# Chapter 04: Patient Records, Medication Orders, and Medication Labels My Nursing Test Banks

Chapter 04: Patient Records, Medication Orders, and Medication Labels

Mulholland: The Nurse, The Math, The Meds, 3rd Edition

ESSAY

1. Define the following medical abbreviations:

a.   NPO:

b.   IV:

c.   IM:

d.   ID (route):

e.   NG:

f.   PO:

g.   SL:

h.   subcut:

i.    stat:

j.    bid:

ANS:

a.   Nothing by mouth

b.   Intravenous

c.   Intramuscular

e.   Nasogastric

f.   By mouth

g.   Sublingual

h.   Subcutaneous

i.    Immediately

j.   Twice a day; two times a day

2. Write the medical abbreviations for the following words and phrases:

a.   Before meals:

b.   After meals:

c.   When needed:

d.   With:

e.   Without:

f.   Immediately:

g.   Three times a day:

h.   As desired:

i.   Every 4 hours:

j.   Twice a day:

ANS:

a.   ac

b.   pc

c.   prn

d.

e.

f.   stat

g.   tid

i.   q4h

j.   bid

3. It is recommended that HS be written out: What are two possible meanings for HS?

ANS:

Hour of sleep (bedtime); half strength (solution)

4. Write out the following order: ibuprofen ent tab 400 mg stat and tid pc.

ANS:

Ibuprofen enteric coated tablet 400 mg immediately and three times daily after meals.

5. Change the traditional time to notations from the 24-hour clock system:

a.   4 PM:

b.   Midnight:

c.   Noon:

d.   1:30 AM:

e.   11:45 AM:

ANS:

a.   1600

b.   2400  0000

c.   1200

d.   0130

e.   1145

6. Name six basic patient rights.

ANS:

Right patient, right drug, right dose, right time, right route, and right documentation. There is one additional patient right: right to refuse.

7. Ordered: 200 mg of a medication PO stat. Supplied as 0.1 g oral tablets.

a.   Write the appropriate conversion formula:

How many tablets will you give?

b.   Estimated dose: (Move the decimal point to estimate.)

c.   Verify with a DA-style equation:

d.   Evaluation:

ANS:

a.   1000 mg = 1 g

b.   Estimate: Give 2 (100 mg) tablets. (0.1 g = 0.100.mg)

c.   Tablets =

8. Ordered: Keflex 0.5 g PO stat.

a.   What is the generic name of this medication?

b.   What is the concentration of this medication?

c.   Write the appropriate conversion formula:

How many capsules will you give?

d.   Estimated dose: (Move the decimal point to estimate.)

e.   Verify with a DA-style equation:

f.   Evaluation:

ANS:

a.   Cephalexin

b.   250 mg per cap

c.   1000 mg = 1 g

d.   Estimate: Give 2 (250 mg) capsules (250 mg  .250  0.25 g)

e.   Capsules =

9. What is missing from the following order: aspirin 2 tablets PO stat?

ANS:

The total dose in measurement units is omitted. Correct example: Aspirin 650 mg by mouth immediately. The number of tablets should not be written in the order. The nurse determines the number of tablets to give based on the strength supplied.

10. What is meant by a scored tablet? How is a scored tablet treated differently from an unscored tablet?

ANS:

A scored tablet has a dividing line cut into it. Only scored tablets may be divided in half. Unscored tablets may not be cut.

11. (1-20):

 Abbreviation Term Term Abbreviation 1 ac 11 nothing by mouth 2 pc 12 intravenous (route) 3 prn 13 intramuscular (route) 4 14 intradermal (route) 5 15 nasogastric (route) 6 stat 16 by mouth 7 bid 17 sublingual (route) 8 ad lib 18 subcutaneous (route) 9 q2h 19 immediately 10 tid 20 gastric tube

ANS:

 Abbreviation Term Term Abbreviation 1 ac before meals 11 nothing by mouth NPO 2 pc after meals 12 intravenous (route) IV 3 prn as needed; when necessary 13 intramuscular (route) IM 4 with 14 intradermal (route) ID 5 without 15 nasogastric (route) NG 6 stat immediately 16 by mouth PO 7 bid twice a day 17 sublingual (route) SL 8 ad lib as desired 18 subcutaneous (route) subcut 9 q2h every two hours 19 immediately stat 10 tid three times a day 20 gastric tube GT

12. Write out the following order for a patient on this antidepressant: Effexor XR tab ent 75 mg AM pc  full glass of water.

ANS:

Give Effexor extended release tablet enteric coated 75 mg after the morning meal with a full glass of water.

13. Why do you think XR, ent, DR, SR, and SL tablets should never be crushed?

ANS:

Crushing these tablets would cancel the delayed or extended or sustained release. The patient might then have an adverse drug event from the side effects of too much of the medication being released and absorbed too soon. The medication may be very irritating to the mucosa of the GI tract if broken down before it leaves the esophagus or stomach.

14. Why do you think unscored tablets should never be cut?

ANS:

The medication may be unevenly distributed within the tablet. The cut probably would not be precise. With either of the foregoing problems, one part would have too much and one part would have too little of the medication. The patient would receive the wrong dose.

15. Why do you think some medications must be given with food, or given after meals, and/or the patient must remain upright for 30 minutes after the medication is administered?

ANS:

The medications may be too irritating to mucosa on an empty stomach or may cause nausea.

Staying upright for 30 minutes after a medication is administered with a full glass of water helps prevent reflux of irritating medications before it reaches the stomach. This helps prevent irritation of the esophagus by a potentially caustic substance.

16. If the nurse does not document the medication promptly after administration, what adverse event might occur during that shift?

ANS:

If the nurse does not document the administration of the medication promptly, the medication may be given again during this shift doubling the dosage and causing a medication error.

COMPLETION

1. Directions: Change the traditional time to the international 24-hour clock:

12:30 PM: _____________

ANS: 1230 hours

2. Directions: Change the traditional time to the international 24-hour clock:

1:00 AM: ___________

ANS: 0100 hours

3. Directions: Change the traditional time to the international 24-hour clock:

10:15 AM: _____________

ANS: 1015 hours

4. Directions: Change the traditional time to the international 24-hour clock:

5:00 PM: _____________

ANS: 1700 hours

5. Directions: Change the traditional time to the international 24-hour clock:

9: 45 PM: ___________

ANS: 2145 hours