NCLEX-RN - Safe Medication Administration & Clinical Nursing Pharmacology Flashcards

Question 1

What is the antidote for Heparin overdose?

Accepted Answer

Protamine Sulfate.

Question 2

What is the antidote for Warfarin overdose?

Accepted Answer

Vitamin K (Phytonadione).

Question 3

What is the antidote for Opioid overdose?

Accepted Answer

Naloxone (Narcan).

Question 4

What is the antidote for Benzodiazepine overdose?

Accepted Answer

Flumazenil.

Question 5

What is the antidote for Magnesium Sulfate toxicity?

Accepted Answer

Calcium Gluconate.

Question 6

What is the antidote for Acetaminophen overdose?

Accepted Answer

Acetylcysteine (Mucomyst).

Question 7

What is the antidote for Digoxin toxicity?

Accepted Answer

Digoxin Immune Fab (Digibind).

Question 8

What is the antidote for a cholinergic crisis (e.g., from organophosphate poisoning or overdose of cholinergic drugs)?

Accepted Answer

Atropine Sulfate.

Question 9

What is the formula for calculating IV drip rate in gtt/min?

Accepted Answer

The formula is $gtt/min = \frac{Volume (mL) 	imes Drop Factor (gtt/mL)}{Time (min)}$.

Question 10

A client is to receive 1000 mL of D5W over 8 hours. The drop factor is 15 gtt/mL. Calculate the IV drip rate in gtt/min.

Accepted Answer

First, convert hours to minutes: $8 	ext{ hours} 	imes 60 	ext{ min/hour} = 480 	ext{ min}$.
Then, apply the formula: $gtt/min = \frac{1000 	ext{ mL} 	imes 15 	ext{ gtt/mL}}{480 	ext{ min}} = \frac{15000}{480} \approx 31.25 	ext{ gtt/min}$. Round to 31 or 32 gtt/min.

Question 11

List the "Six Rights" of Medication Administration.

Accepted Answer

The "Six Rights" are: Right Patient, Right Drug, Right Dose, Right Route, Right Time, and Right Documentation. (Some sources include 10 rights, but 6 are core for safe practice).

Question 12

What is an FDA Black Box Warning?

Accepted Answer

The strongest warning the FDA requires for prescription drugs. It indicates that medical studies have shown the drug carries a significant risk of serious or even life-threatening adverse effects.

Question 13

Provide an example of a drug class with an FDA Black Box Warning related to suicidality in young adults.

Accepted Answer

Antidepressants (e.g., SSRIs) carry a black box warning regarding increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults (up to age 24).

Question 14

What critical assessment is required before administering Digoxin?

Accepted Answer

Assess the apical pulse for a full minute. Hold the medication and notify the provider if the pulse is less than 60 bpm in adults (or as per facility policy/provider order for children/infants) due to risk of bradycardia.

Question 15

What are key nursing considerations for administering Loop Diuretics (e.g., Furosemide)?

Accepted Answer

Monitor for hypokalemia, hyponatremia, dehydration, hypotension, and ototoxicity (especially with rapid IV push). Administer in the morning to prevent nocturia.

Question 16

A client on Warfarin has an INR of 5.5. What nursing intervention is anticipated?

Accepted Answer

Notify the provider immediately. Anticipate holding the next dose of Warfarin and potentially administering Vitamin K (Phytonadione) to reverse the anticoagulant effect, depending on the patient's bleeding risk and clinical status.

Question 17

What are common adverse effects of ACE Inhibitors (e.g., Lisinopril)?

Accepted Answer

Dry, persistent cough, angioedema (rare but serious, swelling of face/lips/tongue), hyperkalemia, and orthostatic hypotension.

Question 18

What is a critical teaching point for clients prescribed corticosteroids (e.g., Prednisone) for long-term use?

Accepted Answer

Do not abruptly stop the medication; it must be tapered gradually to prevent adrenal insufficiency. Also, educate on monitoring for hyperglycemia, increased infection risk, and bone density loss.

Question 19

What are the signs of Serotonin Syndrome, often associated with SSRIs?

Accepted Answer

Mental status changes (agitation, confusion), autonomic instability (tachycardia, labile BP, diaphoresis), neuromuscular hyperactivity (tremor, rigidity, hyperreflexia, clonus), and gastrointestinal symptoms (nausea, diarrhea).

Question 20

What is the primary concern when administering an opioid analgesic, and what is the priority nursing intervention if it occurs?

Accepted Answer

Respiratory depression is the primary concern. If it occurs, administer Naloxone (Narcan) as prescribed, elevate the head of the bed, and stimulate the patient to breathe while monitoring respiratory status closely.

Question 21

What is the significance of "peak" and "trough" levels for certain medications?

Accepted Answer

Peak level indicates the highest concentration of a drug in the bloodstream, while trough level indicates the lowest. They are crucial for drugs with a narrow therapeutic index (e.g., Vancomycin, Gentamicin) to ensure efficacy and prevent toxicity, guiding dosage adjustments.

Question 22

What is the nursing priority when administering a new antibiotic?

Accepted Answer

Before administering the first dose, ensure that a culture and sensitivity (C&S) specimen has been collected, if ordered. Monitor closely for allergic reactions, especially within the first 30 minutes of administration.

Question 23

A client is prescribed a Beta-blocker (e.g., Metoprolol). What vital signs should the nurse assess before administration?

Accepted Answer

Assess heart rate (apical pulse) and blood pressure. Hold the medication and notify the provider if the heart rate is below 60 bpm or if the blood pressure is significantly low (e.g., systolic <90-100 mmHg, depending on baseline and order).

Question 24

What is medication reconciliation, and why is it important?

Accepted Answer

Medication reconciliation is the process of comparing a patient's current medication list with new medications ordered to identify and resolve discrepancies. It's crucial for preventing medication errors, adverse drug events, and ensuring patient safety during transitions of care (admission, transfer, discharge).

Question 25

What is a common FDA Black Box Warning associated with Fluoroquinolone antibiotics (e.g., Ciprofloxacin)?

Accepted Answer

Increased risk of tendinitis and tendon rupture, especially in older adults, patients taking corticosteroids, and those with kidney, heart, or lung transplants. Also, peripheral neuropathy and central nervous system effects.

NCLEX-RN - Safe Medication Administration & Clinical Nursing Pharmacology

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