Deck 31: Medication Administration

Question 1

The nurse knows that the purpose of aspiration on IM injections is to

A) Ensure proper placement of the needle.
B) Increase the force of the injection.
C) Reduce the discomfort of the injection.
D) Prolong the absorption time of the medication.

Answer 1

Ensure proper placement of the needle.

Question 2

The nurse knows that an idiosyncratic event with the stimulant pseudoephedrine (Sudafed)is occurring when the patient

A) Experiences blurred vision while driving.
B) Falls asleep during daily activities.
C) Presents with a pruritus rash.
D) Develops xerostomia.

Answer 2

Falls asleep during daily activities.

Question 3

The nurse is giving an IM injection.Upon aspiration,the nurse notices blood return in the syringe.What should the nurse do?

A) Administer the injection at a slower rate.
B) Withdraw the needle and prepare the injection again.
C) Pull the needle back slightly and inject the medication.
D) Give the injection and hold pressure over the site for 3 minutes.

Answer 3

Withdraw the needle and prepare the injection again.

Question 4

A physician orders 1000 mL of normal saline to infuse at a rate of 50 mL/hr.The nurse plans on hanging a new bag at what time?

A) 2 hours
B) 5 hours
C) 10 hours
D) 20 hours

Question 5

Aspirin is an analgesic,antipyretic,antiplatelet,and anti-inflammatory agent.A physician writes for aspirin 650 mg every 4 to 6 hours prn: febrile.For which patient would this order be appropriate?

A) 7-year-old with hemophilia
B) 21-year-old with a sprained ankle
C) 35-year-old with a severe headache
D) 62-year-old female with pneumonia

Question 6

The nurse is planning to administer a tuberculin test with a 27-gauge,³/₈-inch needle.The nurse should insert the needle at an angle of _____ degrees.

A) 15
B) 45
C) 90
D) 180

Question 7

A patient has an order to receive 20 units of U-50 insulin.The nurse is using a U-100 syringe.How many units should the nurse draw up in the syringe and administer?

A) 0.04 mL
B) 0.4 mL
C) 4 mL
D) 10 mL

Question 8

A nurse knows that patient education has been effective when the patient states

A) "I must take my parenteral medication with food."
B) "If I am 30 minutes late taking my medication, I should skip that dose."
C) "I will rotate the location where I give myself injections."
D) "Once I start feeling better, I will stop taking my medication."

Question 9

A patient who has been receiving intermittent chemotherapy through a peripheral IV site is ordered to receive a high dose of vancomycin through the same vein.Why does this concern the nurse?

A) Chemotherapy is irritating to the vascular system and may cause the vein to infiltrate.
B) Two medications should never be placed into the same IV site.
C) Once chemotherapy is in a patient's system, any additional medicine given will cause a synergistic effect.
D) Chemotherapy treatments require a special pump designed solely for chemotherapy.

Question 10

An order is written for (phenytoin)Dilantin 500 mg IM q3-4h prn for pain.The nurse recognizes that treatment of pain is not a standard therapeutic indication for this drug.The nurse believes that the prescriber meant to write for hydromorphone (Dilaudid).What should the nurse do?

A) Give the patient Dilaudid, as it was meant to be written.
B) Call the prescriber to clarify and justify the order.
C) Administer the medication and monitor the patient frequently.
D) Refuse to give the medication and notify the nurse supervisor.

Question 11

A registered nurse interprets that a scribbled medication order reads 25 mg.The nurse administers 25 mg of the medication to a patient,and then discovers that the dose was incorrectly interpreted and should have been 15 mg.Who is ultimately responsible for the error?

A) Physician
B) Pharmacist
C) Nurse
D) No fault

Question 12

The nurse is preparing to administer a 0.5-mL rabies vaccine into the deltoid muscle of a patient.Which needle size is best for the procedure?

