Chapter 9, Safety and Quality - EAQ PDF

Performance Exit Chapter 9, Safety and Quality - EAQ Due May 19, 2024 by 11:59 pm Failed 13 out of 19 questions answered correctly Completed on May 19, 2024 11:59 pm Incorrect (6)...

Performance Exit Chapter 9, Safety and Quality - EAQ Due May 19, 2024 by 11:59 pm Failed 13 out of 19 questions answered correctly Completed on May 19, 2024 11:59 pm Incorrect (6) Report content error What are the time limits within which the nurse must administer a prescription of 'paracetamol 650 mg by mouth stat?' Immediately Within 1 hour of the prescription Within 2 hours of the prescription Within 3 hours of the prescription Rationale When medications are prescribed as 'stat,' the nurse must administer the dose immediately. Administering a medicine prescribed to be given stat within 1, 2, or 3 hours are all incorrect, because they exceed the time requirement. STUDY TIP: Identify your problem areas that need attention. Do not waste time on restudying information you know. p. 78 Report content error Which action by the nurse determines the 'right patient' when following the six rights of medication administration? Verify the patient’s identity by asking a visitor the patient’s name and validating the name on the patient’s wristband.  Place a name alert band on the patient’s wrist and verify that the medical record number is the same as the wristband. Ask the patient to state name, date of birth, and compare the information with the patient’s driver’s license or another form of official identification. Scan the bar code on the patient’s wristband, verify with the patient’s electronic medical administration record, and ask the patient to state full name. Rationale To correctly perform the 'right patient' assessment, the nurse scans the bar code on the patient’s wristband. After the bar code is scanned, the electronic medical record appears and includes the patient’s medication administration record. Next, for patients who are alert without cognitive impairment, the nurse asks the patient, not a visitor, to state the patient’s full name. At least two forms of patient identification are required to validate 'right patient.' A name alert band serves as a warning that there is another patient with the same first and/or last name, and this band is in addition to the patient’s identification band. Asking the patient for the driver’s license or other form of personal verification is not logical to perform before each medication administration. p. 73 Report content error Which nursing action is appropriate after the nurse administers a medication to the wrong patient? Assess the client for an adverse reaction and report if an adverse event occurs. Document the medication error; no further action is required. Report the error and document the medication on the patient chart. Notify the health care provider and document the error in an incident report. Rationale All medication errors that involve a patient need to be called to the health care provider's attention and documented in an incident report, including those that do not result in an adverse event. p. 82 Report content error According to the current health care laws in the United States, which professional can legally prescribe medications? Select all that apply. One, some, or all responses may be correct. Some correct answers were not selected  Primary health care provider Psychologists Nurse practitioners Physician assistants Nursing assistive personnel Rationale According to current health care laws in the United States, medicine can legally be prescribed only by primary health care providers, nurse practitioners, physician assistants, and dentists. Psychologists and nursing assistive personnel are not legally allowed to prescribe medications. p. 73 Report content error Which military time does the nurse use to document a medication given at 9:00 p.m.? 1500 1800 2100 2400 Rationale Most health care agencies use military time for documenting medicine administration. The military time corresponding to 9:00 p.m. is 2100. Military time of 1500 corresponds to 3:00 p.m.; 1800 corresponds to 6:00 p.m.; and 2400 corresponds to 12:00 a.m. p. 75 Report content error Which part of an order for 'Acetaminophen two tablets PO, every 6 hours as needed for fever.' does the nurse ask the health care provider to clarify? Name Dosage Frequency Route Rationale Acetaminophen tablets are available in two strengths: 325 mg and 500 mg. The dosage of the drug is mentioned as 'two tablets.' The nurse asks the health care provider to confirm the strength of the tablet that the patient requires. The drug name is clearly mentioned in the prescription as acetaminophen. The prescription also clearly mentions  that the drug frequency is 'every 6 hours' and that the drug route is 'PO,' which means per oral. p. 74 Correct (13) Report content error How many times does the nurse check a medication before administering it under the 'right drug' part of the 'six rights' of medication administration? One time Three times Five times It depends on the drug being administered Rationale The nurse should check the medication three times and confirm each time that the medication is the right drug before administering the medication. This requirement does not change depending on