OSCE Pharmacology and Medication Administration 4 — Questions and Answers
Question 1: A nurse is preparing to hang a new IV bag and notes the solution is cloudy. What is the correct action?
- Shake the bag to clarify the solution
- Warm the bag in water to dissolve particles
- Discard the bag and obtain a new one (Correct answer)
- Strain the solution through a filter needle before hanging
Correct answer: Discard the bag and obtain a new one
Cloudiness indicates contamination or precipitation, and the solution must be discarded to prevent administering a compromised medication.
Question 2: A patient prescribed levothyroxine asks when to take the medication. What is the best response?
- Take it with a high-calcium meal for best absorption
- Take it on an empty stomach 30-60 minutes before breakfast (Correct answer)
- Take it at bedtime with a small snack
- Take it at the same time as iron supplements for convenience
Correct answer: Take it on an empty stomach 30-60 minutes before breakfast
Levothyroxine must be taken fasting because food, especially calcium and iron, significantly impairs its absorption.
Question 3: During an IV infusion, a patient reports burning and pain proximal to the IV site, and the area appears pale and cool. The nurse suspects:
- Phlebitis
- Extravasation
- Infiltration (Correct answer)
- Air embolism
Correct answer: Infiltration
Infiltration is the inadvertent infusion of non-vesicant fluid into surrounding tissue, causing pallor, coolness, and swelling at the site.
Question 4: A nurse is preparing IV vancomycin. The infusion should run over at least how long to prevent Red Man Syndrome?
- 15 minutes
- 30 minutes
- 60 minutes (Correct answer)
- 90 minutes
Correct answer: 60 minutes
Vancomycin must infuse over at least 60 minutes to prevent histamine-mediated Red Man Syndrome (flushing, erythema, hypotension).
Question 5: When performing the six rights of medication administration, 'right documentation' means:
- Document the medication before administration to save time
- Document the medication immediately after it is given (Correct answer)
- Document medications at the end of each nursing shift
- Document only if the patient refuses the medication
Correct answer: Document the medication immediately after it is given
Documentation must occur immediately after administration to maintain accurate records and prevent double-dosing errors.
Question 6: A patient is prescribed potassium chloride 40 mEq IV. Which administration method is safe?
- Administer as an IV push over 2-3 minutes
- Add to IV fluid and infuse no faster than 10 mEq/hour (Correct answer)
- Administer as an IV push over 10 minutes with cardiac monitoring
- Add to IV fluid and infuse at 40 mEq/hour for convenience
Correct answer: Add to IV fluid and infuse no faster than 10 mEq/hour
IV potassium must never be given by push; the maximum safe infusion rate is 10 mEq/hour to prevent fatal cardiac dysrhythmias.
Question 7: A nurse receives a verbal telephone order for a medication. What is the correct procedure?
- Administer the medication and document 'per telephone order' in the chart
- Write the order, read it back to the prescriber, then administer and have the order co-signed within the required timeframe (Correct answer)
- Refuse all telephone orders and require written orders only
- Have a second nurse listen on the phone and both sign the order
Correct answer: Write the order, read it back to the prescriber, then administer and have the order co-signed within the required timeframe
The read-back process verifies accuracy of verbal orders; co-signature requirements ensure prescriber accountability within the institution's policy timeframe.
OSCE Pharmacology and Medication Administration 4
A nurse is preparing to hang a new IV bag and notes the solution is cloudy.
What is the correct action?