A) 20 gauge x 1 1/2 inch
B) 23 gauge x 1/2 inch
C) 25 gauge x ⁵/₈ inch
D) 27 gauge x ³/₈ inch

Question 13

A drug requires a low pH to be metabolized.Knowing this,the nurse anticipates that the medication will be administered by which route?

A) Oral
B) Parenteral
C) Buccal
D) Inhalation

Question 14

A patient has an order to receive 10 units of U-50 insulin.The nurse is using a U-100 syringe.How many units should the nurse draw up in the syringe and administer?

A) 0.2 units
B) 2 units
C) 5 units
D) 20 units

Question 15

A 2-year-old child is ordered to have ear irrigation performed daily.The nurse correctly performs the procedure by

A) Pulling the auricle down and back to straighten the ear canal.
B) Pulling the auricle upward and outward to straighten the ear canal.
C) Instilling the irrigation solution by holding the syringe just inside the ear canal.
D) Holding the fluid in the canal for 2 to 3 minutes with a cotton swab.

Question 16

The nurse knows to assess for signs of medication toxicity within older adults because of which physiological change?

A) Reduced glomerular filtration
B) Delayed esophageal clearance
C) Decreased gastric peristalsis
D) Decreased cognitive function

Question 17

A patient is in need of immediate pain relief for a severe headache.The nurse knows that which medication will be absorbed the quickest?

A) Tylenol 650 mg PO
B) Morphine 4 mg SQ
C) Ketorolac (Toradol) 8 mg IM
D) Hydromorphone (Dilaudid) 4 mg IV

Question 18

A patient is to receive medication through a nasogastric tube.What is the most important nursing action to ensure effective absorption?

A) Thoroughly shake the medication before administering.
B) After all medications are administered, flush tube with 15 to 30 mL of water.
C) Position patient in the supine position for 30 minutes.
D) Clamp suction for 30 to 60 minutes after medication administration.

Question 19

The patient is to receive phenytoin (Dilantin)at 0900.The nurse knows that the ideal time to draw a trough level is

A) 0800.
B) 0830.
C) 0900.
D) 0930.

Question 20

Which statement by the patient is an indication to use the Z-track method?

A) "I'm really afraid that a big needle will hurt."
B) "The last shot like that turned my skin colors."
C) "I am allergic to many medications."
D) "My legs are too obese for the needle to go through."

Question 21

A 64-year-old quadriplegic patient needs an IM injection of antibiotic.What is the best site for the administration?

A) Deltoid
B) Dorsal gluteal
C) Ventrogluteal
D) Vastus lateralis

Question 22

The patient is in severe pain and is requesting a prn medication before the prn time interval has elapsed.The nurse's priority is to

A) Give the medication early for any pain score greater than 8.
B) Call the prescriber and request a stat order.
C) Explain to the patient why he will have to wait for the medication.
D) Document the patient's request and pain score.

Question 23

A provider has ordered a STAT medication to be administered.The nurse knows that the best route of administration is

A) IV.
B) IM.
C) SQ.
D) PO.

Question 24

What is the nurse's priority action to protect a patient from medication error?

A) Requesting that the prescriber write out an order, rather than giving a verbal order
B) Asking anxious family members to leave the room before giving a medication
C) Checking the patient's room number against the medication administration record
D) Administering as many of the medications as possible at one time

Question 25

The nurse knows that caring for two patients with the same last name can lead to a medication error involving which right of medication administration?

A) Right medication
B) Right patient
C) Right dose
D) Right route

Question 26

The nurse realizes which patient is at greatest risk for an unintended synergistic effect?

A) 72-year-old who is seeing four different specialists
B) 4-year-old who has mistakenly taken the entire packet of his mother's birth control pills
C) 50-year-old who was prescribed a second blood pressure medication
D) 35-year-old drug addict who has ingested meth mixed with several household chemicals

Question 27

The nurse knows that patient education about a buccal medication has been effective when the patient states

A) "I should let the medication dissolve completely."
B) "I can only drink water, not juice, with this medication."
C) "For faster distribution, I should chew my medication first."
D) "I should place the medication in the same location."