the drug being administered. Test-Taking Tip: A psychological technique used to boost your test- taking confidence is to look into a mirror whenever you pass one and say out loud, 'I know the material, and I'll do well on the test.' Try it; many students have found that it works because it reduces 'test anxiety.' p. 74 Report content error Which method helps standardize medication prescriptions? Computerized order entry Bar coding of medication Standardization of guidelines Frequent monitoring Rationale Computerized order entry helps standardize prescribing functions, because it avoids errors caused by abbreviations and handwriting. It also helps as a backup source in case the patient loses the prescription. Bar coding helps check whether the patient is receiving the correct medication that was prescribed by the primary health care provider. Standardizing guidelines helps provide effective care but does not help completely minimize errors in prescriptions caused by poor handwriting. Frequent monitoring helps the nurse document the patient's response to the medications. p. 73 Report content error Which safety feature is specific to computerized health care provider (HCP) order entry systems? Save precious time by omitting the need to verify dosages for high-risk medications. Permit the nurse to verbally validate the written medication prescription with the physician. Establish a safety net for licensed practical nurses to work independently of a registered nurse. Include the ability to identify drug interactions with the patient’s current and newly prescribed drugs. Rationale A safety feature specific to the computerized HCP order entry system is the ability to identify drug interactions with the patient’s current and newly prescribed drugs. High-risk medications, such as insulin, require two nurses to verify and document the dosage on the medication administration record. There are no verbal exchanges between nurses and HCPs to validate written prescriptions, because they are all electronic. Supervision from a health care provider and/or a registered nurse is required for licensed practical nurses. p. 73 Report content error Which term best describes the nurse's action when asking the patient to provide a list of all medications, including herbal and over-the-counter drugs, the patient takes? Error reporting Quality improvement Notifying the patient Medication reconciliation Rationale Medication reconciliation is a process in which the nurse asks the patient to provide a list of all medications, including herbal and over- the-counter drugs the patient is currently taking. This knowledge prevents medication errors. Error reporting involves notifying the appropriate people about errors related to medication administration. Medication reconciliation helps in quality improvement. Notifying the patient is a process whereby the patient is informed about possible medication errors. p. 77  Report content error For which reason are specific medications classified as "high-alert" medications? Potential for patient harm is higher with these medications. Medications always cause certain adverse effects. States require that these medications be on the high-alert list. Only registered nurses (RNs) are allowed to administer these medications. Rationale Medications on the high-alert list have been identified as such because of their potentially toxic nature and the need for special care when prescribing, dispensing, and administering them. Although medications can have certain adverse effects, this does not explain why some medications are specified as 'high-alert.' This is a federal requirement, not a state requirement. It is not necessarily true that only RNs are allowed to administer the medications. p. 80 Report content error Which number of patient identifiers will the nurse check before administering a medication to a patient? One Two Three Four Rationale The Joint Commission requires that two patient identifiers (e.g., name, birthday, account number) be checked before administering any medication. Checking one patient identifier would not be enough; checking three or four is more than the Joint Commission requires. Test-Taking Tip: Read the question carefully before looking at the answers: (1) Determine what the question is really asking by looking for keywords; (2) Read each answer thoroughly, and see if it completely covers the material asked by the question; and (3) Narrow the choices by immediately eliminating answers you know are incorrect. p. 73 Report content error Which missing component of a prescription for 'gentamicin 100 mg every 8 hours' would prompt the nurse to consult with the health care provider? Generic name Dose Route Strength Rationale The prescription does not indicate the route for administering the drug, and therefore the nurse must contact the health care provider for this information. The drug name, dose, and frequency of administration are all included in the prescription; therefore no clarification is necessary for these items. The strength of the drug is not required on the prescription. This factor is usually determined by the pharmacist. STUDY TIP: Enhance your time-management abilities by designing a study program that best suits your needs and current daily routines by considering issues such as the following: (1) Amount of time needed; (2) Amount of time available; (3) 'Best' time to study; and (4) Time for emergencies and relaxation. p. 76 Report content error How many times does the nurse verify a prescription before administering a medication to the patient? Record your answer using a whole number. 