Safe **parenteral** administration practices include: Select all that apply.

Which routes **bypass first-pass hepatic metabolism**? The client needs a fast onset and to avoid a significant first-pass effect. Select all that apply.

During a 0700 med pass, the nurse performs the main 5 rights at three checkpoints (pulling, preparing, bedside). What is the **primary** purpose of three checks?

The prescriber initiates a medication that carries a Black Box Warning. When counseling the client, which description of a Black Box Warning is most accurate?

Common age-related changes that alter pharmacokinetics in older adults include:

Pre-dose vitals for an antihypertensive are BP 90/60, HR 58. The client is lightheaded when standing. What is the nurse’s best action?

During an evening shift, the nurse is preparing to administer insulin to a client newly diagnosed with type 1 diabetes. As she double-checks the medication, her preceptor reminds her to verify the dose with another nurse. The nurse wonders why this is necessary, given her confidence in her calculations.

The care team targets a minimum effective concentration (MEC) for a seizure medication. Which best defines MEC?

Nurse David works on a medical-surgical unit where several clients have recently experienced medication errors related to similar documentation issues. Instead of blaming individual nurses, David reviews the unit’s workflow and realizes that the electronic health record prompts are confusing and inconsistent. He collaborates with the nurse manager and IT department to adjust the system, helping prevent future errors for the entire hospital. Which example demonstrates “systems thinking” in nursing practice?

Mr. Johnson, a 62-year-old client with hypertension, is prescribed metoprolol (a beta-blocker) to help control his blood pressure and heart rate. During the morning medication pass, he crosses his arms and says, “I’m not taking that pill. It made me feel dizzy yesterday.” What is the nurse’s best initial response?