N1110 Test Blueprint Exam #3 Medication Administration



Medication Administration Test Questions/Blueprint

|Question |Course Objective |Step in the Nursing|Cognitive Level |Difficulty |Item |Response |

| | |Process |(Blooms) |Level |Discrim. | |

|If a client makes a comment implying that a particular medication seems unusual in any way, the | |Assess |Understand |1.000 |0.0 | |

|nurse’s responsibility is to | |implement |apply | | | |

|convince the patient to take it because the nurse was careful to obtain the correct medication. | | | | | | |

|hold the medication until the nurse has double checked the order, the medication, the patient, and | | | | | | |

|is positive all are correct. | | | | | | |

|have another nurse give the medication to reassure the patient that the medication is correct. | | | | | | |

|skip this dose and assess the patient for confusion. | | | | | | |

|The nurse is to give a patient medication for pain. The order reads, “Morphine Sulfate 20 mg. | |assess |Understand |0.987 |0.1 | |

|intravenously (IV) q 2 hr prn pain.” The drug book states the normal dose is 2-10 mg. The nurse | | |Apply | | | |

|should | | |analyze | | | |

|administer the ordered amount of the drug. | | | | | | |

|administer the usual dose of the drug. | | | | | | |

|contact the physician concerning the written order. | | | | | | |

|check with the head nurse to see if it is safe to give the ordered amount. | | | | | | |

|Your patient on Atenolol, a medication given for high blood pressure causes fatigue and impotence. | |assess |Remember |0.987 |0.1 | |

|This is a predictable but unavoidable response to this drug. This is defined as: | | | | | | |

|therapeutic effect | | | | | | |

|A cumulative effect | | | | | | |

|A side effect | | | | | | |

|An allergic reaction. | | | | | | |

|When a nurse provides a medication to a client, who has the ultimate responsibility for the | |assess |Understand |0.883 |0.1 | |

|medication that is being administered? | | |apply | | | |

|The nurse administering the medication | | | | | | |

|The client taking the medication | | | | | | |

|The pharmacist dispensing the medication | | | | | | |

|The physician prescribing the medication | | | | | | |

|Disease or impairment of which body organ places your patient at the highest risk for developing | |assess |Understand |0.844 |0.3 | |

|toxic effects of medications given related to excretion: | | |apply | | | |

|large intestines | | | | | | |

|lungs | | | | | | |

|liver | | | | | | |

|kidneys | | | | | | |

|Before administering Furosemide (Lasix), a loop diuretic, it is essential that the nurse will | |assess |Understand |0.831 |0.2 | |

|assess the following before administering as ordered: | | |Apply | | | |

|heart rate | | |Analyze | | | |

|blood pressure | | |Evaluate | | | |

|last serum potassium level | | | | | | |

|both B & C | | | | | | |

|The patient is ordered a medication to be given by the sublingual route. The nurse will | |implement |Understand |1.000 |0.0 | |

|place the medication between the cheek and gums.. | | |apply | | | |

|instruct the patient to place the medication under his tongue. | | | | | | |

|tell the patient to take a full glass of water after swallowing the medication. | | | | | | |

|straighten the ear canal before giving the medication. | | | | | | |

|Which of the following statements best describes how the physiologic changes of aging influence the| |assess |Understand |0.766 |0.1 | |

|administration of medications to elderly persons? | | |apply | | | |

|There is an increase in renal blood flow, resulting in rapid uptake of medication by the kidney. | | | | | | |

|There is less complete and slower absorption from the gastrointestinal tract, because of decreased | | | | | | |

|gastric motility and blood flow to the G.I. tract. | | | | | | |

|There is an increased proportion of lean body mass, which increases the potential for toxicity of | | | | | | |

|fat-soluble drugs. | | | | | | |

|There is faster biotransformation of drugs in the liver, and therefore higher potency of | | | | | | |

|medication. | | | | | | |

|The client is in the bathroom. When the nurse enters the room to give her medications, the client | |assess |Understand |0.844 |0.2 | |

|asks her to leave the pills on the bedside table. What should the nurse do? | |implement |apply | | | |

|Leave the medication on the bedside table. | | | | | | |

|Wait in the room until the client comes out of the bathroom. | | | | | | |

|Go into the bathroom and give the client her pills. | | | | | | |

|Tell the client she will return shortly to administer the medications. | | | | | | |

|The nurse is preparing to administer 8 mg of a 10 mg dose of an intravenous narcotic. Which of the| | | |0.987 |0.1 | |

|following statements made by the nurse best reflects an understanding of the appropriate manner to | | | | | | |

|handle this situation? | | | | | | |

|“I will sign out the narcotic before the end-of-shift count is completed.” | | | | | | |

|“I need to get another RN to witness the waste and sign the narcotic sheet.” | |implement |Understand | | | |

|“Narcotics are expensive, so it makes sense to save the unused portion for the next time they need | | |apply | | | |

|the drug.” | | | | | | |

|“I always make sure someone sees me place the unused portion on the narcotic in the sharps | | | | | | |

