Medicines Management Flashcards
6 cards from real NMC OSCE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Medicines Management flashcards as text
A patient has a nasogastric tube and is prescribed a modified-release tablet. What should the nurse do?
Answer: Contact the prescriber to request an alternative formulation
Modified-release (MR) tablets must never be crushed as this destroys the release mechanism and can cause toxicity from rapid drug release. The prescriber should be contacted to prescribe a suitable alternative formulation for NG administration.
Which of the following is a common symptom of digoxin toxicity?
Answer: Nausea, vomiting, and bradycardia
Digoxin toxicity classically presents with nausea, vomiting, visual disturbances (yellow-green halos), and bradycardia or heart block. It has a narrow therapeutic index and toxicity can occur even at 'normal' doses, especially with electrolyte imbalances.
What is the significance of a drug having a narrow therapeutic index?
Answer: A small difference between therapeutic and toxic doses requires careful monitoring
A narrow therapeutic index means the difference between the effective dose and the toxic dose is small. Drugs like warfarin, lithium, digoxin, and phenytoin require regular monitoring of blood levels to maintain efficacy while avoiding toxicity.
A nurse administers the wrong medication to a patient. The patient is unharmed. What must the nurse do?
Answer: Complete an incident report and inform the patient and prescriber
All medication errors must be reported regardless of patient outcome, using the organisation's incident reporting system. The duty of candour also requires the nurse to inform the patient about what happened. This is both a legal and professional obligation.
Which statement about heparin is correct?
Answer: Unfractionated heparin requires APTT monitoring; LMWH generally does not require routine monitoring
Unfractionated heparin (UFH) has an unpredictable response and requires monitoring via APTT ratio. Low molecular weight heparins (e.g., enoxaparin) have predictable pharmacokinetics and generally do not require routine laboratory monitoring in standard doses.
A patient is receiving a potassium infusion peripherally. What is the maximum safe concentration for peripheral IV potassium replacement?
Answer: Up to 40 mmol/L
The maximum concentration for peripheral IV potassium replacement is 40 mmol/L administered at no more than 20 mmol/hour. Higher concentrations risk phlebitis, severe pain, and cardiac toxicity. Concentrations above 40 mmol/L require central venous access.