Question 28

The nurse is preparing to administer medications to two patients with the same last name.After the administration,the nurse realizes that she did not check the identification of the patient before administering medication.Which of the following actions should the nurse complete first?

A) Return to the room to check and assess the patient.
B) Administer the antidote to the patient immediately.
C) Alert the charge nurse that a medication error has occurred.
D) Complete proper documentation of the medication error in the patient's chart.

Question 29

A confused patient refuses his medication.What is the nurse's first response?

A) Agrees with the patient's decision and documents it in his chart
B) Educates the patient about the importance of the medication
C) Discreetly hides the medication in the patient's favorite Jell-O
D) Informs the patient that he must take the medication whether he wants to or not

Question 30

Which patient using an inhaler would benefit most from using a spacer?

A) 3-year-old with a cleft palate
B) 25-year-old with multiple sclerosis
C) 50-year-old with hearing impairment
D) 72-year-old with left-sided hemiparesis

Question 31

A nurse is attempting to administer medication to a child,but the child refuses to take the medication.The nurse asks for the parent's cooperation by saying

A) "Please hold your child's arms down at her sides, so I can get the full dose of medication into her mouth."
B) "I will prepare the medication for you and observe if you would like to try to administer the medication."
C) "Let's turn the lights off and give the child a moment to fall asleep before administering the medication."
D) "Since your child loves applesauce, let's add the medication to it, so your child doesn't resist."

Question 32

A patient needs assistance excreting a gaseous medication.What is the correct nursing action?

A) Encourage the patient to cough and deep-breathe.
B) Suction the patient's respiratory secretions.
C) Administer the antidote via inhalation.
D) Administer 100% FiO₂ via simple face mask.

Question 33

A nurse is caring for a patient who is in hypertensive crisis.When the nurse is flushing the patient's peripheral IV,the patient complains of pain.Upon assessment,the nurse notices a red streak that is warm to the touch.What is the nurse's initial action?

A) Notify the physician.
B) Administer pain medication.
C) Discontinue the IV.
D) Apply a cool compress to the site.

Question 34

The nurse is administering an intravenous medication that is to be administered over 10 minutes.Which method should the nurse choose to efficiently administer the medication?

A) Place the medication in a large-volume cath-tipped syringe.
B) Mix the medication into the patient's maintenance fluids.
C) Attach separate tubing and set the medication syringe in a mini-infusion pump.
D) Stand at the patient's bedside and carefully watch the clock while pushing the medication.

Question 35

The nurse knows that a subcutaneous injection takes longer to absorb because

A) Fewer blood vessels are found under the subcutaneous level.
B) Adipose tissue takes longer to metabolize medication.
C) Connective tissue holds medication in place longer.
D) Some medication leaks out after instillation.

Question 36

The prescriber wrote for a 40-kg child to receive 25 mg of medication 4 times a day.The therapeutic range is 5 to 10 mg/kg/day.What is the nurse's priority?

A) Administer the medication because it is within the therapeutic range.
B) Notify the physician that the prescribed dose is in the toxic range.
C) Notify the physician that the prescribed dose is below the therapeutic range.
D) Change the dose to one that is within range.

Question 37

A nurse has withdrawn a narcotic from the medication dispenser.Upon checking the drug against the medication administration record,the nurse notices that the narcotic order has expired.What should be the nurse's first action?

A) Return the medication to the medication dispenser according to protocol.
B) Exit the medication room to call the physician to request a reorder of the narcotic.
C) Assess the patient to see if the narcotic is still needed; if so, administer the medication.
D) Call the pharmacy and request that the narcotic be removed from the patient profile.

Question 38

A patient who is being discharged today is going home with an inhaler.The patient is to administer 2 puffs of his inhaler twice daily.The inhaler contains 200 puffs.When should the nurse appropriately advise the patient to refill his medication?

A) As soon as he leaves the hospital
B) When the inhaler is half empty
C) 6 weeks from the start of using the inhaler
D) 50 days after discharge

Question 39

A patient is at risk for aspiration.What nursing action is most appropriate?