|container.” | | | | | | |

|A client is prescribed an ophthalmic medication. Which of the following actions should the nurse | |Implement |Understand |0.922 |0.0 | |

|perform? | | |apply | | | |

|Instruct the client to look down while administering the medication. | | | | | | |

|Instruct the client to look toward their nose while administering the medication. | | | | | | |

|See if the client can administer their own medication. | | | | | | |

|Instill the medication in the lower conjunctival sac | | | | | | |

|Research shows that the primary reason nurses make medication errors is related to: | |implement |Understand |0.896 |0.1 | |

|The complexity of making accurate drug calculations. | | |apply | | | |

|Events that distract the nurse during the administration process. | | | | | | |

|The presence of multiple drugs with similar generic and trade names. | | | | | | |

|Heavy client assignments that require massive medication administrations. | | | | | | |

|The nurse discovers that she has made a medication error. Which of the following should be her | |implement |Understand |0.974 |-0.1 | |

|first response? | | |Apply | | | |

|Record the error on the medication sheet immediately. | | |Evaluate | | | |

|Notify the physician regarding course of action. | | | | | | |

|Check the patient’s condition to note any possible effect of the error. | | | | | | |

|Complete the incident report, explaining how the mistake was made. | | | | | | |

|The nurse is caring for a client who is experiencing severe pain and is insistent about “getting | |implement |Understand |1.000 |0.0 | |

|some relief quickly.” Which of the following prn medication orders available to you is most likely | | |apply | | | |

|to produce the quickest pain relief? | | | | | | |

|Percocet orally | | | | | | |

|Lidocaine patch topically | | | | | | |

|Demerol intramuscularly | | | | | | |

|Morphine sulfate intravenously | | | | | | |

|The nurse recognizes which of her patients as being at greatest risk for developing a possible | |Assess |Understand |0.779 |0.3 | |

|allergic reaction? | |implement |Apply | | | |

|A 69-year-old client receiving an antibiotic for a respiratory tract infection | | |evaluate | | | |

|A 45-year-old prescribed a decongestant as needed for seasonal allergies | | | | | | |

|A 50-year-old client prescribed a therapeutic dose of an antihypertensive medication | | | | | | |

|A 26-year-old receiving steroids for the initial flare-up of rheumatoid arthritis | | | | | | |

|On beginning the administration of an intravenous medication on your patient they develop a rash | |Assess |Understand |0.922 |0.2 | |

|and complain of difficulty breathing. The nurse quickly identifies this as a symptom of a(n): | |implement |Apply | | | |

|Toxic effect | | |evaluate | | | |

|Anaphylactic allergic reaction | | | | | | |

|Idiosyncratic reaction | | | | | | |

|Side effect | | | | | | |

|You administer Percocet, an oral narcotic for pain in your patient after surgery. According to | |Assess |Understand |0.987 |-0.1 | |

|Davis Drug Guide the onset of this medication is 15 minutes, the peak is 60 minutes, and the | |implement |Apply | | | |

|duration is 4-6 hours. The BEST time to reassess your patient’s response to this medication is: | | |Evaluate | | | |

|15 minutes | | | | | | |

|30 minutes | | | | | | |

|60 minutes | | | | | | |

|2 hours | | | | | | |

|Your patient with hypertension has just been started on Atenolol, whose mechanism of action is to | |assess |Understand |0.935 |0.1 | |

|block stimulation of beta 1 (cardiac) adrenergic receptors on the heart. Therefore you will | | |Apply | | | |

|anticipate which of the following therapeutic effects: | | |Evaluate | | | |

|decreased respiratory rate | | | | | | |

|decreased heart rate | | | | | | |

|decreased blood pressure | | | | | | |

|both B&C | | | | | | |

|Your morning vital signs on your patient are T-98.8, P-64, R-20, BP-86/66. Your patient is to | |Assess |Understand |0.987 |0.0 | |

|receive Atenolol 25 mg po. Based on your knowledge of medications, the best initial nursing action | |implement |Apply | | | |

|would be to: | | |Analyze | | | |

|Give the medication as ordered | | |evaluate | | | |

|Hold the medication | | | | | | |

|Notify the charge nurse and then administer | | | | | | |

|Call the physician | | | | | | |

|Your morning vital signs on your patient are T-98.4, P-68, R-20, BP-96/66. (These findings are | |Assess |Understand |0.948 |0.1 | |

|consistent with previous vital signs.) Your patient is to receive Lisinopril 20 mg po an ACE | |implement |Apply | | | |

|inhibitor. Based on your knowledge of medications, the best nursing action would be to: | | |Analyze | | | |

|Give the medication as ordered | | |evaluate | | | |

|Hold the medication | | | | | | |

|Notify the charge nurse and then administer | | | | | | |

|Call the physician | | | | | | |

KEY:

|Cognitive Level: |Item Discrimination = how well an item distinguishes between high and low scoring students. |

|Remembering |0 is OK if it’s info that everyone absolutely needs to know, i.e. key content. |

|Understanding |.2 to .3 is desirable for most |

|Applying |.4 or higher is OK for just a few questions. If all were .4, most of our students would fail the test. |

|Analyzing |Negative discrimination means a problem, like a poorly written question, mis-speaking in lecture, not fully clarifying a topic, or an error on the answer key. |

|Evaluating | |

|Creating | |

Add the item analysis statistics to the blueprint after you administer the test. Use these stats for improving you test items.

