Question 1

A client is observed swallowing a chewable form of aspirin.Which of the following statements made by the nurse shows the best understanding of the educational reinforcement needed by this client?

Accepted Answer

A medication given by the sublingual route should not be swallowed because the medication will not have the desired effect.The option suggesting a change in the medication routine is not necessarily appropriate while the remaining options do not give the client the total explanation.

Question 2

A 78-year-old client with congestive heart failure (CHF)is reporting vascular pain in his lower legs and requests his oral narcotic analgesic.The nurse recognizes that the client's pain relief will be negatively affected primarily because of:

Accepted Answer

Clients with congestive heart failure have impaired circulation,which impairs medication delivery to the intended site of action.Therefore the efficacy of medications in these clients is delayed or altered.The other options reflect possible barriers,but they are not as directly responsible as is the heart's functional capacity

Question 3

During the admission interview a client shares with the nurse that she is allergic to latex.The nurse's immediate response is to:

Accepted Answer

The client needs to wear an identification bracelet that alerts nurses and physicians to the allergy.While the other options are not incorrect,the application of the identification bracelet has priority.

Question 4

The nurse is aware that which of the following clients is at greatest risk for developing medication toxicity?

Accepted Answer

The degree to which medications bind to serum proteins such as albumin affects medication distribution.Older adults have a decrease in albumin levels in the bloodstream,probably caused by a change in liver function.The same is true for clients with liver disease or malnutrition.Because of the potential for more medication being unbound,some older adults are at risk for an increase in medication activity or toxicity or both.

Question 5

A 20-year-old diagnosed with Crohn's disease is experiencing severe pain and is requesting the prescribed morphine as often as it can be administered.The nurse is particularly concerned about opioid toxicity because of:

Accepted Answer

Toxic effects develop after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion.For example,toxic levels of morphine,an opioid,cause severe respiratory depression and death.This client's gastrointestinal problem puts her at particular risk.The remaining options,while not incorrect,are not the primary cause for concern related to toxicity.

Question 6

A client on the medical unit receives regular insulin at 7:00 AM.The nurse is alert to a possible hypoglycemic reaction by:

Accepted Answer

Regular insulin reaches its peak in 2 to 4 hours after administration.If the client received regular insulin at 7:00 AM,the nurse should be alert for a possible hypoglycemic reaction from 9:00 AM to 11:00 AM.Regular insulin has an onset in 30 minutes.Intermediate-acting insulin (i.e. ,NPH insulin)would peak in 6 to 12 hours,not regular insulin.The client would not be at risk for a hypoglycemic reaction from regular insulin 13 hours after administration.Long-acting insulin would have an effect this length of time after administration.

Question 7

The nurse assigns ancillary personnel the task of giving a client a pre-procedure enema.Which of the following statements made by the personnel requires immediate follow-up by the nurse?

Accepted Answer

An enema is an example of an instillation whereby the fluid is retained for a period of time to facilitate a therapeutic response.What the ancillary personnel was describing was an irrigation-the liquid runs over or into the area and is allowed to immediately flow away.Options 1,3,and 4 are correct and do not require follow-up.

Question 8

The nurse is to administer several medications to the client via the N/G tube.The nurse's first action is to:

Accepted Answer

The nasogastric tube should be verified for placement before administering any medication through it.Medications should never be added to the tube feeding.Not all tablets can be crushed,such as sustained release tablets,nor all capsules should be opened.Medications should be reviewed carefully before crushing a tablet or opening a capsule.Medications should be dissolved and administered separately,flushing between 1 and 30 mL of water between each medication.

Question 9

To minimize the risk for injury to the oral mucosa,a client ordered a buccally administered medication is instructed to:

Accepted Answer

Administration of a medication by the buccal route involves placing the solid medication in the mouth and against the mucous membranes of the cheek until the medication dissolves.Teach clients to alternate cheeks with each subsequent dose to avoid mucosal irritation.The remaining options provide information that is not correct for the buccal route of medication administration

Question 10

The client is to receive heparin by injection.The nurse prepares to inject this medication in the client's:

Accepted Answer

The abdomen is the site most frequently recommended for heparin injections is the abdomen.The scapular areas may be used for subcutaneous injections,but it is not recommended site for heparin injections.The vastus lateralis is used for intramuscular injections,not subcutaneous injections.The posterior gluteal site is not recommended for heparin injections.

