DOH Nursing Medication Management

Question 1

What are the 'Five Rights' of medication administration?

Accepted Answer

Right patient, right drug, right dose, right route, right time

Answer

The Five Rights are the foundation of safe medication administration: Right Patient (two identifiers), Right Drug (verify against order), Right Dose (calculate and verify), Right Route (check order and appropriateness), Right Time (within acceptable window). Modern practice adds Right Documentation as a sixth right.

Question 2

A patient is prescribed gentamicin 5 mg/kg IV once daily. The patient weighs 70 kg. What is the correct dose?

Accepted Answer

350 mg

Answer

5 mg/kg × 70 kg = 350 mg. Once-daily dosing of aminoglycosides achieves a higher peak concentration (concentration-dependent killing) while allowing the trough to fall low enough to reduce nephrotoxicity and ototoxicity. Trough levels should be monitored.

Question 3

Which medication interaction should the nurse be most concerned about when a patient on warfarin is prescribed aspirin?

Accepted Answer

Synergistic anticoagulation/antiplatelet effect dramatically increasing bleeding risk

Answer

Warfarin and aspirin used together significantly increase bleeding risk through two different mechanisms: warfarin inhibits clotting factor synthesis while aspirin irreversibly inhibits platelet aggregation. This combination requires careful risk-benefit assessment and close monitoring.

Question 4

A patient is prescribed IV vancomycin. Which monitoring parameter is most important?

Accepted Answer

Renal function (serum creatinine, BUN) and vancomycin trough levels

Answer

Vancomycin is nephrotoxic and ototoxic. Renal function is monitored because the drug is renally cleared and accumulates with renal impairment. AUC-guided monitoring (area under the curve) is preferred over trough-only monitoring per current guidelines to optimize efficacy and minimize toxicity.

Question 5

A patient is prescribed metformin. What is the most important contraindication to assess before administration?

Accepted Answer

Renal impairment (eGFR <30 mL/min/1.73m²) due to lactic acidosis risk

Answer

Metformin is contraindicated in significant renal impairment (eGFR <30) because decreased renal clearance leads to drug accumulation and potentially fatal lactic acidosis. Hold metformin before contrast dye procedures and reassess when renal function stabilizes.

DOH Nursing Practice Test

DOH Nursing Practice Test

DOH Nursing Medication Management