CCN Medication Administration & Emergency Response 3 — Questions and Answers
Question 1: An inmate begins experiencing anaphylaxis after receiving a penicillin injection. After calling for emergency assistance, what is the nurse's immediate priority action?
- Administer oral diphenhydramine
- Administer epinephrine 1:1000 via intramuscular injection (Correct answer)
- Start an IV line for fluid resuscitation
- Apply oxygen via nasal cannula at 2 L/min
Correct answer: Administer epinephrine 1:1000 via intramuscular injection
Intramuscular epinephrine 1:1000 (0.3–0.5 mg in adults) into the anterolateral thigh is the first-line treatment for anaphylaxis.
Question 2: A correctional nurse receives an order for a medication not on the facility formulary. What is the most appropriate next step?
- Substitute the closest formulary equivalent without contacting the provider
- Notify the prescribing provider and request a formulary alternative or a non-formulary exception (Correct answer)
- Administer the medication anyway if the nurse believes it is appropriate
- Delay treatment until the next provider visit
Correct answer: Notify the prescribing provider and request a formulary alternative or a non-formulary exception
The nurse must communicate with the prescribing provider to either obtain a formulary-approved alternative or initiate the non-formulary approval process.
Question 3: When performing CPR on an inmate in cardiac arrest, at what compression-to-ventilation ratio should a single rescuer without advanced airway perform CPR?
- 15:2
- 30:2 (Correct answer)
- 10:1
- 5:1
Correct answer: 30:2
Current AHA guidelines recommend a 30:2 compression-to-ventilation ratio for single-rescuer CPR without an advanced airway in adults.
Question 4: An inmate on antipsychotic medication develops sudden-onset muscle rigidity, high fever, altered mental status, and autonomic instability. The nurse should suspect which condition?
- Serotonin syndrome
- Tardive dyskinesia
- Neuroleptic malignant syndrome (Correct answer)
- Akathisia
Correct answer: Neuroleptic malignant syndrome
Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotics characterized by hyperthermia, muscle rigidity, altered consciousness, and autonomic dysfunction.
Question 5: A nurse administers a medication to the wrong inmate. After ensuring patient safety, what is the next required action?
- Document the event in the medical record only if the inmate is harmed
- Complete an incident report and notify the provider immediately (Correct answer)
- Wait to see if any adverse effects develop before reporting
- Inform the inmate's attorney of the error
Correct answer: Complete an incident report and notify the provider immediately
Medication errors require immediate provider notification for patient safety evaluation and mandatory incident reporting regardless of whether harm occurred.
Question 6: Which assessment finding in an inmate taking lithium most urgently requires the nurse to withhold the medication and notify the provider?
- Mild hand tremor
- Thirst and increased urination
- Nausea with the first week of therapy
- Coarse tremor, confusion, and ataxia (Correct answer)
Correct answer: Coarse tremor, confusion, and ataxia
Coarse tremor, confusion, and ataxia are signs of lithium toxicity requiring immediate dose withholding and provider notification to prevent serious neurological damage.
Question 7: During an emergency in a correctional facility, the nurse's role is best described as which of the following?
- Assuming command of all emergency operations
- Providing clinical care within scope of practice while following the facility's emergency response plan (Correct answer)
- Deferring all medical decisions to custody staff during lockdown
- Evacuating all inmates before rendering any medical care
Correct answer: Providing clinical care within scope of practice while following the facility's emergency response plan
The correctional nurse provides clinical care within their scope while coordinating with custody staff and following the facility's established emergency response plan.
CCN Medication Administration & Emergency Response 3
An inmate begins experiencing anaphylaxis after receiving a penicillin injection.
After calling for emergency assistance, what is the nurse's immediate priority action?