Question 11

The nurse is administering an injection at the ventrogluteal site.On aspiration,the nurse notices that there is blood in the syringe.The nurse should:

Accepted Answer

If blood appears in the syringe,the nurse should remove the needle and dispose of the medication and syringe properly.The nurse should then prepare another dose of medication for administration.The medication should not be injected,as it would be entering a blood vessel.The needle should not be pulled back slightly and then injected,as there is no assurance of the needle being out of the vessel.The medication should not be injected,because there is no assurance of the needle being out of the vessel.

Question 12

The nurse is preparing to administer 8 mg of a 10 mg dose of an intravenous narcotic.Which of the following statements made by the nurse best reflects an understanding of the appropriate manner to handle this situation?

Accepted Answer

If a nurse gives only part of a premeasured dose of a controlled substance,a second nurse witnesses disposal of the unused portion.If paper records are kept,both nurses sign their names on the form.Do not place wasted portions in the sharps containers.Instead,flush wasted portions of tablets down the toilet and wash liquids down the sink.Unused portions of narcotics must not be saved.

Question 13

The nurse recognizes which of the following clients as being at greatest risk for anaphylactic shock?

Accepted Answer

Among the different classes of medications,antibiotics cause a high incidence of allergic reactions.

Question 14

A priority for the nurse in the administration of oral medications and prevention of aspiration is:

Accepted Answer

To protect the client from aspiration,the nurse should determine the presence of a gag reflex before administering oral medications.The nurse should first check for a gag reflex.Then,if possible,the client should be allowed to self-administer oral medications.Checking for a gag reflex takes priority over assessing the ability to cough in preventing aspiration.Straws should be avoided because they decrease the control the client has over volume intake,which increases the risk of aspiration.Some clients cannot tolerate thin liquids such as water,and need for them to be thickened.

Question 15

The client has an order for 30 units of U-500 insulin.The nurse is using a U-100 syringe and will draw up and administer:

Accepted Answer

U-500 insulin is 5 times as strong as U-100 insulin.Therefore the amount of U-500 insulin should be divided by 5.30 units of U-500 insulin ÷ 5 = 6 units of insulin to draw into a U-100 syringe.Options 1,3,and 4 are incorrect dosages.

Question 16

The nurse is caring for a client who is experiencing severe pain and is insistent about "getting some relief quickly." Which of the following prescriptions is most likely to produce the quickest pain relief?

Accepted Answer

Each route of medication administration has a different rate of absorption.When applying medications on the skin,absorption is slow because of the physical makeup of the skin.Medications placed on the mucous membranes and respiratory airways are quickly absorbed because these tissues contain many blood vessels.Because orally administered medications pass through the gastrointestinal tract,the overall rate of absorption is usually slow.Intravenous (IV)injection produces the most rapid absorption because medications are immediately available when they enter the systemic circulation.

Question 17

A medication is prescribed for the client and is to be administered by IV bolus injection.A priority for the nurse before the administration of medication via this route is to:

Accepted Answer

A priority for the nurse before the administration of medication via the IV route is to confirm placement of the IV line.Confirming the placement of the IV catheter and the integrity of the surrounding tissue ensures that the medication is administered safely.The nurse should first confirm placement of the IV line.The nurse should first confirm placement of the IV line before administering a medication by the IV route.The client's mental alertness may be something the nurse monitors after medication administration.The nurse should first confirm placement of the IV line before administering any IV fluids.

Question 18

To best prevent a systemic effect from a topically applied medication patch,the nurse must:

Accepted Answer

Systemic effects often occur if a client's skin is thin or broken,if the medication concentration is high,or if contact with the skin is prolonged.The remaining options are more directed towards preventing skin irritations.

Question 19

The nurse is evaluating the integrity of the ventrogluteal injection site.The nurse finds the site by locating the:

Accepted Answer

The nurse finds the ventrogluteal site by locating the greater trochanter with the heel of the hand,the anterior iliac spine with the index finger,and the iliac crest with the middle finger.The vastus lateralis site is found by locating the middle third of the lateral thigh.The anterior aspect of the thigh may be used for subcutaneous injections;it is not how the ventrogluteal site is located.The acromion process and axilla may be used to locate the deltoid site.

Question 20

A 3-year-old child is to receive an iron preparation orally.The nurse should:

Accepted Answer

Straws may help children swallow pills.If it is a liquid iron preparation,the straw may help the child as they are less able to see the medication and may see drinking from a straw as desirable.The child is to receive the medication orally.The oral route is preferred unless contraindicated.The medication should not be mixed with water as the child may refuse to drink all of the larger mixture,and water does not mask the flavor of the medication.Juice,a soft drink,or a frozen juice bar may be offered after a medication is swallowed.Many 3-year-olds have difficulty swallowing pills,and liquid forms are safer to swallow to avoid aspiration.

Quiz 35: Medication Administration