It also publishes a newsletter titled Safe Medicine.

Global Rationale:

 

Cognitive Level: Remembering

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 7-12

 

Question 22

Type: MCMA

The nurse makes a medication error, but the patient is not harmed. The patient’s family asks the nurse manager what is considered a medication error. Which of the following are potential responses by the nurse manager?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Failure to follow health care provider’s orders
  2. Failure to give the right medication
  3. Failure to give a medication at the ordered time
  4. Failure to call the pharmacy and report that the medication has been given
  5. Failure to give the right dose of the medication

Correct Answer: 1,2,3,5

Rationale 1: In this medication error, the patient does not receive the drug as the health care provider intended it to be given.

Rationale 2: In this medication error, the patient does not receive the drug the health care provider intended to be given.

Rationale 3: In this medication error, the patient does not receive the drug at the time the health care provider intended it to be given.

Rationale 4: The delivery of the medication is recorded on the medical administration record (MAR); the nurse does not report to the pharmacy each time a medication has been given.

Rationale 5: In this medication error, the patient does not receive the dose of the drug the health care provider intended to be given.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-3

 

Question 23

Type: MCMA

A nurse on the medical-surgical unit is caring for several very ill patients. One patient says, “I was supposed to get my medications an hour ago.” The nurse recognizes that medication errors can have what repercussions?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Medication errors can potentially extend the patient’s length of hospital stay.
  2. Medication errors can result in expensive legal costs to the facility.
  3. Medication errors can damage the facility’s reputation.
  4. Medication errors can be physically devastating to nurse and patient.
  5. Medication errors cause preventable deaths during hospitalizations.

Correct Answer: 1,2,3,5

Rationale 1: Medication errors can cause harm, which can extend the patient’s length of stay.

Rationale 2: If a medication error causes a patient harm, it can result in expensive legal fees for hospital defense.

Rationale 3: If the incidence of medication errors is publicized, it can cause the facility to be seen as unsafe or to be delivering substandard care.

Rationale 4: Medication errors can be physically devastating to patients but would be emotionally devastating to the nurse.

Rationale 5: Medication errors are the most common cause of morbidity and preventable death within hospitals.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-2

 

Question 24

Type: MCMA

A new nurse on the orthopedic floor makes a medication error. Which statements by the nurse manager foster a safe environment in which nurses will report medication errors?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Many of us have made a medication error in our careers. The most important issue is to identify why the error occurred.”
  2. “I know you could not feel any worse than you already do. We need to discuss how this error happened and how we can prevent it from happening again.”
  3. “It’s really good that your patient is OK and did not suffer any harmful effects of this error. We should discuss why this error occurred and how it can be prevented in the future.”
  4. “Because you are a new nurse, we should sit down and discuss the procedure you followed to see what you could have done to prevent this error.”
  5. “We need to sit down as soon as possible and write up an incident report describing everything you did incorrectly that caused this error.”

Correct Answer: 1,2,3,4

Rationale 1: All errors should be investigated with the goal of identifying why they occurred. This investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear of punishment.

Rationale 2: All errors should be investigated with the goal of identifying why they occurred. This investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear of punishment.

Rationale 3: All errors should be investigated with the goal of identifying why they occurred. This investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear of punishment.

Rationale 4: All errors should be investigated with the goal of identifying why they occurred. This investigation should be done in a manner that is not punitive and will encourage staff to report errors without fear of punishment.

Rationale 5: An incident report will need to be written, but the nurse who made the error should feel the report will identify factors contributing to the error rather than place blame.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-3

 

Question 25

Type: MCMA

A community health nurse is preparing a teaching plan regarding medications and safety for a new parent class. Which topics should be addressed?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Parents should maintain a list of current medications for each child.
  2. Parents should be aware of each child’s medication allergies.
  3. Parents should know what the child’s prescribed medication is for, how it should be administered, and when to expect the child to feel better.
  4. Parents should be aware that any leftover medication should be appropriately disposed of, not saved for future use.
  5. Parents should read the drug label for any foods the child should avoid while taking the medication and for possible adverse effects to watch out for.

Correct Answer: 1,2,3,4

Rationale 1: Parents should make a complete list of all prescribed medications, over-the-counter drugs, and any vitamins the child takes.

Rationale 2: It is very important that parents be aware of a child’s allergies in order to prevent an unnecessary allergic response.

Rationale 3: Parents should know what condition the child’s medication is prescribed for, and how, when, and how much to administer. It is also important for parents to know when to expect the child to feel better so a follow-up visit can be made if the child is not feeling better.

Rationale 4: Parents should be aware that it is not safe to self-diagnose and treat with leftover medication.

Rationale 5: Parents should be aware the label often describes food and drinks to avoid. The label will not describe possible adverse effects; the nurse will need to describe these to the parents.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7-8

 

Question 26

Type: MCMA

The nurse is preparing a teaching plan for an older patient who is taking multiple medications. Which principles should the nurse keep in mind during the planning phase?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The patient should use only one pharmacy to fill prescriptions.
  2. The patient should keep a list of all medications for easy accessibility.
  3. Polypharmacy is a common cause of medication errors in older patients.
  4. Polypharmacy is unique to older patients and is the most common cause of medication errors.
  5. The patient should be aware of each prescribed medication, the dose, and possible side effects.

Correct Answer: 1,2,3,5

Rationale 1: It is common for older patients to have medical conditions requiring the use of multiple medications that could have possible interactions. Using one pharmacy will ensure the pharmacist will discover any problematic interactions between multiple drugs.

Rationale 2: Keeping a list available is important for unexpected trips to a health care facility.

Rationale 3: The use of multiple drugs for multiple chronic conditions is a common cause for medications errors in older patients.

Rationale 4: Polypharmacy is not unique to older patients, although it is most often seen in this group.

Rationale 5: Knowing the names, dose, and possible side effects of medications will reduce the risk for medication errors.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7-8

 

Question 27

Type: MCMA

The nurse has made a medication error. The nurse manager determines the error was based on a common misinterpretation of which abbreviation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. IU
  2. SQ
  3. Q.O.D.
  4. U
  5. mcg

Correct Answer: 1,2,3,4

Rationale 1: This is the abbreviation for international unit but can be mistaken for IV or 10. The prescriber should write out “international unit.”

Rationale 2: This is the abbreviation for subcutaneous but can be mistaken for 5q or 5 every. The prescriber should write out “subcutaneous.”

Rationale 3: This is the abbreviation for every other day but can be mistaken for every day or four times a day. The prescriber should write out “every other day.”

Rationale 4: This is the abbreviation for unit but can be mistaken for 4. The prescriber should write out “unit.”

Rationale 5: This abbreviation for microgram is not commonly misinterpreted.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7-6

pharmacology for nurses adams 5th edition test bank