FINAL EXAM

|Question |Course Objective |Step in the Nursing |Cognitive Level |Difficulty Level|Item |Response |

| | |Process |(Blooms) | |Discrim. | |

| MEDICATION ADMINISTRATION-ORAL | |Assess |Apply |0.972 |0.1 | |

| | |Implement |Analyze | | | |

|1. Your morning vital signs on your patient are: T-98.4, P-68, R-20, BP-86/46. | |evaluate | | | | |

|Your patient is to receive Furosemide (Lasix) 40 mg po. Based on your knowledge of | | | | | | |

|medications, the best nursing action would be to: | | | | | | |

|a. Give the medication as ordered | | | | | | |

|b. Hold the medication | | | | | | |

|c. Notify the charge nurse and then administer | | | | | | |

|d. Call the physician | | | | | | |

|2. Your patient has Diabetes and has end stage renal disease as a result. Which | |assess |Apply |0.931 |-0.1 | |

|aspect of pharmokinetics will be influenced by their renal disease and needs to be | | | | | | |

|considered by the nurse when administering medications: | | | | | | |

|a. Absorption | | | | | | |

|b. Distribution | | | | | | |

|c. Metabolism | | | | | | |

|d. Excretion | | | | | | |

|3. You have an order to administer Morphine 2-6 mg IV prn to this same patient with | |Assess |apply |0.972 |0.1 | |

|renal disease. How will your knowledge of pharmokinetics influence your decision to | |implement | | | | |

|administer what dosage of Morphine? | | | | | | |

|a. Give the higher dose of Morphine because a larger dose is needed to get the | | | | | | |

|desired effect | | | | | | |

|b. Give the lower dose of Morphine because a smaller dose is needed to prevent | | | | | | |

|possible toxicity | | | | | | |

|c. Give the lower dose of Morphine because a smaller dose is needed to relieve the | | | | | | |

|pain | | | | | | |

|d. It makes no difference which dose you give. | | | | | | |

|4, A client is nauseated, has been vomiting for several hours, and needs to receive | |Assess |Apply |0.611 |0.1 | |

|an antiemetic (antinausea) medication. The nurse recognizes that which of the | |implement |Analyze | | | |

|following is accurate? | | | | | | |

|a. An enteric-coated medication should be given. | | | | | | |

|b. Medication will not be absorbed as easily because of the nausea. | | | | | | |

|c. Parenteral administration is the route of choice. | | | | | | |

|d. A rectal suppository must be administered. | | | | | | |

|5. The nurse is documenting administration of a medication that is scheduled at | |implement |Apply |0.972 |0.1 | |

|0800, 1400 and 2000. The medication that the nurse is documenting is: | | | | | | |

|a. Morphine sulfate, 10 mg q4h prn | | | | | | |

|b. Propranolol (Inderal), 10 mg po b id | | | | | | |

|c. Diazepam, 5 mg po tid | | | | | | |

|d. Cephalexin (Keflex), 500 mg po q8h | | | | | | |

|6. Morphine given intravenously (IV) has a time action profile of: onset 5 minutes,| |Implement |Apply |0.861 |0.2 | |

|peak 20 minutes and duration of 4-5 hours. Based on this information, once | |evaluate |evaluate | | | |

|administered when would you expect this medication to BEGIN to lower pain: | | | | | | |

|a. 5 minutes | | | | | | |

|b. 20 minutes | | | | | | |

|c. 60 minutes | | | | | | |

|d. 4-5 hours | | | | | | |

|7. During the admission interview the client reports to the nurse that she is “a | |assess |Apply |0.944 |0.2 | |

|little allergic to penicillin.” Which of the following questions asked by the nurse | | | | | | |

|is most likely to provide the most relevant information regarding the client’s | | | | | | |

|possible allergy to penicillin? | | | | | | |

|a. “Who told you that you are allergic to penicillin?” | | | | | | |

|b. “What makes you think you are allergic to penicillin?” | | | | | | |

|c. “Can you describe what happens when you take penicillin?” | | | | | | |

|d. “What do you take for an infection since you are allergic to penicillin?” | | | | | | |

|8. A client on the medical unit receives regular insulin 10 units at 7:00 AM. The | |Assess |Apply |0.528 |0.3 | |

|nurse is alert to a possible hypoglycemic reaction by: | |evaluate |Evaluate | | | |

|a. 7:30 AM | | | | | | |

|b. 10:00 AM | | | | | | |

|c. 12:30 PM | | | | | | |

|d. 2:00 PM | | | | | | |

-----------------------

B or D accepted, students don’t have experience yet to judge that they don’t have time to wait for patient, and that wasn’t stated in lecture

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download