PSB-PN Pharmacology & Medication Administration 2 — Questions and Answers
Question 1: A practical nurse is preparing to administer an oral medication to a patient who is having difficulty swallowing. The FIRST action should be to:
- Crush all tablets and mix with water
- Contact the prescribing provider to request an alternative form (Correct answer)
- Ask the patient to take a large sip of water first
- Divide the tablet and give half at a time
Correct answer: Contact the prescribing provider to request an alternative form
Crushing tablets or altering dosage forms can change absorption and is contraindicated for many medications; the provider must be contacted for a safe alternative form.
Question 2: A patient is receiving IV potassium chloride. The practical nurse knows that IV potassium must NEVER be administered:
- At a rate slower than 10 mEq/hr
- Undiluted as a direct IV push (Correct answer)
- In a saline-based IV solution
- Through a peripheral IV line
Correct answer: Undiluted as a direct IV push
IV potassium given undiluted as a direct push causes fatal cardiac arrhythmias; it must always be diluted and infused slowly.
Question 3: Which of the following is a sign of narcotic (opioid) overdose that the practical nurse should recognize and report immediately?
- Hypertension and tachycardia
- Respiratory rate of 8 breaths per minute (Correct answer)
- Pupil dilation (mydriasis)
- Agitation and hyperreflexia
Correct answer: Respiratory rate of 8 breaths per minute
A respiratory rate below 12 breaths per minute (respiratory depression) is the hallmark sign of opioid overdose and requires immediate intervention with naloxone.
Question 4: The nurse is reviewing a medication administration record (MAR). The abbreviation 'PRN' means the medication should be given:
- Before meals
- By mouth only
- As needed, based on patient condition (Correct answer)
- Immediately (stat)
Correct answer: As needed, based on patient condition
PRN (Latin: pro re nata) means 'as needed' — the medication is given based on the patient's specific condition or complaint rather than on a fixed schedule.
Question 5: A patient is allergic to penicillin. The practical nurse should be aware that there is a potential cross-reactivity with which class of antibiotics?
- Macrolides (e.g., azithromycin)
- Cephalosporins (e.g., cephalexin) (Correct answer)
- Fluoroquinolones (e.g., ciprofloxacin)
- Sulfonamides (e.g., trimethoprim-sulfamethoxazole)
Correct answer: Cephalosporins (e.g., cephalexin)
Penicillins and cephalosporins share a beta-lactam ring structure; patients allergic to penicillin have a small but significant risk of cross-reactivity to cephalosporins.
Question 6: When applying a nitroglycerin transdermal patch, the practical nurse should:
- Apply it to the same site each day to maintain consistent absorption
- Remove the old patch and rotate to a new hairless skin site (Correct answer)
- Apply over the previous patch site without removing it
- Place it on the chest only for cardiac effect
Correct answer: Remove the old patch and rotate to a new hairless skin site
Removing the old patch prevents cumulative drug buildup, and rotating sites prevents skin irritation and ensures consistent absorption.
PSB-PN Pharmacology & Medication Administration 2
A practical nurse is preparing to administer an oral medication to a patient who is having difficulty swallowing.
The FIRST action should be to: