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NUR 304 ( LATEST 2024 / 2025 ) TEST 1 | PASSED | A+ RATED GUIDE | NEW FULL EXAM
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NUR 304 ( LATEST 2024 / 2025 ) TEST 1 | PASSED | A+ RATED GUIDE | NEW FULL EXAM
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NUR 304 Test 11. An 86-year-old is being discharged to home on digoxin and has little in- formation
regarding the medication. Which statement best reflects a realistic outcome of patient teaching
activities?
Answer
The patient and patient's daughter will state the proper way to take the drug
2. A patient has a new prescription for a blood pressure medication that may cause him to feel
dizzy during the first few days of therapy. Which is the best nursing diagnosis for this situation?
Answer
Potential for injury
3. A patient's chart includes an order that reads as follows
Answer
digoxin 0.025 mcg once daily at 0900 hours. Which action by the nurse is correct?
The nurse contacts the prescriber to clarify the dosage route
4. The nurse is compiling a drug history for a patient. Which question from the nurse will obtain
the most information from the patient?
Answer
"When you have pain, what do you do to relieve it?"
5. A 77-year-old man who has been diagnosed with an upper respiratory infection tells the
nurse that he is allergic to penicillin. What is the most appropriate response by the nurse?
Answer
"What type of reaction did you have when you took penicillin?"
6. The nurse is preparing a care plan for a patient who has been newly diagnosed with type 2
diabetes mellitus. Put into correct order the steps of the nursing process, with 1 being the first
step and 5 being the last step.
,Answer
1. Assessment
2. Nursing diagnoses
3. Planning
4. Implementation
5. Evaluation
7. The nurse is reviewing new medication orders that have been written for a newly admitted
patient. Which orders will the nurse need to clarify? Select all that apply.
Answer
- Sitagliptin (Januvia) 50 mg daily
- Docusate (Colace) as needed for constipation
8. The nurse is reviewing data collected from a medication history. Which of these data are
considered objective data? (Select all that apply)
Answer
- white blood cell count 22,000 mm3
- blood pressure 150/94 mm Hg
- patient's weight is 150 lb
9. What are the crucial responsibilities of the nurse when implementing drug therapy?
Answer
The nurse is responsible for being adequately informed about both the patient and the drug
before implementing drug therapy. The nurse must assess each patient before giving any
medication and must then observe the patient's response to the drug therapy; must determine any
other actions to be implemented; and must continue to assess, teach, and work collaboratively
with pharmacists, and diligently with patients, to enhance compliance at home. Carrying out the
nursing process with astute and thorough assessment, nursing diagnoses, planning,
implementation, and evaluation are as criticalto safe nursing care in drug therapy as they are
to the overall nursing care of patients. Being efficient, safe, and knowledgeable about patients
and their medications, using proper administration techniques, and constantly monitoring
patients and all other sources of data are also important to safe and effective drug therapy.
,10. When medications were administered during the night shift, a patient refused to take his
0200 hours dose of an antibiotic, claiming that he had just taken it. What actions by the nurse
would ensure sound decision making and maintain patient safety?
Answer
Whenever a patient questions a particular medication or mentions something about the
medication that is not in accordance with what the nurse thinks, the nurse must always be
prudent—stop, recheck the prescriber's order against the medication administration record or
profile, and check the dispens- ing system or medication record/profile to determine whether a
dose was given and signed off by another nurse. Never ignore a patient's concerns! Never
assume that the patient is unaware of his or her medication; always double-check to be safe. If all
records and orders have been checked, and the nurse is certain that the drug has not been given,
then the nurse proceeds with medication administration. A simple explanation could then be
given to the patient. If the patient continues to refuse the medication, document this in the
nurses' notes and report it to the charge nurse or nurse supervisor and to the prescriber.
11. During a busy shift, the nurse notes that the chart of a newly admitted
patient has a few orders for medications and diagnostic tests that were taken by telephone by
another nurse.The nurse is on the way to the patient's room to do an assessment when the unit
secretary says that one of the orders reads as follows "furosemide, 20 mg, stat." What is the priority
action by the nurse? How does the nurse go aboutgiving this drug? Explain the best action to take
in this situation.
Answer
Because this is a newly admitted patient, it would be best to perform an assessment before giving
any medications. However, because the order is stat, meaning to give immediately, the
assessment has to be brief and focused. Assess the patient's vital signs (blood pressure, pulse,
respirations, temperature) and level of consciousness. Check for signs of fluid retention (pedal
edema), ask about urine output and function, and listen to breath and heart sounds. Do not
forget to assess for drug allergies and other drug reactions. However, the stat order is missing
something—a route. Never assume that a medication is to be given by mouth. Even though this
patient was just admitted and may or may not have an intravenous line, the best action is to
clarify the route by which this drug should be given. The order was taken by telephone by
another nurse, so you can ask the nurse whether a route was specified when the nurse spoke to
the prescriber. If not, the prescriber must be contacted right away for clarification. To save time,
the order can be checked by another nurse or,in some facilities, the pharmacist, while you are
performing the assessment.
, 12. In which step of the nursing process does the nurse determine the out- come of medication
administration?
Answer
Evaluation
13. The nurse plans care for a male patient who is 80 years of age. The nursing diagnosis is
nonadherence with the medication regimen related to living alone, as evidenced by uncontrolled
blood pressure. What should the nurse do next?
Answer
Enlist the help of a home care nurse for pharmacotherapy.
14. Which statement is an example of objective data? (Select all that apply.)
Answer
- The patient says that she feels like someone is touching her arm.
- The patient states that she has a headache.
15. What should the nurse check when reviewing a prescription with a patient? (Select all that
apply.)
Answer
- The route of administration
- The signature of the prescriber
16. What information should the nurse chart when documenting medication administration?
(Select all that apply.)
Answer
- The dosage of medication administered
- The time of administration
- The route of administration
17. An older adult woman took a prescription medicine to help her to sleep; however, she felt
restless all night and did not sleep at all. The nurse recognizes that this woman has experienced
which type of reaction or effect?
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