3 times Rationale The nurse should check the prescription three times before administering the medication to the patient. This helps the nurse avoid the misinterpretation of abbreviations and clearly understand the instructions. If there are any doubts, the nurse should consult more experienced health care providers. p. 74 Report content error Which information is of the highest priority when obtaining a pharmacologic history from a patient? Allergies Use of over-the-counter medications Home remedy use Alcohol intake Rationale The key to this question is the phrase 'of the highest priority.' Identification of allergies is of highest priority. Giving a patient a medication to which he or she is allergic can be life-threatening. Use of over-the-counter medications, home remedy use, and alcohol intake all affect the prescribing and administering of many medications, but allergies are the highest priority. Test-Taking Tip: On a test day, eat a normal meal before going to school. If the test is late in the morning, take a high-powered snack with you to eat 20 minutes before the examination. The brain works best when it has the glucose necessary for cellular function. p. 73 Report content error Which information in the medication prescription does the nurse verify before administering the drug? Date of drug prescription Age of the patient Sex of the patient Occupation of the patient Rationale While checking themedication prescription, the following six elements should be checked: Patient's name, date of drug prescription, name of drug(s), drug dosage amount and frequency, route of administration, and health care provider's signature. This ensures accuracy of drug administration. The patient's age, sex, and occupation are not checked on medication prescriptions. p. 73 Report content error Which information does the nurse need to clarify before administering a prescription for two tablets of acetaminophen by mouth today at 2100? Time Route Dose Purpose Rationale When administering a drug, the nurse is always cognizant of the six rights of drug administration. A prescription written by the health care provider must include the name of the drug, exact dosage of the drug to be given, the route of administration of the drug, and the time the drug is to be given. The health care provider must sign the prescription. The nurse then clarifies the exact dosage of the acetaminophen to be given. The health care provider wrote for two tablets to be given but did not indicate the tablet strength. Acetaminophen is available in 325 mg and 500 mg tablets; therefore in this prescription, it is unclear whether the intended dosage is 650 mg or 1000 mg. The prescription includes the time the drug is to be given and the route of administration; therefore no clarification of these two items is required. The purpose of the drug prescription is not required on the prescription; however, the nurse should be aware of the reason the drug is prescribed for the patient. STUDY TIP: Remember that intelligence plays a vital role in your ability to learn; however, being smart involves more than just intelligence. Being practical and applying common sense are also part of the learning experience. p. 74 Report content error Which member of the health care team is most appropriate for the nurse to contact with questions regarding the hospitalized patient’s medications? Senior nurse colleague Patient guardians Nurse manager  Clinical pharmacist Rationale The nurse would consult the clinical pharmacist for drug therapy questions. Pharmacists have knowledge of medications and their side effects, dosage dispensing, and administration technique. Pharmacists can give the best advice to the nurse regarding the drug therapy prescribed for the patient. If the nurse and the pharmacist work together, most medication errors can be avoided. A senior nurse colleague may not provide sufficient information to the nurse regarding the drugs and the side effects. Patient guardians cannot provide information on drug therapy, because they may not know the medications and health care aspects. The nurse manager cannot give as accurate information as the pharmacist can. p. 74 Report content error What are the time limits within which the nurse must administer a prescription of 'paracetamol 650 mg by mouth stat?' Immediately Within 1 hour of the prescription Within 2 hours of the prescription  Within 3 hours of the prescription Rationale When medications are prescribed as 'stat,' the nurse must administer the dose immediately. Administering a medicine prescribed to be given stat within 1, 2, or 3 hours are all incorrect, because they exceed the time requirement. STUDY TIP: Identify your problem areas that need attention. Do not waste time on restudying information you know. p. 78 1 topics covered Chapter 9, Safety and Quality Intermediate McCuistion: Pharmacology, 11th Edition Novice Intermediate Proficient Questions answered You 38 Quiz me on this topic