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MEDICATION PROFICIENCY EXAM  
 
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Part I: Principles of Administration and Pharmacology
1.)  Which of the following is the correct terms for the following abbreviations: gm, KVO, a.c., mg, and b.i.d.?
  A.) grain, keep vein open, before meals, milligram, twice daily.
B.) gram, keep vein open, after meals, milligram, twice daily
C.) gram, keep vein open, before meals, milligram, three times daily
D.) gram, keep vein open, before meals, milligram, twice daily
E.) None of the Above
         
2.) Which answer has the safest method for identifying a patient other than asking the patient to state their name?
  A.) ask another nurse
B.) ask a family memeber
C.) read their armband
D.) use the room number
3.) What are two potential risks for an infusion left in the saem vein for an extended period of time?
  A.) infiltration and phlebitis
B.) phlebitis and fractures(s)
C.) medication overdosing and phlebitis
D.) medication underdosing and phlebitis
     

4.) The physician’s order reads “NPH Insulin 20 U q AM.  Test blood glucose with chemstrips AC & HS and cover with Regular Insulin 180-239 = 5 units and 240 or above = 240 units. What is the pharmacological basis for ordering these two types of insulin?   
  A.) NPH only works on some patients and Regular works on the patients that NPH does not
B.) NPH provides long duration coverage and Regular provides short duation coverage and peaks quickly
C.) NPH is porcine and Regular is not
D.) None of the Above

5.) In which of the following situations may a nurse leave a medication at a patient’s bedside to be taken later?
    (1 point)
  A.) An alert, cooperative patient who is talking on the telephone.
B.) The patient is in the bathroom when the nurse makes medication rounds.
C.) The patient is away from the unit for X-Ray procedure.
D.) None of the Above
E.) All of the Above

6.) Which of the following injection sites would the nurse select to administer a medication that required the
       deep IM route?  (1 point)
  A.) Dorsogluteal
B.) Anterior thigh
C.) Deltoid
D.) Lateral thigh

7.) The intramuscular site of choice for the pediatric patient is the : (1 point)
  A.) Deltoid muscle
B.) Anterolateral midthigh region
C.) Ventrogluteal region
D.) Dorsogluteal region

8.) When experiencing difficulty in reading a physician’s order, the safest action would be:  (1point)
  A.) Try to decipher the context within which the order was written.
B.) Ask another nurse for assistance.
C.) Check with the physician as to the correct interpretation.
D.) Ask the patient what medication his physician said he would order for him.

9.) When a patient has pain, the nurse should first: (1 point)
  A.) Call the patient's physician.
B.) Check the patient's chart to see what has been ordered for his pain.
C.) Administer an analgesic.
D.) Evaluate the patient's pain and institute nursing measures as indicated.

10.) The selection of the length of the needle for administration of an intramuscular injection depends on:
        (1point)
  A.) Size of the patient's muscle.
B.) Amount of adipose tissue present.
C.) Both A and B
D.) Neither A or B

11.) Which of the following nursing precautions might be recommended for a patient receiving frequent
        intramuscular injections? (1 point)
  A.) Extra dilution of the medication.
B.) Rotation of injection sites.
C.) Use of a short needle.
D.) Use of a 45 degree angle for injection.

12.) The most common side effect of “p.o.” antibiotic therapy is: (1 point)
  A.) Diarrhea
B.) Generalilzed Rash
C.) Nervousness
D.) Insomnia

13.) Patients who are taking Lanoxin commonly have side effects which require the doctor to change the
       dosage or discontinue the drug.  The most frequently encountered of these side effects is: (1 point)
  A.) Bleeding from urinary system
B.) Nausea, vomiting, diarrhea, anorexia
C.) Itching, rash
D.) Mental confusion and dizziness

14.) The most serious side effect of diuretic therapy is: (1 point)
  A.) Dizziness
B.) Nausea
C.) Hypokalemia
D.) Skin rash

Match these medications with the best answer:
15. A.  Give over at least 1 ½ hours
16. B.  Only given in ICU/CVICU and CVU
17. C.  Monitor electrolytes; Daily weight
18. D.  Call MD before giving if pulse <60
19. E.  Give 1 hr before or 2 hrs after a meal
     ACE inhibitor; 25-50 mg. BID or TID
20. F.  Liver functions at start and periodically
21. G.  Stimulates white cell production
22. H.  Proton pump inhibitor – for GI disease
23. I.   P.O. 2.5-10 mg. b..i.d.; IV–1.25 mg. over 5 min.
     Avoid salt substitutes – hyperkalemia risk.
      Enalapril.
24. J.  Caution if allergic to erythromycin; do not give
     with food or antacids.
Part II: Medication Solving
Solve the following problems.  Show all work and label answer correctly. 
No partial credit given.  (6 points each calculation)

25. The physician ordered the following preoperative medication:
 

Demerol - 45 mg IM
Phenergan - 35 mg IM
Atropine - 0.3 mg IM

You have Demerol 50 mg/cc, Phenergan 50mg/cc and Atropine gr 1/150 in 0.5 cc
What is the appropirate doses?

A.) 0.9 cc Demerol, .07 cc Phenergan and 0.375 or 0.4 cc Atropine
B.) 0.7 cc Demerol, .09 cc Phenergan and 0.375 or 0.4 cc Atropine
C.) 0.6 cc Demerol, .08 cc Phenergan and 0.5 Atropine
D.) 0.6 cc Demerol, .09 cc Phenergan and 0.7 Atropine


26.) The doctor ordered Lanoxin 0.2mg IM stat. You have Lanoxin in an ampule 0.5/2ml
How many ml is the correct dose?

  A.) 0.2 ml
B.) 0.4 ml
C.) 0.6 ml
D.) 0.8 ml

27.) The order reads Dilaudid 1.5mg IM q 4 hr pm pain. The prefilled syringe label reads Diaudid 2mg/cc.
What is the correct dose?
  A.) 0.9 cc
B.) 0.5 cc
C.) 0.75 cc
D.) 1.0 cc

28.) The MD ordered Morphine 10mg IM stat. The prefilled syringe label reads Morphine 15mg/cc. What is the correct dosage?
  A.) 0.8 cc
B.) 0.66 cc
C.) 0.5 cc
D.) 1.5 cc

29.) The order was written for Digoxin 0.125 mg.  po  and the pharmacy sent scored tablets labeled 0.25 mg. per tablet. What is the correct dosage?
  A.) 1 tablet
B.) 0.5 tablet
C.) 2 tablets
D.) 1.5 tablets


30.) The physician's order reads as follows:
             Heparin 1100 units/hr. IV fusion.
             Pharmacy dispensed 25,000 units of Heparin in 250 cc of D5W.
       What is the correct flow rate in cc/hr?

  A.) 10 cc/hr
B.) 22 cc/hr
C.) 11 cc/hr
D.) 20 cc/hr

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