A) Hold the patient's cup for him so he can concentrate on taking pills.
B) Thin out liquids so they are easier to swallow.
C) Give the patient a straw to control the flow of liquids.
D) Have the patient self-administer the medication.

Question 40

A patients states that she would prefer not to take her daily allergy pill this morning because it makes her too drowsy throughout the day.The nurse responds therapeutically by saying,

A) "The physician ordered it; therefore you must take your medication every morning at the same time whether you're drowsy or not."
B) "Let's change the time you take your pill to 9 PM, so the drowsiness occurs when you would normally be sleeping."
C) "You can skip this medication on days when you need to be awake and alert."
D) "Try to get as much done as you can before you take your pill, so you can sleep in the afternoon."

Question 41

Which of the following demonstrates proper oral medication administration?

A) Removing the medication from the wrapper and placing it in a cup labeled with the patient's information
B) Using the edge of the medicine cup to fill with 0.5 mL of liquid medication
C) Placing all of the patient's medications in the same cup, except medications with assessments
D) Combining liquid medications from 2 single dose cups into 1 medicine cup

Question 42

Which of the following are methods to reduce the risk of needlestick injury?

A) Recap the needle after giving an injection.
B) Have sharps boxes emptied when three-quarters full.
C) Use two hands to dispose of sharps into the disposal.
D) Never force a needle into the sharps disposal.
E) Clearly mark sharps disposal containers.
F) Use needleless devices whenever possible.

Question 43

The nurse is administering 250 mg of a medication elixir to the patient.The medication comes in a dose of 1000 mg/5 mL.How many milliliters should the nurse administer?

Question 44

A patient informs the nurse that his urine is starting to look discolored.How should the nurse respond?

A) "Don't worry, that is a normal side effect of your medication."
B) "That is an unusual side effect. I'll notify your provider immediately."
C) "You need to drink more fluids to flush the medication from your system."
D) "Other than the discoloration, has anything changed with your urination?"

Question 45

The physician orders 4 mg of oxycodone to be delivered every 6 hours.After 4 hours,the patient is complaining that she is in more pain.The nurse advises the physician to make which medication adjustment?

A) Add an additional narcotic on top of the oxycodone.
B) Divide the dose in half and administer 2 mg every 3 hours.
C) Give another 4 mg of oxycodone after 4 hours.
D) Change the medication being administered for pain relief.

Question 46

What methods are used to properly discard narcotics?

A) Placing the syringe of narcotics in the sharps container
B) Washing liquids down the sink
C) Flushing tablets down the toilet
D) Returning the open tablet to the medication dispenser
E) Locking the narcotic in a secure cabinet
F) Throwing tablets into the trash

Question 47

The patient is to receive amoxicillin (Moxatag)500 mg q8h; the medication is dispensed at 250 mg/5 mL.How many teaspoons would the nurse administer for one dose?

Question 48

A patient who is receiving IV fluids notifies the nurse that his arm feels tight.Upon assessment,the nurse notes that the arm is swollen and cool to the touch.What should the nurse's first action be?

A) Discontinue the IV site, and apply a warm compress.
B) Attached a syringe, and pull back on the plunger to aspirate the IV fluid.
C) Start a new IV site distal from the site.
D) Stop the IV fluids, and notify the physician immediately.

Question 49

Which nursing action is the number one priority for ensuring that medication stays in the target therapeutic range?

A) Drawing the peak and trough levels at the same time each day
B) Administering a double dose after a dose was missed
C) Delivering the same amount of the drug at the same time each day
D) Increasing absorption by holding all other medications 1 hour before administration

Question 50

A patient is taking 1 tablet of hydrocodone bitartrate 5 mg and acetaminophen 500 mg (Vicodin)every 4 hours.He is also taking 2 tablets of acetaminophen (Tylenol)325 mg every 12 hours.How many grams of acetaminophen is he taking daily?